Abstract | PURPOSE: 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.
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Authors | Patrick Loriaut, Otman Sandali, Mohamed El Sanharawi, Isabelle Goemaere, Vincent Borderie, Laurent Laroche |
Journal | Cornea
(Cornea)
Vol. 33
Issue 10
Pg. 1123-8
(Oct 2014)
ISSN: 1536-4798 [Electronic] United States |
PMID | 25127189
(Publication Type: Journal Article)
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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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