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New combined technique of deep intrastromal arcuate keratotomy overlayed by LASIK flap for treatment of high astigmatism.

AbstractPURPOSE:
The aim of this study was to describe a novel technique combining deep intrastromal arcuate keratotomy and superficial lamellar keratotomy followed by excimer photoablation for the management of high naturally occurring or postkeratoplasty astigmatism.
METHODS:
In this retrospective case series, the first step was deep intrastromal arcuate keratotomy and superficial lamellar keratotomy performed at 100-μm depth by femtosecond laser. Manual incisions were made for flap elevation. The second step, after 1 month, consisted of reopening the flap and using an excimer laser to correct residual ametropia.
RESULTS:
Nine eyes series were studied. The mean preoperative refractive cylinder correction was 6.11 ± 2.54 diopters (D). The mean postoperative refractive cylinder correction was 2.85 ± 1.31 D. The mean correction index was 1.07 ± 0.28 D. The mean best-corrected visual acuity improved from 20/40 to 20/22 after the 2 steps. The median follow-up was 11 (range, 9-17) months. No complications were observed and postoperative outcome was satisfactory.
CONCLUSIONS:
Permitting correction of a broader range of high astigmatism with good accuracy, this combined approach minimizes excision of corneal stromal tissue and postoperative complications.
AuthorsPatrick Loriaut, Otman Sandali, Mohamed El Sanharawi, Isabelle Goemaere, Vincent Borderie, Laurent Laroche
JournalCornea (Cornea) Vol. 33 Issue 10 Pg. 1123-8 (Oct 2014) ISSN: 1536-4798 [Electronic] United States
PMID25127189 (Publication Type: Journal Article)
Topics
  • Adult
  • Astigmatism (surgery)
  • Corneal Stroma (surgery)
  • Female
  • Humans
  • Keratomileusis, Laser In Situ (methods)
  • Lasers, Excimer (therapeutic use)
  • Male
  • Middle Aged
  • Surgical Flaps
  • Tomography, Optical Coherence
  • Visual Acuity (physiology)
  • Young Adult

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