Limbal Relaxing Incision during Phacoemulsification for the Correction of Astigmatism
Purpose: To determine the difference in mean post-operative astigmatism of
patients having limbal relaxing incisions with phacoemulsification as compared to
phacoemulsification alone for the correction of pre-existing corneal astigmatism.
Material and Methods: This study was conducted in the Civil Hospital Karachi
Eye Unit II, from 1
st December 2009 - 1
st December 2010, for duration of 12
months. Patients enlisted for phacoemulsification cataract surgery with coexisting
astigmatism were recruited and divided into two groups. Eyes that
underwent cataract surgery with limbal relaxing incisions (cataract LRI group)
and eyes that underwent cataract surgery only (control group). All patients
underwent a comprehensive baseline ophthalmic examination that included
uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA),
manifest refraction, anterior segment slit – lamp examination, 90 D examination
of fundus, keratometry and ultrasound biometry. Patients were evaluated at 1st
day, 1st month and 3rd month postoperatively Post-operative examination
included BCVA, anterior segment slit-lamp microscopy and keratometry. The
data thus obtained was analyzed on SPSS 17.
Results: A total of 50 eyes (29 right eyes and 21 left eyes) of 44 patients were
included in the study. Mean patients age was 61 yrs ± 11.3 yrs (range: 30 to 80)
in the LRI group and 57 yrs ± 11.8 yrs (range 30 to 80) in the control group. Data
analysis demonstrated statistically significant reduction in the mean postoperative
astigmatism in the LRI eyes from 1.78 ± 0.81 D@125° (range: 0.75 to
3.70 D) preoperatively to 0.73 ± 0.71 D @ 130° (range: 0.0 to 2.70) in the 3rd
postoperative month as compared to control group from 1.28 ± 0.41 D @ 145°
(range: 0.75 to 1.97 D) preoperatively to 1.17 ± 0.57 D @ 144° (range: 0.10 to
2.30) p-value 0.021. There were no intraoperative complications or postoperative
subjective complaints (such as halo or glare) in our patients.
Conclusion: Limbal relaxing incisions performed during phacoemulsification
surgery appear to be safe and effective procedure to reduce pre-existing corneal
Key Words: Limbal relaxing incision, Phacoemulsification, Astigmatism.