Limbal relaxing incisions to correct corneal astigmatism during phacoemulsification

PURPOSE: To evaluate the safety and efficacy of limbal relaxing incisions for the correction of corneal astigmatism during phacoemulsification. METHODS: Fifty eyes of 37 patients (mean age 66.5 years, range: 45 to 80 years) with cataract and coexisting topographic astigmatism were included in the study. Eyes were randomly 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 limbal relaxing incisions were performed during phacoemulsification. Best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), and corneal topography were recorded preoperatively and 1, 3, and 6 months postoperatively. RESULTS: A statistically significant improvement in BSCVA was seen in the cataract LRI eyes from 0.9 +/- 0.7 preoperatively to 0.1 +/- 0.1 at 1, 3, and 6 months postoperatively (P < .01). A statistically significant improvement in BSCVA was seen in control eyes from 0.8 +/- 0.6 before surgery to 0.2 +/- 0.2 at 1, 3, and 6 months after surgery (P < .01). No difference in postoperative BSCVA was noted between the groups. A statistically significant reduction in the mean topographic astigmatism was seen in the cataract LRI eyes from 1.93 +/- 0.58 diopters (D) preoperatively to 1.02 +/- 0.60 D 6 months postoperatively (P < .05). The control eyes did not show a statistically significant change in topographic astigmatism. CONCLUSIONS: Limbal relaxing incisions performed during phacoemulsification surgery appear to be a safe, effective, and stable procedure to reduce pre-existing corneal astigmatism.