الفهرس 
Femtosecond laser arcuate keratotomy for the correction of post-keratoplasty astigmatism
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Abstract
To determine the feasibility and initial outcomes of using a femtosecond laser to perform arcuate keratotomies to correct high post-keratoplasty astigmatism. Prospective non comparative interventional study. Twenty eyes of 20 consecutive patients (mean age 29.50 ±14.15 years) who presented with a high degree of astigmatism, non-correctable with spectacles or contact lenses (17 post-penetrating keratoplasty,3 post-deep lamellar keratoplasty), and were candidates for relaxing incisional corneal surgery. The Femtosecond laser (Abbott medical company optics, USA, 150 KHz) femtosecond laser performed paired 90-degree angled arcuate incisions on the graft. The incision sites and depths were programmed at 1.00 mm inside the graft edge and at 80-90% of the corresponding local graft thickness, whereas the angular lengths of the cuts were determined by analyzing the locations and extents of the steepest meridians at the topographic map. Changes in uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA), mean subjective and topographically k-reading determined astigmatism. At the final follow up, the preoperative cylinder decreased by more than two diopters in 15eyes (75%), although it increased in four eyes (20%), one eye (5%) experienced no changes the mean preoperative refractive astigmatism was 7.54± 2.18D (range from 12 to 4.25 D) changed to 5.5 ± 3.1D (range from 12 to 1.75 D) at the first month (P=0.05) and changed to 5.13 ± 3.2D(range from 12 to 1.25 D) in 3th month (P = 0.03) at the final follow up the changes were 5.06±3.23D (range from 12 to 1.25 D) (P = 0.02) these results were statistically significant (P=0.004).The mean spherical equivalent was -6.6±2.9 Diopters (D) (range from 1.75 to 14 D) changed to 6.5±2.9D - range from 1.25 to 12.07 D postoperatively. This change was statistically insignificant P-value=0. 919