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Limbal relaxing incision during cataract extraction versus photoastigmatic keratectomy after cataract extraction in controlling pre-existing corneal astigmatism

  • Refractive Surgery
  • Published:
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Abstract

Background

The techniques of limbal relaxing incision (LRI) and photoastigmatic keratectomy (PAK) are both effective methods for correcting pre-existing astigmatism with cataract extraction, but no previous study has directly compared them.

Purpose

To compare the effects of limbal relaxing incision (LRI) and photoastigmatic keratectomy (PAK) on preoperative astigmatism and higher-order aberrations (HOAs) in eyes undergoing cataract surgery.

Setting

Kitasato University Hospital, Japan.

Patients and methods

A retrospective study of eyes which had undergone phacoemulsification and intraocular lens implantation through an astigmatically neutral incision either accompanied by LRI (LRI group, 20 eyes) or followed after 3 months by PAK (PAK group, 27 eyes), to control pre-existing corneal astigmatism.

Results

Among eyes that underwent LRI, manifest astigmatism (corrected to the corneal plane) averaged -1.72 ± 0.95 D preoperatively and -0.98 ± 0.58 D postoperatively. Corneal astigmatism averaged 2.03 ± 0.49 D preoperatively and 1.34 ± 0.60 D postoperatively. Among eyes that underwent PAK, manifest astigmatism averaged –2.02 ± 0.64 D preoperatively and –0.70 ± 0.58 D postoperatively. Corneal astigmatism averaged 2.30 ± 0.81 D preoperatively and 1.05 ± 0.36 D postoperatively. With regard to HOAs, in the LRI group, corneal HOAs averaged 0.172 ± 0.051 μm (total aberrations for 4 mm pupil diameter) and 0.681 ± 0.433 μm (total, 6 mm) preoperatively, but 0.172 ± 0.053 μm (total, 4 mm) and 0.651 ± 0.187 μm (total, 6 mm) postoperatively. In the PAK group, the corneal HOAs averaged 0.179 ± 0.073 μm (total, 4 mm) and 0.679 ± 0.314 μm (total, 6 mm) preoperatively, but 0.206 ± 0.095 μm (total, 4 mm) and 0.816 ± 0.380 μm (6 mm, total) postoperatively. The only statistically significant differences in the postoperative HOAs between LRI and PAK groups were in the S4 and S6 (spherical and spherical-like aberrations being bigger in the PAK group ).There were no vision-threatening complications in either group.

Conclusions

PAK is more effective than LRI in the control of pre-existing manifest astigmatism. LRI causes less accentuation of the spherical HOAs than PAK.

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, Zagazig University, Zagazig, Sharkia, Egypt

    Sameh Fouda

  2. Department of Ophthalmology, Kitasato University, Sagamihara, Kanagawa, Japan

    Kazutaka Kamiya, Daisuke Aizawa & Kimiya Shimizu

Authors
  1. Sameh Fouda
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  2. Kazutaka Kamiya
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  3. Daisuke Aizawa
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  4. Kimiya Shimizu
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Corresponding author

Correspondence to Sameh Fouda.

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None of the authors has a proprietary interest in any material or method mentioned.

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Fouda, S., Kamiya, K., Aizawa, D. et al. Limbal relaxing incision during cataract extraction versus photoastigmatic keratectomy after cataract extraction in controlling pre-existing corneal astigmatism. Graefes Arch Clin Exp Ophthalmol 248, 1029–1035 (2010). https://doi.org/10.1007/s00417-009-1272-6

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  • DOI: https://doi.org/10.1007/s00417-009-1272-6

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