Hashemian Mohammad Naser, Ojaghi Habib, Mohammadpour Mehrdad, Jabbarvand Mahmoud, Rahimi Firouzeh, Abtahi Mohammad-Ali, Mazloumi Mehdi, Abtahi Seyed-Hossein
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Ophthalmology, Ardebil University of Medical Sciences, Ardebil, Iran.
J Res Med Sci. 2017 Feb 16;22:17. doi: 10.4103/1735-1995.200267. eCollection 2017.
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.
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.
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 ( < 0.05). Mean subjective astigmatism was 7.79 ± 2.64 diopter (D) preoperatively and 3.69 ± 2.25D at 6-month after surgery ( < 0.05). Surgically induced astigmatism was 9.27 ± 5.00D. Mean refractive spherical equivalent showed no significant ( = 0.69) hyperopic shift from - 4.21 ± 4.84D preoperatively to - 2.16 ± 6.09D postoperatively. Two (8.7%) microperforations were observed.
FLAK is a relatively safe and effective method for the treatment of postkeratoplasty astigmatism.
散光在穿透性角膜移植术（PKP）和深板层角膜移植术（DALK）后的视力恢复中是主要并发症；在本研究中，我们评估了飞秒激光弧形角膜切开术（FLAK）在伊朗圆锥角膜患者行DALK和PKP后的效果。
在这个前瞻性干预性病例系列中，评估了FLAK治疗圆锥角膜角膜移植术后散光的屈光和角膜曲率预测性、疗效及并发症；纳入了23例连续的高度散光患者的23只眼（平均年龄32.43±9.11岁）。飞秒激光进行成对的90°角弧形切口。
矫正视力和未矫正视力的最小分辨角对数平均值分别从术前的0.30±0.18和0.85±0.32提高到术后6个月时的0.19±0.17和0.65± 0.33（P<0.05）。平均主观散光术前为7.79±2.64屈光度（D），术后6个月为3.69±2.25D（P<0.05）。手术诱导散光为9.27±5.00D。平均等效球镜度屈光从术前的-4.21±4.84D到术后的-2.16±6.09D无显著（P=0.69）远视性偏移。观察到2例（8.7%）微小穿孔。
FLAK是治疗角膜移植术后散光的一种相对安全有效的方法。
