{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:44:18Z","timestamp":1787118258095,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T00:00:00Z","timestamp":1604016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To compare the outcomes of femtosecond astigmatic keratotomy (FSAK) and manual astigmatic keratotomy (AK) in treatment of postkeratoplasty astigmatism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective, comparative, pairwise\u2010matched case series including 150 patients who underwent either FSAK (<jats:italic>n<\/jats:italic>\u00a0=\u00a075) or manual AK (<jats:italic>n<\/jats:italic>\u00a0=\u00a075) for the treatment of astigmatism (&gt;3.00 D) following penetrating keratoplasty or deep anterior lamellar keratoplasty. Pairwise matching for baseline variables (age, visual acuity and astigmatism) was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age was 57.5\u00a0\u00b1\u00a016.0\u00a0years. The FSAK group had significantly better postoperative best\u2010corrected visual acuity (BCVA) (p\u00a0=\u00a00.010), uncorrected visual acuity (UCVA) (p\u00a0=\u00a00.049), corneal astigmatism (p\u00a0=\u00a00.020) and manifest astigmatism (p\u00a0&lt;\u00a00.001) compared with the manual AK group. Gain of \u22653 lines in BCVA (logMAR) was seen in five eyes (6.7%) and 21 eyes (28.0%) in manual AK and FSAK, respectively (p\u00a0=\u00a00.005). Alpins vector analysis showed lower (closer to 0) index of success (0.50\u00a0\u00b1\u00a00.24 and 0.79\u00a0\u00b1\u00a00.48, p\u00a0&lt;\u00a00.001) and higher (closer to 1) correction index (0.94\u00a0\u00b1\u00a00.45 and 0.74\u00a0\u00b1\u00a00.55, p\u00a0=\u00a00.020) in FSAK compared with manual AK. Corneal and manifest astigmatism improved significantly in both groups, while BCVA and UCVA improved significantly in FSAK only.<\/jats:p><jats:p>Repeat AK rate was 32% (24 eyes) in manual AK and 4% (three eyes) in FSAK (p\u00a0&lt;\u00a00.001). Overcorrection\u2010related re\u2010suturing rate was 0% in manual AK and 8% (six eyes) in FSAK (p\u00a0=\u00a00.037). There was one microperforation (1.3%) in FSAK, and there were no occurrences of graft dehiscence, infectious keratitis or graft rejection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both manual AK and FSAK were safe and effective in reducing postkeratoplasty astigmatism. FSAK had superior visual and keratometric outcomes compared with manual AK.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.14653","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T07:23:32Z","timestamp":1604042612000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Comparison of manual and femtosecond astigmatic keratotomy in the treatment of postkeratoplasty astigmatism"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1292-1475","authenticated-orcid":false,"given":"Nir","family":"Sorkin","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Vision Sciences University of Toronto Toronto ON Canada"},{"name":"Department of Ophthalmology Tel Aviv Medical Center and Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4661-0993","authenticated-orcid":false,"given":"Michael","family":"Mimouni","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Sciences University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisella","family":"Santaella","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Sciences University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Kreimei","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Sciences University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Trinh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Sciences University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yelin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Sciences University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danyal","family":"Saeed","sequence":"additional","affiliation":[{"name":"Michael G. 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