Clinical Ophthalmology (Feb 2023)
Accuracy of the LaserArcs Femtosecond Cataract Surgery Arcuate Incision Nomogram in Patients Undergoing Cataract Surgery and Astigmatism Reduction
Abstract
Michael Jones,1 John A Hovanesian,2 Andrew Keyser2 1Quantum Vision Centers, Belleville, IL, USA; 2Harvard Eye Associates, Laguna Hills, CA, USACorrespondence: John A Hovanesian, Harvard Eye Associates, 23961 Calle Magdalena, Suite 300, Laguna Hills, CA, 92653, USA, Tel +1 949 951 2020, Email [email protected]: The purpose of this study is to evaluate the efficacy and safety of the laserarcs.com nomogram in reducing astigmatism among cataract patients that underwent astigmatism reduction with laser arcuate incisions.Methods: In this retrospective study, 50 patients who underwent uncomplicated cataract surgery with laser arc incisions for the reduction of astigmatism with a single surgeon between the dates of January 23, 2021 and February 10, 2022 were evaluated in a single eye. Preoperative astigmatism was determined on the basis of keratometry from biometry (IOLmaster, Carl Zeiss Meditec or LenStar LS900, Haag-Streit, Bern, Switzerland) and was compared to the postoperative manifest astigmatism. The percent change in the absolute magnitude of astigmatism was calculated along with the percent of patients with various levels of postoperative astigmatism.Results: Mean cylinder was 0.97 ± 0.49 D pre-op and 0.21 ± 0.28 D postop. Mean reduction in cylinder was 81.4 ± 47.7% (P < 0.00001, one-sample t-test compared to a hypothetical 60% reduction in cylinder). Residual cylinder was ≤ 0.5 D in 90%, 0.25 D in 72%, and 0 D in 58%. Postoperative uncorrected visual acuity was 20/30 or better in 92% and 20/20 or better in 40%. Subgroup analysis showed that residual astigmatism was not affected by patient age, magnitude of preoperative astigmatism, preoperative spherical equivalent, or corneal curvature. No adverse events related to the laser arcuate incisions were noted.Conclusion: Use of the LaserArcs nomogram yielded a significant reduction in preoperative astigmatism. Postoperative uncorrected visual acuity was substantially similar to best-corrected visual acuity, suggesting that many patients undergoing treatment will function without correction for distance tasks.Keywords: nomogram, LaserArcs, astigmatism, cataract surgery, femtosecond laser, keratotomy
