A prospective study investigating the long-term stability of changes in astigmatism following arcuate lamellar keratotomy (ALK): 3-year results |
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Authors: | Kirk Nordwald Norbert Anders Tony Walkow Duy Thoai Pham |
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Institution: | Augenklinik der Charité am Virchow-Klinikum der Humboldt-Universit?t zu Berlin, XX Augenabteilung, Krankenhaus Neuk?lln, Berlin, XX
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Abstract: | Introduction: The correction of low to moderate astigmatism is possible today by means of photoablation (PRK), while the treatment of moderate
and higher astigmatism still involves refractive keratotomy. Experience has shown that cataract surgery, using modern tunnel
techniques with self-healing incisions, results in earlier stability in both the refractive outcome and wound healing. In
this study, we attempted to combine the advantages of lamellar keratotomy with those of a pair-wise T-incision as arcuate
lamellar keratotomy (ALK).
Patients and methods: The clinical outcome of 41 patients who underwent ALK was investigate in a prospective study over a period of 3 years. The
pre- and postoperative investigations undertaken included the measurement of astigmatism using a Zeiss keratometer, uncorrected
visual acuity, and corrected glare vision using a Humphrey autorefractor. All patients had astigmatism between 2.0 and 7.0
D. Together with a uniform arcuate incision, we used 7 mm (n = 26) and 8 mm (n = 15) mm zones for correction.
Results: The average preoperative astigmatism was 4.01 ± 1.90 (median, 3.50) D. After a 3-year follow-up the average postoperative
astigmatism was 1.59 ± 1.29 (median, 1.38) D. The astigmatic change induced (Jaffé) after 3 years was about 3.23 ± 2.23 (median,
3.16) D. The average uncorrected visual acuity (log MAR) before ALK was 0.20 ± 0.12 (median, 0.22) and after follow-up, 0.41
± 0.14 (median, 0.39). Corrected glare vision before surgery was 0.23 ± 0.19 (median, 0.10) and afterwards, 0.25 ± 0.22 (median,
0.14).
Conclusions: Arcuate lamellar keratomy (ALK) stood the test as a routine clinical procedure for correction of moderate astigmatism with
stable postoperative functional outcomes. We did not find impairment of glare vision following this procedure.
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Keywords: | Arcuate lamellar keratotomy (ALK) • Astigmatism surgery • Clinical trial • Cornea surgery • Correction of astigmatism • Long-term results • Refractive surgery • Prospective studies |
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