{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T04:54:53Z","timestamp":1776401693231,"version":"3.51.2"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      To compare the clinical outcomes of femtosecond laser-assisted cataract surgery (FSLACS) with astigmatic keratotomy (AK) versus toric intraocular lens (IOL\n                      <jats:sub>t<\/jats:sub>\n                      ) implantation for astigmatism correction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective comparative case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      60 eyes (45 IOL\n                      <jats:sub>t<\/jats:sub>\n                      cases and 15 AK cases) with patient\u2019s mean age of 61.46\u202f\u00b1\u202f12.84\u202fyears underwent FSLACS with astigmatic correction. Pre and post-operative evaluations included autorefractometry, corneal topography, IOL Master analysis, and assessment of total ocular astigmatism (OA\n                      <jats:sub>tot<\/jats:sub>\n                      ), anterior\/posterior\/total corneal astigmatism (CA\n                      <jats:sub>ant<\/jats:sub>\n                      \/CA\n                      <jats:sub>post<\/jats:sub>\n                      \/CA\n                      <jats:sub>tot<\/jats:sub>\n                      ), corneal higher-order aberrations (HOAs), vector analysis, and best-corrected\/uncorrected distant visual acuity (BCVA; UDVA; LogMAR). The average follow-up period was 16.29\u202f\u00b1\u202f11.15\u202fmonths.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In term of OA\n                      <jats:sub>tot<\/jats:sub>\n                      as demonstrated by polar plots, significant reductions were observed in both the IOL\n                      <jats:sub>t<\/jats:sub>\n                      and the AK groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). In regard to CA\n                      <jats:sub>ant<\/jats:sub>\n                      , a statistically significant change was observed in the AK group. No significant change was noted in the IOL\n                      <jats:sub>t<\/jats:sub>\n                      group. In view of CA\n                      <jats:sub>post<\/jats:sub>\n                      , there was no statistically significant difference in CA\n                      <jats:sub>post<\/jats:sub>\n                      for either the IOL\n                      <jats:sub>t<\/jats:sub>\n                      or AK groups, indicating stability of the posterior corneal surface. As for CA\n                      <jats:sub>tot<\/jats:sub>\n                      , the AK group showed a significant pre to post-operative change (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). No significance was found in the IOL\n                      <jats:sub>t<\/jats:sub>\n                      group. Likewise, corneal HOAs remained stable in IOL\n                      <jats:sub>t<\/jats:sub>\n                      but significantly increased in AK (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01). This is associated with a significant intergroup difference of\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001. Vector astigmatism analysis utilizing Double Angle Vector Diagrams to show that TIA\/SIA\/DV\/CI for the IOL\n                      <jats:sub>t<\/jats:sub>\n                      group and for the AK group. Vector astigmatism analysis implied that there was no significant difference in target\/surgery induced astigmatism (TIA\/SIA) between groups. BCVA (LogMAR) improved significantly in both groups [IOL\n                      <jats:sub>t<\/jats:sub>\n                      : 0.40 (0.40, 0.50) to 0.10 (0.00, 0.10); AK: 0.40 (0.40, 0.50) to 0.10 (0.10, 0.15); both\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001]. There is with no significant difference between both groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.49).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FSLACS with toric IOL implantation offers an effective and more stable astigmatism correction without increasing HOAs, but also having similar visual outcome improvement, when compared to AK\u2019s astigmatism correction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1752650","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T04:14:33Z","timestamp":1776399273000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Femtosecond laser assisted phacoemulsification plus IOL implant: toric IOL vs. astigmatic keratotomy"],"prefix":"10.3389","volume":"13","author":[{"given":"Howard Wen-Haur","family":"Chao","sequence":"first","affiliation":[{"name":"Department of Medicine, School of Medicine, Aston University","place":["Birmingham, United Kingdom"]},{"name":"Department of Medical Education, Leeds University","place":["Leeds, United Kingdom"]},{"name":"Queen Elizabeth University Hospital","place":["Birmingham, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Windsor Wen-Jin","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Medicine, Aston University","place":["Birmingham, United Kingdom"]},{"name":"New Cross Hospital","place":["Wolverhampton, United Kingdom"]},{"name":"Department of Science, University of British Columbia","place":["Vancouver, BC, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Kuo","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital","place":["Taipei, Taiwan"]},{"name":"School of Medicine, Catholic Fu-Jen University","place":["Taipei, Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiow-Wen","family":"Liou","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital","place":["Taipei, Taiwan"]},{"name":"School of Medicine, National Taiwan University","place":["Taipei, Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pai-Huei","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital","place":["Taipei, Taiwan"]},{"name":"School of Medicine, Catholic Fu-Jen University","place":["Taipei, Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiao-Ming","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital","place":["Taipei, Taiwan"]},{"name":"Department of Chinese Medicine, School of Chinese Medicine, China Medical University","place":["Taichung, Taiwan"]},{"name":"Institute of Pharmacology, School of Medicine, National Yang Ming Chiao Tung University","place":["Taipei, Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1016\/j.jcrs.2018.05.027","article-title":"Refractive outcomes after limbal relaxing incisions or femtosecond laser arcuate keratotomy to manage corneal astigmatism at the time of cataract surgery","volume":"44","author":"Roberts","year":"2018","journal-title":"J Cataract Refract Surg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1762","DOI":"10.1016\/j.jcrs.2019.08.002","article-title":"Femtosecond laser-assisted arcuate keratotomy at the time of cataract surgery for the Management of 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