Development of a nomogram for femtosecond laser astigmatic keratotomy for astigmatism after keratoplasty

Ryan M. St. Clair, Anushree Sharma, David Huang, Fei Yu, Yakov Goldich, David Rootman, Sonia H Yoo, Florence Cabot, Jason Jun, Lijun Zhang, Anthony J. Aldave

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose To develop a nomogram for femtosecond laser astigmatic keratotomy (AK) to treat post-keratoplasty astigmatism. Setting Three academic medical centers. Design Retrospective interventional case series. Methods A review of post-keratoplasty femtosecond laser AK was performed. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, and keratometry were recorded preoperatively and 1, 3, 6, and 12 months postoperatively. The location, length, depth, and diameter of the AK incisions were recorded, and the surgically induced astigmatic correction was related to these variables using regression analysis. Results One hundred forty femtosecond laser AK procedures were performed after penetrating keratoplasty (PKP) (n = 129) or deep anterior lamellar keratoplasty (DALK) (n =11), with 89 procedures (80 PKP, 9 DALK) included in the analysis. The mean CDVA improved from 20/59 (0.47 logMAR ± 0.38 [SD]) preoperatively to 20/45 (0.35 ± 0.31 logMAR) postoperatively (P =.013) (n = 46). The mean keratometric astigmatism decreased from 8.26 ± 2.90 diopters (D) preoperatively to 3.62 ± 2.59 D postoperatively (P <.0001) (n = 89). The mean refractive cylinder decreased from 6.77 ± 2.80 D preoperatively to 2.85 ± 2.57 D postoperatively (P <.0001) (n = 69). A nomogram for femtosecond laser AK to treat post-keratoplasty astigmatism was generated using regression analysis. Conclusions Femtosecond laser AK significantly improved UDVA and CDVA and significantly reduced keratometric astigmatism and refractive cylinder after keratoplasty. The nomogram generated should improve the accuracy of post-keratoplasty femtosecond laser AK. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned.

Original languageEnglish (US)
Pages (from-to)556-562
Number of pages7
JournalJournal of Cataract and Refractive Surgery
Volume42
Issue number4
DOIs
StatePublished - Apr 1 2016

Fingerprint

Nomograms
Corneal Transplantation
Astigmatism
Lasers
Penetrating Keratoplasty
Regression Analysis
Disclosure
Visual Acuity

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Surgery

Cite this

Development of a nomogram for femtosecond laser astigmatic keratotomy for astigmatism after keratoplasty. / St. Clair, Ryan M.; Sharma, Anushree; Huang, David; Yu, Fei; Goldich, Yakov; Rootman, David; Yoo, Sonia H; Cabot, Florence; Jun, Jason; Zhang, Lijun; Aldave, Anthony J.

In: Journal of Cataract and Refractive Surgery, Vol. 42, No. 4, 01.04.2016, p. 556-562.

Research output: Contribution to journalArticle

St. Clair, RM, Sharma, A, Huang, D, Yu, F, Goldich, Y, Rootman, D, Yoo, SH, Cabot, F, Jun, J, Zhang, L & Aldave, AJ 2016, 'Development of a nomogram for femtosecond laser astigmatic keratotomy for astigmatism after keratoplasty', Journal of Cataract and Refractive Surgery, vol. 42, no. 4, pp. 556-562. https://doi.org/10.1016/j.jcrs.2015.12.053
St. Clair, Ryan M. ; Sharma, Anushree ; Huang, David ; Yu, Fei ; Goldich, Yakov ; Rootman, David ; Yoo, Sonia H ; Cabot, Florence ; Jun, Jason ; Zhang, Lijun ; Aldave, Anthony J. / Development of a nomogram for femtosecond laser astigmatic keratotomy for astigmatism after keratoplasty. In: Journal of Cataract and Refractive Surgery. 2016 ; Vol. 42, No. 4. pp. 556-562.
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AU - Huang, David

AU - Yu, Fei

AU - Goldich, Yakov

AU - Rootman, David

AU - Yoo, Sonia H

AU - Cabot, Florence

AU - Jun, Jason

AU - Zhang, Lijun

AU - Aldave, Anthony J.

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N2 - Purpose To develop a nomogram for femtosecond laser astigmatic keratotomy (AK) to treat post-keratoplasty astigmatism. Setting Three academic medical centers. Design Retrospective interventional case series. Methods A review of post-keratoplasty femtosecond laser AK was performed. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, and keratometry were recorded preoperatively and 1, 3, 6, and 12 months postoperatively. The location, length, depth, and diameter of the AK incisions were recorded, and the surgically induced astigmatic correction was related to these variables using regression analysis. Results One hundred forty femtosecond laser AK procedures were performed after penetrating keratoplasty (PKP) (n = 129) or deep anterior lamellar keratoplasty (DALK) (n =11), with 89 procedures (80 PKP, 9 DALK) included in the analysis. The mean CDVA improved from 20/59 (0.47 logMAR ± 0.38 [SD]) preoperatively to 20/45 (0.35 ± 0.31 logMAR) postoperatively (P =.013) (n = 46). The mean keratometric astigmatism decreased from 8.26 ± 2.90 diopters (D) preoperatively to 3.62 ± 2.59 D postoperatively (P <.0001) (n = 89). The mean refractive cylinder decreased from 6.77 ± 2.80 D preoperatively to 2.85 ± 2.57 D postoperatively (P <.0001) (n = 69). A nomogram for femtosecond laser AK to treat post-keratoplasty astigmatism was generated using regression analysis. Conclusions Femtosecond laser AK significantly improved UDVA and CDVA and significantly reduced keratometric astigmatism and refractive cylinder after keratoplasty. The nomogram generated should improve the accuracy of post-keratoplasty femtosecond laser AK. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned.

AB - Purpose To develop a nomogram for femtosecond laser astigmatic keratotomy (AK) to treat post-keratoplasty astigmatism. Setting Three academic medical centers. Design Retrospective interventional case series. Methods A review of post-keratoplasty femtosecond laser AK was performed. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, and keratometry were recorded preoperatively and 1, 3, 6, and 12 months postoperatively. The location, length, depth, and diameter of the AK incisions were recorded, and the surgically induced astigmatic correction was related to these variables using regression analysis. Results One hundred forty femtosecond laser AK procedures were performed after penetrating keratoplasty (PKP) (n = 129) or deep anterior lamellar keratoplasty (DALK) (n =11), with 89 procedures (80 PKP, 9 DALK) included in the analysis. The mean CDVA improved from 20/59 (0.47 logMAR ± 0.38 [SD]) preoperatively to 20/45 (0.35 ± 0.31 logMAR) postoperatively (P =.013) (n = 46). The mean keratometric astigmatism decreased from 8.26 ± 2.90 diopters (D) preoperatively to 3.62 ± 2.59 D postoperatively (P <.0001) (n = 89). The mean refractive cylinder decreased from 6.77 ± 2.80 D preoperatively to 2.85 ± 2.57 D postoperatively (P <.0001) (n = 69). A nomogram for femtosecond laser AK to treat post-keratoplasty astigmatism was generated using regression analysis. Conclusions Femtosecond laser AK significantly improved UDVA and CDVA and significantly reduced keratometric astigmatism and refractive cylinder after keratoplasty. The nomogram generated should improve the accuracy of post-keratoplasty femtosecond laser AK. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned.

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