Correcting postoperative astigmatism using curved lamellating keratotomy

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Error Correction

Background:

• Post-surgical astigmatism is a common complication after cataract surgery.
• Accurate correction of induced astigmatism is crucial for visual rehabilitation.

Purpose of the Study:

• To evaluate the efficacy of paired lamellating keratotomy in correcting astigmatism in living eyes.
• To determine if wound healing influences the refractive outcomes of this procedure.

Main Methods:

• Prospective study of 45 patients with pre-existing astigmatism (≥2.00 D) following cataract surgery.
• Paired lamellating incisions with varying optical zones (7.0 and 8.0 mm) and chordal lengths (3.0 and 5.0 mm) were performed.
• Follow-up duration was 15 months, assessing refractive error, visual acuity, and endothelial cell count.

Main Results:

• Mean preoperative astigmatism of 3.64 D was reduced to 1.00 D post-procedure, with an induced astigmatism of 3.18 D.
• The 7.0 mm optical zone resulted in significantly higher induced astigmatism (3.93 D) compared to the 8.0 mm zone (2.60 D).
• Visual acuity improved significantly, and endothelial cell count remained stable, showing no significant difference between pre- and post-operative measurements.

Conclusions:

• Curved lamellating keratotomy is a stable and effective surgical option for correcting post-cataract surgery astigmatism.
• The procedure does not adversely affect corneal endothelial cells or visual acuity.
• Optical zone size is a critical factor influencing the degree of astigmatism correction achieved.