A Study Of Astigmatism By Phacoemulsification Combined With Different Length Incision

Objective: To evaluate the efficacy, predictability, and safety of phacoemulsification combined with limbal relaxing incisions(LRI) on the correction of corneal astigmatismMethod:140 cataract patients(140 eyes) hospitalized in the ophthalmology department of Wuhan Union hospital were involved in the study. IOL master measured the preoperative corneal astigmatism. According to corneal astigmatism,they were divided into three groups. There are 20 patients(20 eyes), whose preoperative corneal astigmatism were more than 1.5 D were included in the control group.60 patients(60 eyes) whose corneal astigmatism were between 1.5 D to 2.5 D,were included in group A. Another 60 patients, whose preoperative corneal astigmatism larger than 2.5 D were included in B group. In the control group, all patient only received normal phacoemulsification with the temporal corneal incision.In both A and B group, patients received phacoemulsification with temporal corneal incision, combined with limbal relaxing incisions(LRI) at the steepest meridian axis.In each LRI group, we divided the patients into three groups(30 degrees, 45 degrees,and 60 degrees) equally and randomly, according to the incision length. At 3 months postoperatively, IOL-master measured the residual corneal astigmatism. The results were statistically analyzed.Results In all three groups, postoperative uncorrected visual acuity was obviously improved.According to the statistical analyze of the control group, there was no different astigmatism change between pre- and post-operation. But in the LRI group, the corneal astigmatism was obviously improved in both group A and group B. What is more, in both A and B group, there was a positive correlation existed between the limbal relaxing incision length and the corrected corneal astigmatism. When the pre-operative corneal astigmatism is more than 1.5 D, 60 degrees LRI is the optional solution for the astigmatism correction.Conclusion Normal phacoemulsification, with temporal corneal incision, will not cause significantly iatrogenic astigmatism. Phacoemulsification combined with limbal relaxing incisions(LRI), can be used to correct the pre-operative corneal astigmatism.There was a positive correlation existed between the limbal relaxing incision length and corrected astigmatism. Phacoemulsification combined with limbal relaxing incisions(LRI), is an easy-to-follow, economic, effective and safe method to reduce corneal astigmatism.