Effect of Limbal Relaxing Incisions on Corneal Aberrations

PURPOSE:To study the effect of limbal relaxing incisions on corneal aberrations after phacoemulsification with aspheric intraocular lens (IOL) implantation.METHODS:Forty-five eyes underwent microincision cataract surgery with on-axis phacoemulsification incision. These eyes were divided into two groups: limbal relaxing incision group (23 eyes) and control group (22 eyes). In the limbal relaxing incision group, a single limbal relaxing incision was performed on the steepest meridian of corneal topography and the degrees of arc were determined using the DONO-Donnenfeld nomogram. The eyes in the control group were operated on by microincision cataract surgery without limbal relaxing incision. Corneal topography and wavefront analysis over 6-mm pupil size were performed preoperatively and 1 month postoperatively in both groups. Target induced astigmatism vector, surgically induced astigmatism vector, difference vector, magnitude of error, flattening effect, and torque were analyzed using the Alpins vectorial method.RESULTS:The limbal relaxing incision group showed significant reduction in topographic astigmatism by 51.87% of preoperative topographical astigmatism (The limbal relaxing incision group showed significant reduction in topographic astigmatism by 51.87% of preoperative topographical astigmatism (P< .0001). The mean surgically induced astigmatism of limbal relaxing incision was 1.29 ± 0.71 diopters (D), which was close to the mean target induced astigmatism (1.33 ± 0.20 D), whereas the control group did not show a significant change in topographic astigmatism (0.17 ± 0.11 D; P= .73). Higher order aberrations of the cornea did not show significant change in either group except quatrefoil aberration, which significantly increased in the limbal relaxing incision group but not in the control group, with no significant difference between the two groups regarding corneal aberrations.CONCLUSIONS:Limbal relaxing incision is an effective method in reducing corneal astigmatism with neutral effect on corneal aberrations.[[J Refract Surg. 2016;32(3):156–162.]