[Correction of corneal astigmatism in femtosecond laser-assisted cataract extraction surgery].

PURPOSE: To perform a comparative analysis of clinical and functional results and efficiency of corneal astigmatism correction after femtosecond laser-assisted cataract surgery (FLACS) with implantation of toric intraocular lens (TIOL) and in combination with arcuate keratotomy (FL-AC).

MATERIAL AND

METHODS

The examination included 60 patients (60 eyes). The first group consisted of 30 patients (30 eyes) who underwent FLACS with implantation of TIOL (Acrysof IQ Toric, Alcon, U.S.A.); the second group consisted of 30 patients (30 eyes) who underwent FLACS in combination with FL-AC. The examination was carried out before the operation, on the 3rd day and 3 months after surgery. Corneal astigmatism correction efficiency was analyzed using the Alpins method and graphical vector analysis.

RESULTS

Uncorrected visual acuity (UCVA) indices increased to 0.70±0.24 and 0.66±0.31 in the FLACS with TIOL and FLACS with FL-AC groups, respectively, without statistically significant differences between the groups (p=0.03). The value of the residual cylinder was significantly lower in the FLACS with TIOL group (-0.77±0.58 and -0.80±0.39) compared with FLACS with FL-AC (-1.08±0.81 and -1.18±0.63) both on day 3 (p=0.02), and 3 months after surgery (p=0.02). In the FLACS with TIOL group, a higher correction index (0.99±0.18) and a smaller difference vector (0.77±0.64) were achieved compared to the FLACS with FL-AC group (0.78±0.35 and 1.05±0.76, respectively). Corneal higher-order aberrations (HOA) significantly differed on the 3rd day after surgery in the 3.0 mm (p=0.04) and 5.0 mm (p=0.04) zones between the groups. Endothelial cells density was 2460.50±328.40 and 2526.125±196.74 cl/mm2 after 3 months of observation in the FLACS with TIOL and FLACS with FL-AC groups, respectively (p=0.61).

CONCLUSION

Both methods had comparable visual acuity results (p=0.03). FLACS with TIOL provided more effective correction of the cylindrical component of refraction to 3.0 D.