management of corneal astigmatism by limbal relaxing incisions during cataract surgery

purpose : to evaluate the safety and efficacy of limbal relaxing incisions (lris) for corneal astigmatism correction during phacoemulsification methods : 24 eyes of 24 patients with the mean age of 65.71 years (range: 55 to 83 years) with senile cataracts and mean corneal astigmatism of 1.9±0.83 diopters (d) (range: 1.5 to 3.5 d) were included in this study. all lris were performed during phacoemulsification by one surgeon. topography indices were recorded preoperatively and postoperatively in months 2 and 6. results : a statistically significant reduction in the mean corneal astigmatism was seen from 1.9±0.83 d preoperatively to 1.4±0.84 d and 1.4±0.92, 2 months and 6 months postoperatively (p<0.001). surgical induced astigmatism (sia) (the amount and axis of astigmatism change induced by the surgery) was 0.90±0.48 at 2 months and 0.96±0.59 at 6 months. correction index (ci) (calculated by determining the ratio sia/ target induced astigmatism (tia) was 0.55±0.41 and 0.57±0.32 at 2 and 6 months, respectively. index of success (ios) (ratio of topographic residual astigmatism and tia) was measured 0.44±0.41 and 0.47±0.32 at months 2 and 6 correspondingly. conclusion : combined lri and phacoemulsification appears to be safe and fairly effective to correct mild to moderate corneal astigmatism. however, under correction is a common limitation that may be further managed by modified nomograms in future studies.   iranian journal of ophthalmology 201022(1):15-20 © 2010 by the iranian society of ophthalmology