Abstract: Arcuate keratotomy (AK) is an important method for correcting corneal astigmatism during cataract surgery. It is suitable for patients with normal corneal structure and preoperative regular corneal astigmatism of 1.0 to 1.5 diopters. The effectiveness of AK is influenced by factors such as incision length, incision depth, incision location, the type of preoperative astigmatism, and the degree of preoperative astigmatism. Compared to manual AK, femtosecond laser-assisted astigmatic keratotomy (FSAK) offers higher correction accuracy and long-term stability and can serve as an alternative to Toric intraocular lenses (Toric IOL) in certain cases. Based on the depth of the incision, FSAK is classified into penetrating and intrastromal FSAK, with the former providing greater corrective power and the latter offering higher safety. Studies have shown that its efficacy is influenced by incision location, corneal biomechanics, and postoperative wound healing. In the future, optimizing nomograms and integrating personalized planning may further enhance the corrective effectiveness of FSAK, making it a promising approach for managing astigmatism in cataract patients.

Key words: Arcuate keratotomy, Cataract, Astigmatism, Femtosecond laser