Limbal relaxing incision (LRI)
Introduction: Small incision cataract surgery is surgery with predictable neutral astigmatism. Spherical correction with intraocular lenses has reached high predictablity. Limbal relaxing incision is one solution to correct induced mild astigmatism.
Method: We performed a prospective study with 2 groups ( Gruppe I: 20 patients with preexisting astigmatismus, Gruppe II: 10 patients with induced stigmatisme). Astigmatism from 1,00 bis 3,75 D had been selected. Amount, axis and symmetry of corneal cylinder are determined by keratometry and topography. Number and size of incisions (1 or 2 incision, 6 or 8mm long, 600 µ deep) depende on hight of astigmatism, lokalisation (in steep meridian of + Zylinder) was determined by the shape of astigmatism (Nomogramm of Gills). After astigmatismincisions, catharact surgery (topical anasthesia, U/S-phaco emulsifikation, 3 mm incision, foldable IOL).
Results: Pre-operative average astigmatismus was 1,75 dpt (-1,75 till 3,50 dpt). He had been reduced by 1,50 D. There had been no changes of axis.
Discussion: Limbal and arcuate relaxing incisions (LRI) are of great value to correct mild astigmatism up to 3,50 D. Using Gill´s nomogramm mild residual astigmatismremains. Higher degrees of astigmatism can be corrected with additional corneal relaxing incisions (CRI). Limbal relaxing incisions are easy to perform, they have a low potential for complications and only few instruments are necessary.
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