• Mohammad Naser Hashemian, Habib Ojaghi, Mehrdad Mohammadpour, Mahmoud Jabbarvand, Firouzeh Rahimi, Mohammad-Ali Abtahi, Mehdi Mazloumi, and Seyed-Hossein Abtahi.
• Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
• J Res Med Sci. 2017 Jan 1; 22: 17.

BackgroundAstigmatism is the leading complication in visual recovery after penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty (DALK); in this study, we evaluated the outcome of femtosecond laser arcuate keratotomy (FLAK) after DALK and PKP in Iranian keratoconic patients.Materials And MethodsIn this prospective interventional case series, refractive and keratometric predictability, efficacy, and complications of FLAK for postkeratoplasty astigmatism in keratoconus were evaluated; 23 eyes of 23 consecutive patients (mean age of 32.43 ± 9.11 years) with high astigmatism were enrolled. The femtosecond laser performed paired 90°-angled arcuate incisions.ResultsMean logarithm of the minimum angle of resolution of corrected and uncorrected visual acuity improved from preoperative values of 0.30 ± 0.18 and 0.85 ± 0.32 to 6-month values of 0.19 ± 0.17 and 0.65 ± 0.33, respectively (P < 0.05). Mean subjective astigmatism was 7.79 ± 2.64 diopter (D) preoperatively and 3.69 ± 2.25D at 6-month after surgery (P < 0.05). Surgically induced astigmatism was 9.27 ± 5.00D. Mean refractive spherical equivalent showed no significant (P = 0.69) hyperopic shift from - 4.21 ± 4.84D preoperatively to - 2.16 ± 6.09D postoperatively. Two (8.7%) microperforations were observed.ConclusionFLAK is a relatively safe and effective method for the treatment of postkeratoplasty astigmatism.

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