Comparison of surgically induced astigmatism between femtosecond laser and manual clear corneal incisions for cataract surgery. Issue 10 (October 2015) - Diakonis, Vasilios F.
Abstract : Purpose : To assess the surgically induced corneal astigmatism (SIA) introduced by femtosecond laser–assisted clear corneal incisions (CCIs) for cataract extraction and to compare it with the SIA of manually created CCIs. Setting : Bascom Palmer Eye Institute, Miller School of Medicine, Miami, Florida, USA. Design : Prospective nonrandomized comparative case series. Methods : Eyes received femtosecond laser–assisted CCIs (Group 1) or manual CCIs (Group 2). The surgical plan included 1 primary and 1 secondary port; the sites of the incisions were the same in both groups and were diametrically opposed between the right eye and left eye. The SIA was assessed using the preoperative and 1‐month postoperative keratometric values obtained from corneal topography examinations. Results : This study included 72 eyes of 68 patients with a mean age of 69.0 years ± 9.87 (SD) (range 36 to 90 years). Thirty‐six eyes received femtosecond laser–assisted CCIs (Group 1) and 36 received manual CCIs (Group 2). The mean preoperative topographic corneal astigmatism was −1.19 ± 0.68 diopters (D) (range 0 to 2.50 D) and −0.92 ± 0.63 D (range 0.10 to 2.45 D) for Group 1 and Group 2, respectively, whereas, 1 month after cataract surgery, it was −1.16 ± 0.63 D (range 0.20 to 2.57 D) and −0.95 ± 0.64 D (range 0.21 to 2.37 D), respectively. Multivariate vector analysis revealed no statistically significant difference between the 2 groups for preoperative astigmatism, postoperative astigmatism, and SIA ( P > .05 for all comparisons between Group 1 and Group 2). Conclusion : Femtosecond laser–assisted and manual corneal incisions for cataract surgery did not appear to significantly alter corneal astigmatism, whereas they showed comparable SIA. Financial Disclosure : Drs. Yoo and Donaldson are speakers for and consultants to Alcon Surgical, Inc., and Abbott Medical Optics, Inc. No other author has a financial or proprietary interest in any material or method mentioned.