To assess outcomes of femtosecond laser astigmatic keratotomy (femto-AK), astigmatic keratotomy with a diamond knife (AK) and Laser in-situ keratomileusis (LASIK) procedures in the treatment of high astigmatism

A retrospective review was performed on thirty patients. Eleven patients underwent LASIK surgery with Nidec 5000. AK was performed for 11 cases with a diamond knife (Ellis) on routine manner. For eight patients (11 eyes) the operation was performed using a femtosecond laser (FEMTEC R, Technolas Perfect Vision, GmbH, Heidelberg, Germany) to create paired arcuate cuts (Bascom Palmer nomogram).

Preoperative spherical equivalent was zero in all patients and average follow up was 6 months. In femto AK patient group, mean preoperative UCVA (logMAR) and mean cylinder significantly improved in 3 and 6 month (p<0.001and p=0.001, respectively). Significant difference in UCVA achieved by LASIK and AK which was 0.43 and 0.8±0.18 respectively (p=0.03).The amount of spherical correction was -0.5±0.76D, -1.6±0.6, -1.67±0.19 in LASIK, AK and femto-AK group (p=0.001). There was also significant reduction of cylinder in both AK and LASIK groups, -2.29 and -2.14 D respectively.

Astigmatic keratotomy using femtosecond laser seems valuable in reducing corneal astigmatism while the center of cornea is not manipulated.