Comparison of clinical outcomes between limbal relaxing incisions and toric intraocular lenses in eyes with astigmatic corneas

Freitas, Giuliano de Oliveira; Boteon, Joel Edmur; Carvalho, Marina Vieira de; Pinto, Rogério de Melo Costa

doi:10.5935/0034-7280.20140003

Cited by 1 publication

(2 citation statements)

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“…Arcuate keratotomies or corneal relaxing incisions have limited predictability and often result in overcorrection, especially in eyes with low and moderate astigmatism. Currently, limbal relaxing incisions are the preferred technique to reduce preexisting astigmatism at the time of cataract surgery [ 11 , 14 – 16 ]. Limbal relaxing incisions appear to have potential advantages over corneal relaxing incisions or arcuate keratotomy by causing less distortion and irregularity on corneal topographies and less variability in refraction because they are placed at the limbus.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, correction index (CI) was calculated to evaluate the achieved power effect versus the targeted power, CI = |SIA|/|TIA| [ 10 ]. The ideal value would be close to 1; CI >1.0 D indicated overcorrection, while CI <1.0 D indicated undercorrection [ 11 ]. Calculations of Thibos vectors for refractive and corneal astigmatism were performed using Microsoft ExcelTM for MacIntosh spreadsheets.…”

Section: Methodsmentioning

confidence: 99%

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Effect of Limbal relaxing incisions during implantable collamer lens surgery

Han

et al. 2017

BMC Ophthalmol

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BackgroundThe limbal relaxing incisions (LRIs) technique is a safe and an inexpensive procedure, which is simple for experts to perform. It can effectively reduce astigmatism and result in a rapid visual rehabilitation. But there are few reports about reducing pre-existing corneal astigmatism by LRI in ICL surgery. Our research was aimed to study the effect of limbal relaxing inci sions during implantable collamer lens (ICL) surgery.MethodsA prospective analysis reviewing consecutive cases of corneal astigmatism that had either independent ICL surgery (control group) or combined with LRIs (LRIs group). The study population consisted of 45 patients, 85 eyes, with high myopia and regular corneal astigmatism more than 0.50 diopter (D) and less than 3.00 D. The first group received ICL surgery combined with LRIs (limbal relaxing incisions); the control group received only ICL surgery alone. The outcomes considered were uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCVA), refraction, keratometry, slit lamp biomicroscopy, indirect ophthalmoscopy, corneal topography, corneal astigmatism, endothelial cell count, and patient satisfaction. The follow-up period covered 12 months.ResultsThe mean uncorrected distance visual acuity (UDVA) and the best corrected visual acuity (BCVA) demonstrated statistically significant improvement after surgery in both groups. At the end of the follow-up period, the UCVA was statistically better for the patients with LRIs compared with those underwent ICL surgery alone. The LRIs group showed significant reduction in the mean topographic astigmatism from 1.48 ± 0.35 D preoperatively to 0.37 ± 0.14 D postoperatively (P < .0001) after one month. The control eyes did not show a statistically significant change (P > 0.05). The mean magnitude of the surgically induced astigmatism (SIA) read 1.10 ± 0.35 D,1.13 ± 0.34D,1.13 ± 0.34D,1.11 ± 0.35D by the end of the 1st, the 3rd, the 6th and the 12th month postoperatively in LRIs group, which was slightly lower than the target-induced astigmatism (TIA). The difference in SIA between the LRI and the control group was statistically significant by the end of the 1st, the 3rd, the 6th and the 12th month postoperatively (P < 0.001). The mean correction index (CI) was less than 1, which indicated undercorrection effect of limbal relaxing incision. No difference was observed in the postoperative endothelial cell count between the two groups. There was no intraoperative and postoperative ocular or systemic complication.ConclusionLimbal relaxing incision is an effective method in reducing corneal astigmatism during implantable collamer lens surgery.Trial registrationThe trial was retrospectively registered in 14 April 2017. (NO:ChiCTR-ONR-17011147).Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-017-0458-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%