Clinical Scorecard: Long-Term Stability of Incisions With Dual-Pulse Femtosecond Laser for Astigmatism

At a Glance

Key Highlights

• Significant reduction in astigmatism maintained from 4-6 weeks up to 24-36 months postoperatively
• Over 90% of eyes achieved surgically induced astigmatism within 0.5 D of target
• 95.5% of eyes attained uncorrected distance visual acuity of 20/30 or better at long-term follow-up

Guideline-Based Recommendations

Diagnosis

• Assess preoperative keratometric astigmatism to determine candidacy for arcuate incisions

Management

• Use dual-pulse femtosecond laser to create beveled arcuate incisions for astigmatism correction during cataract surgery
• Consider this technique especially when toric intraocular lenses are unavailable or inappropriate

Monitoring & Follow-up

• Follow-up keratometric measurements and uncorrected distance visual acuity assessments at intervals up to 36 months

Risks

• Beveled incision design reduces risk of regression or wound gaping, promoting corneal biomechanical stability

Patient & Prescribing Data

20 eyes of 20 patients with low-to-moderate astigmatism undergoing refractive cataract surgery

Long-term data supports durable astigmatism correction and stable visual acuity outcomes with dual-pulse femtosecond laser arcuate incisions

Clinical Best Practices

• Employ beveled arcuate incisions created by dual-pulse femtosecond laser for precise and stable astigmatism correction
• Use vector analysis and keratometric comparisons to evaluate surgical outcomes
• Maintain long-term follow-up to monitor stability of astigmatic correction and visual acuity

References

• 2025 ASCRS Annual Meeting Presentation by Denise Visco, MD, MBA, ABO