Arcuate keratotomy to correct naturally occurring astigmatism

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Abstract
Purpose: To evaluate retrospectively the safety, efficacy, and complications of arcuate keratotomy (AK) in correcting naturally occurring astigmatism. Setting: Laser Ultravision Institute, Montreal, Canada. Methods: Surgically induced refractive change was evaluated in 25 eyes of 15 patients with naturally occurring astigmatism. All patients had mixed or compound myopic astigmatism and were treated with AK alone or both AK and radial keratotomy (RK). Minimum follow-up of 24 months was necessary for inclusion in this study. We used vector analysis to evaluate the refractive and keratometric astigmatic change at 1 month and 1 and 2 years. Results: Ten eyes (40%) had AK only and 15 eyes (60%), both AK and RK. It was necessary to redeepen the original incisions in 21 eyes (84%). All patients had improved uncorrected visual acuity postoperatively. The reduction in refractive cylinder, quantified by vector analysis, was significant. Two years postoperatively, mean reduction was 3.30 diopters (D) ± 1.32 (SD) in eyes that had AK alone and 2.71 ± 1.53 D in eyes that had both AK and RK. Conclusion: Arcuate keratotomy is an effective and safe method for correcting naturally occurring astigmatism. Further analysis of this series of patients is planned.