Femtosecond Laser-assisted Arcuate Keratotomy Versus Toric IOL Implantation for Correcting Astigmatism

To evaluate the clinical efficacy and safety of femtosecond laser-assisted arcuate keratotomy (FS-AK) versus toric intraocular lens (IOL) implantation for correcting astigmatism in patients with cataract.A retrospective chart review was performed. All patients had senile cataracts with corneal astigmatism (range: +1.00 to +3.00 diopters [D]) before cataract surgery. Twenty-five patients agreed to undergo toric IOL implantation (the toric IOL group). Twenty-three patients did not agree to undergo toric IOL implantation despite astigmatism; however, these patients were not satisfied with their remaining astigmatism following cataract surgery and requested astigmatism correction using FS-AK (the FS-AK group). Visual acuity and intraocular pressure were evaluated, and automated refraction, keratometry, and slit-lamp examinations were performed at 1 day, 1 week, 1 month, and 5 months after surgery.Refractive astigmatism decreased in both groups. The mean preoperative and postoperative refractive cylinders were 1.71 ± 1.15 and 0.78 ± 1.06 D, respectively, in the FS-AK group (P < .001) and 1.67 ± 0.13 and 0.83 ± 0.097 D, respectively, in the toric IOL group (P < .001). There were no statistically significant differences between groups at any time during the follow-up period.FS-AK is a fast, customizable, adjustable, precise, and safe procedure for reducing refractive errors in patients with residual astigmatism after cataract surgery. The results of this procedure are comparable to the toric IOL.