Abstract Purpose To investigate the stability of corneal astigmatism and higher-order aberrations after combined femtosecond-assisted phacoemulsification and arcuate keratotomy. Design Retrospective, interventional case series Methods Surgery was performed using VICTUS (Bausch & Lomb Inc, Dornach, Germany) platform. A single, 450-μm deep, arcuate keratotomy was paired at 8 mm zone with the main phacoemulsification incision in the opposite meridian. The keratotomy incisions were not opened. Corneal astigmatism and higher-order aberrations measurements obtained preoperatively, and at 2 months and 2 years postoperatively were analyzed. Results Fifty eyes of 50 patients (mean age 66.2 ± 10.5 years) were included. The mean preoperative corneal astigmatism was 1.35 ± 0.48 diopters (D). This was reduced to 0.67 ± 0.54 D at two months and 0.74 ± 0.53 D at two years postoperatively (p < 0.001). There was no statistically significant difference between postoperative corneal astigmatism over 2 years (p = 0.392). Both magnitude of error and absolute angle of error were comparable between the 2 postoperative time points (p > 0.283). At postoperative 2 months and 2 years, 72% and 70% of eyes were within 15 degrees of preoperative meridian of astigmatism, respectively. All wavefront measurements increased significantly at 2 months and 2 years (p < 0.007), except spherical aberration (p > 0.150). There was no significant difference in higher-order aberrations between 2 months and 2 years postoperatively (p > 0.486). Conclusions Our study showed the stability of femtosecond-assisted arcuate keratotomy. Further studies using other platforms and nomograms are needed to corroborate the findings of this study.