Femtosecond incisions can be more precise, better centered than manual
NEW YORK — Both intrastromal and penetrating femtosecond incisions can be more precise, better centered and provide a higher percentage of patients with less than 0.5 D of manifest refractive astigmatism postoperatively when compared with their preoperative astigmatism, a speaker said here.
“In the past, we used to do a lot of manual AKs, which I really haven’t done one in a long time. Some of the issues can be a little bit of the unpredictable outcome and patients do notice the foreign body sensation. Of course, there is the risk of infection. More recently we’ve been using the femtosecond to do both the penetrating and intrastromal incisions. Theoretically, it’s more precise in terms of its length and centration and [has] less inflammation,” Zaina Al-Mohtaseb, MD, said at OSN New York 2017.
In a current study, Al-Mohtaseb and colleagues are evaluating outcomes for intrastromal and penetrating incisions in randomized patients. For intrastromal incisions, the percentage of patients with postoperative manifest refractive astigmatism is much lower, with 72% of patients having less than 0.5 D postoperatively. For the penetrating incisions, there is also a higher percentage of patients with less than 0.5 D postoperatively compared with their preoperative measurements. The numbers are too small to be compared statistically at this moment, she said.
To be most effective, Al-Mohtaseb said surgeons should rule out corneal pathology and irregular astigmatism on the topography and determine the magnitude of astigmatism before moving forward.
“We’re waiting to see our outcomes of our study to see a nomogram for both intrastromal or penetrating and if this lasts a year in terms of our study,” she said. – by Robert Linnehan
Al-Mohtaseb Z. Finessing the femto arcuates: pearls for intrastromal and penetrating incisions. Presented at: OSN New York 2017; Oct. 20 to 22. 2017; New York.
Disclosure: Al-Mohtaseb reports she is a consultant for Alcon and Allergan.