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Correcting postoperative astigmatism using curved lamellating keratotomy

N Anders1, D T Pham, H J Huebscher

  • 1Virchow Memorial Hospital Eye Clinic, Faculty of Humboldt University, Berlin, Germany.

Journal of Cataract and Refractive Surgery
|March 1, 1997
PubMed
Summary

Paired lamellating keratotomy effectively corrects astigmatism after cataract surgery in living eyes. This refractive surgery provides stable results without negatively impacting visual acuity or endothelial cell count.

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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.

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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.