Femtosecond laser arcuate keratotomy for the correction of postkeratoplasty high astigmatism in keratoconus

Background: astigmatism is the leading complication in visual recovery after penetrating keratoplasty (pkp) and deep anterior lamellar keratoplasty (dalk); in this study,we evaluated the outcome of femtosecond laser arcuate keratotomy (flak) after dalk and pkp in iranian keratoconic patients. materials and methods: in this prospective interventional case series,refractive and keratometric predictability,efficacy,and complications of flak for postkeratoplasty astigmatism in keratoconus were evaluated; 23 eyes of 23 consecutive patients (mean age of 32.43 ± 9.11 years) with high astigmatism were enrolled. the femtosecond laser performed paired 90°‑angled arcuate incisions. results: mean logarithm of the minimum angle of resolution of corrected and uncorrected visual acuity improved from preoperative values of 0.30 ± 0.18 and 0.85 ± 0.32 to 6‑month values of 0.19 ± 0.17 and 0.65 ± 0.33,respectively (p < 0.05). mean subjective astigmatism was 7.79 ± 2.64 diopter (d) preoperatively and 3.69 ± 2.25d at 6‑month after surgery (p < 0.05). surgically induced astigmatism was 9.27 ± 5.00d. mean refractive spherical equivalent showed no significant (p = 0.69) hyperopic shift from − 4.21 ± 4.84d preoperatively to − 2.16 ± 6.09d postoperatively. two (8.7%) microperforations were observed. conclusion: flak is a relatively safe and effective method for the treatment of postkeratoplasty astigmatism. © 2017 journal of research in medical sciences.