ArticleBMC ophthalmology2025
Vector analysis valuation of astigmatism in the cornea after femtosecond laser-assisted corneal astigmatism incision in cataract surgery.
Article in BMC ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe aim of this article is to evaluate the effectiveness of anterior penetrating femtosecond laser-assisted astigmatism keratotomy (FS-AK) using vector analysis.
methodsThis retrospective before-after study included 68 patients with corneal astigmatism > 1D who underwent FLACS at Dalian Third People's Hospital between June 2023 and July 2024 as research participants. All patients received monofocal non-spherical intraocular lenses. The femtosecond laser, operated on the Catalys platform (Johnson & Johnson, Santa Ana, CA, USA), utilized the corneal limbus center as a reference point, with an 8 mm cutting range centered on the optical zone and a cutting depth of 80%. The planned penetration type is anterior penetrating. The planned parameters were 20% uncut posterior, and 90°side cut angle. The arc length was calculated and optimized using Dr. Julian Stevens' nomogram. Astigmatism was analyzed using the vector method, incorporating three basic parameters: target-induced astigmatism vector (TIA), surgically induced astigmatism (SIA), and differential vector (DV), and multiple evaluation parameters: error angle (AE), correction index (CI), adjustment coefficient (CA), and flattening index. Data were analyzed by group according to astigmatism type, age, and white-to-white measurement.
resultsThe 68 patients (76 eyes) had an average TIA of 1.812 ± 0.769 D, an average SIA of 0.865 ± 0.489 D, and an average DV of 0.947 ± 0.777 D. The average AE was - 1.671 ± 28.836, average CI was 0.509 ± 0.259, and average CA was 4.453 ± 7.675, representing a general mild undercorrection. In the subgroup analysis, the cylindrical error correction effect of the against-the-rule astigmatism group was better than that of the with-the-rule astigmatism group, and the correction effect in patients over 60 years was better than that in those under 60 years (P = 0.000). The combined use of FLACS and APAK cylindrical error correction vector analysis showed that there was slight under-correction in both cases.
conclusionThis study demonstrated that femtosecond laser-assisted anterior corneal penetrating arc incision safely and effectively reduced corneal astigmatism after cataract surgery; however, there was an overall under-correction. By conducting a long-term analysis of the APAK results, further studies can help optimize nomogram parameters to improve the precision of femtosecond laser-assisted astigmatism keratotomy cylindrical error correction.
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