Management of Corneal Astigmatism by Limbal Relaxing Incisions during Cataract Surgery

Purpose: To evaluate the safety and efficacy of limbal relaxing incisions (LRIs) for corneal astigmatism correction during phacoemulsification Methods: 24 eyes of 24 patients with the mean age of 65.71 years (range: 55 to 83 years) with senile cataracts and mean corneal astigmatism of 1.9±0.83 diopters (D) (range: 1.5 to 3.5 D) were included in this study. All LRIs were performed during phacoemulsification by one surgeon. Topography indices were recorded preoperatively and postoperatively in months 2 and 6. Results: A statistically significant reduction in the mean corneal astigmatism was seen from 1.9±0.83 D preoperatively to 1.4±0.84 D and 1.4±0.92, 2 months and 6 months postoperatively (P<0.001). Surgical induced astigmatism (SIA) (the amount and axis of astigmatism change induced by the surgery) was 0.90±0.48 at 2 months and 0.96±0.59 at 6 months. Correction index (CI) (calculated by determining the ratio SIA/ target induced astigmatism (TIA) was 0.55±0.41 and 0.57±0.32 at 2 and 6 months, respectively. Index of success (IOS) (ratio of topographic residual astigmatism and TIA) was measured 0.44±0.41 and 0.47±0.32 at months 2 and 6 correspondingly. Conclusion: Combined LRI and phacoemulsification appears to be safe and fairly effective to correct mild to moderate corneal astigmatism. However, under correction is a common limitation that may be further managed by modified nomograms in future studies.