Prince Hamzah Hospital, Amman, Jordan.
Department of Special and General Surgery, The Hashemite University, Zarqa, Jordan.
BMC Ophthalmol. 2022 Mar 4;22(1):102. doi: 10.1186/s12886-022-02327-9.
Though Limbal Relaxing Incisions (LRI) were used widely to correct pre-existing corneal astigmatism during cataract surgery, they have been replaced recently with the more expensive methods like the use of toric Intra Ocular Lenses (IOL) and femtosecond during cataract surgery. We conducted our study to re-evaluate the role of (LRI) in correcting pre-existing moderate corneal astigmatism during cataract surgery in settings where other options are neither available nor affordable.
Retrospective analysis of all consecutive cases of LRI performed by a single surgeon at the time of cataract surgery to correct moderate corneal astigmatism (1.5-3D) in a community hospital over a period of 6 months. Corneal astigmatism, uncorrected distance visual acuity (UDVA) and best corrected distance visual acuity (CDVA) were recorded pre-operatively, 4 weeks and 3 months post-operatively. Data on age, intraocular lens (IOL) power, predictive refraction and post-operative spherical equivalent was also collected and analyzed. The number and position of LRI was determined based on the pre-existing corneal astigmatism using online calculator.
29 eyes of 25 patients with the mean age of 73.6 years (range: 46 to 90 years) and corneal astigmatism between 1.5 to 3D were included. Statistically significant reduction in the mean corneal astigmatism was recorded from 2.05 ± 0.45D preoperatively to 0.85 ± 0.56D postoperatively (P < 0.0001). All eyes showed reduction in astigmatism; 83% of eyes had < 1.0D post-operatively and 66% of eyes had < 0.75D. UDVA of 6/9 or better was recorded in 80% of eyes post-operatively (CDVA of 6/9 or better in 100%). The spherical equivalent was within 1.0D of the predictive refraction postoperatively in nearly all eyes (97%) and within 0.5D in 86% of the eyes. There were no peri-operative or post-operative complications were recorded in any case.
Combining LRI and cataract surgery to address moderate degrees of corneal astigmatism is a safe, reliable and predictable option especially in areas where more expensive methods such as toric IOL or excimer laser are not available or affordable. LRI has no significant effect on the spherical equivalent and is an excellent tool in reducing patient's spectacle dependence.
虽然 Limbal Relaxing Incisions（LRI）广泛用于在白内障手术期间矫正先前存在的角膜散光，但最近已被更昂贵的方法（如使用 toric Intra Ocular Lenses（IOL）和白内障手术期间的飞秒激光）所取代。我们进行这项研究是为了重新评估在其他方法既不可用也不可负担的情况下，在白内障手术期间进行 LRI 以矫正先前存在的中度角膜散光的作用。
对在社区医院进行白内障手术的一位外科医生在 6 个月期间进行的所有 LRI 连续病例进行回顾性分析，以矫正中度角膜散光（1.5-3D）。术前、术后 4 周和 3 个月记录角膜散光、未矫正远视力（UDVA）和最佳矫正远视力（CDVA）。还收集和分析了年龄、眼内晶状体（IOL）度数、预测屈光和术后等效球镜度数的数据。根据先前存在的角膜散光，使用在线计算器确定 LRI 的数量和位置。
纳入了 25 名患者的 29 只眼，平均年龄为 73.6 岁（范围：46 至 90 岁），角膜散光在 1.5 至 3D 之间。术前平均角膜散光从 2.05±0.45D 显著降低至术后 0.85±0.56D（P<0.0001）。所有眼睛的散光均有减少；术后 83%的眼睛散光<1.0D，66%的眼睛散光<0.75D。术后 80%的眼睛 UDVA 达到 6/9 或更好（100%的眼睛 CDVA 达到 6/9 或更好）。术后几乎所有眼睛（97%）的等效球镜度数均在预测屈光度数的 1.0D 以内，86%的眼睛在 0.5D 以内。在任何情况下均未记录到围手术期或术后并发症。
将 LRI 与白内障手术结合起来矫正中度角膜散光，是一种安全、可靠和可预测的选择，尤其是在无法获得或负担得起 toric IOL 或准分子激光等更昂贵方法的地区。LRI 对等效球镜度数没有显著影响，是减少患者对眼镜依赖的极好工具。
