Limbal Relaxing Incision Combined with Cataract Surgery Reducing Preoperative Corneal Astigmatism

ABSTRACT

PURPOSE: Corneal astigmatic correction is necessary to improve best uncorrected visual acuity (BUVA) after cataract extraction. The purpose of the study is to know the effect and safety of limbal relaxing incision combined with cataract extraction to reduce preoperative astigmatism in patients whose corneal astigmatism was 1.0 diopter or more. METHODS: Eighten eyes from 16 patients had cataract with corneal astigmatism 1.0 diopter or more. We checked preoperative uncorrected visual acuity (UCVA), autokeratometry, manifest refraction, corneal topography and so on. We phacoemulsified and inserted intraocular lens in the bag. After that, we made limbal relaxing incision at the previously-determined axis with previously-determined length and depth. We followed up them with autokeratometry, manifest refraction and corneal topography at 1week, 4, 8 and 12 weeks after surgery. RESULTS: There was a statistically significant improvement of final UCVA transformed by log MAR (minimum angle of resolution) compared with preoperative UCVA. According the analysis of autokeratometric astigmatism with Naeser's polar value concept, astigmatic polar value (AKP) was 1.37+/-0.53 diopter before surgery, .0.17+/-0.30 diopter at 1week after surgery, .0.07+/-0.36 diopter at 4weeks, .0.13+/-0.30 diopter at 8weeks, .0.07+/-0.38 diopter at 12weeks. Over the whole follow-up period, there was a statistically significant decrease of AKP compared with preoperative one (p=0, 0, 0, 0.001). There was also a statistically significant decrease of AKP measured by manifest refraction compared with preoperative ones (p=0.007, 0.001, 0.002, 0.015). There was a statistically significant decrease of AKP checked by corneal topography compared with preoperative ones (p=0.001, 0, 0, 0.002). CONCLUSIONS: Twelve weeks follow up after cataract extraction with limbal relaxing incision showed a statistically significant improvement of final UCVA compared with preoperative UCVA and reduction of preoperative astigmatism checked by autokeratometry, manifest refraction and corneal topography. Limbal relaxing incision combined with cataract extraction was an effective procedure to reduce preoperative astigmatism.