Limbal relaxing incisions at the time of apodized diffractive multifocal intraocular lens implantation to reduce astigmatism with or without subsequent laser in situ keratomileusis

Müftüoğlu, Orkun; Dao, Lori; Cavanagh, Harrison D; McCulley, James P.; Bowman, R. Wayne

doi:10.1016/j.jcrs.2009.10.037

Cited by 29 publications

(21 citation statements)

References 31 publications

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“…Figure 2A provides information concerning TIA and SIA trends over time within and between groups; the mean TIAs were comparable between groups (Mann-Whitney U test; P=0.62); however, the mean SIAs were significantly lower in the LRI group than in the toric IOL group (Mann-Whitney U test; P≤0.01). In addition, the mean SIAs were significantly lower than the mean TIAs in the LRI group (Wilcoxon test P=0.00); this was in accordance with values reported in the current literature, which documents that LRI most often undercorrects astigmatism (2,3,10) . In both the LRI and toric IOL groups, there were no significant differences in the mean SIAs throughout the follow-up period (Wilcoxon test; P≥0.25).…”

Section: Discussionsupporting

confidence: 90%

“…Overcorrection was observed in approximately 7% eyes in the toric IOL group and 3% eyes in the LRI group. In our study, the greater number of patients with against the rule and oblique astigmatisms in the LRI group may have induced some bias because such categories of astigmatism are somewhat less responsive to LRI (2,3,10) . The proportion of eyes that achieved the intended correction in the toric IOL group is remarkable compared with that in the LRI group.…”

Section: Discussionmentioning

confidence: 70%

“…One way to correct astigmatism simultaneously during cataract surgery is to place limbal relaxing incisions (LRIs) (2,3) . It is possible, however, that late corneal biomechanics may play an unfavorable role in refractive outcomes over time (4) .…”

Section: Introductionmentioning

confidence: 99%

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Treatment of astigmatism during phacoemulsification

Freitas¹,

Boteon²,

Carvalho³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Purpose: To compare the effectiveness of limbal relaxing incisions (LRI) with that of toric intraocular lens (IOL) implantation for the treatment of astigmatism during phacoemulsification using nonvectorial (predictability, safety, and efficacy) and vectorial analyses. Methods: This longitudinal observational case series assessed 62 eyes of 31 consecutive cataract patients with preoperative corneal astigmatism of 0.75-2.50 diopters (D) in both eyes. Patients were randomly assigned to 2 groups: a toric IOL group, which received toric IOLs in both eyes, and an LRI group, which received spherical IOLs associated with LRI placement in both eyes. All patients were evaluated at 1, 3, and 6 months after surgery, when refractive astigmatism analysis was performed using both nonvectorial and Alpins vectorial methods. Outcomes were assessed within each group and compared between groups. Results: The proportion of eyes within ±0.50 D of the intended correction at 3 and 6 months after surgery was 75% and 71.88%, respectively, in the LRI group and 40% and 66.67%, respectively, in the toric IOL group. In the remaining period, the proportion was greater in the toric IOL group. The safety index showed no difference at any time point. The efficacy index at 1 and 3 months after surgery was significantly higher in the toric IOL group (0.43 and 0.44, respectively) than in the LRI group (0.31 and 0.36, respectively). At 6 months after surgery, the status of eyes in the LRI group was as follows: 53.13% were undercorrected, 43.74% achieved the intended correction, and 3.13% were overcorrected. In the toric IOL group, 16.76% eyes were undercorrected, 76.67% achieved the intended correction, and 6.67% were overcorrected. The success rates for astigmatic surgery, astigmatism reduction at the intended axis, and astigmatism corrected were 43%, 62%, and 64%, respectively, in the LRI group and 57%, 81%, and 94%, respectively, in the toric IOL group. Conclusions: Our results suggest that the use of toric IOLs may be advantageous over the use of LRIs for the treatment of astigmatism during phacoemulsification. Although such advantages seem subtle in nonvectorial analyses, they are highlighted in vectorial analyses.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 70%

See 1 more Smart Citation

Treatment of astigmatism during phacoemulsification

Freitas¹,

Boteon²,

Carvalho³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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show abstract

“…Such an approach has become the most popular way to manage astigmatism at the time of cataract surgery (12,(31)(32)(33)(34)(35)(36)(37)(38)(39) . The use of LRI offer several advantages over astigmatic incisions placed within the cornea, at smaller optical zones, including less chance of causing a shift in the resultant cylinder axis and a lesser tendency to cause irregular corneal flattening with irregular astigmatism.…”

Section: A) Incisional Approachmentioning

confidence: 99%

Astigmatism treatment during phacoemulsification: a review of current surgical strategies and their rationale

Freitas¹,

Boteon²,

Carvalho³

et al. 2013

Rev. bras.oftalmol.

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“…(3) One popular approach to correct corneal astigmatism simultaneously to cataract surgery is to treat pre-existing cylinder by creating limbal relaxing incisions (LRI). (4)(5)(6) Toric intraocular lens (IOL) implantation is another valuable option in the treatment of corneal astigmatism in cataract patients. (7) To ascertain which approach constitutes a better surgical option remains under debate.…”

mentioning

confidence: 99%

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

Freitas¹,

Boteon²,

Carvalho³

et al. 2014

Revista Brasileira De Oftalmologia

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Limbal relaxing incisions at the time of apodized diffractive multifocal intraocular lens implantation to reduce astigmatism with or without subsequent laser in situ keratomileusis

Abstract: Limbal relaxing incisions at the time of apodized diffractive multifocal IOL implantation, with or without subsequent LASIK, were effective and safe in reducing astigmatism.

Cited by 29 publications

References 31 publications

Treatment of astigmatism during phacoemulsification

Treatment of astigmatism during phacoemulsification

Astigmatism treatment during phacoemulsification: a review of current surgical strategies and their rationale

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

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