Limbal Relaxing Incisions for Astigmatism Correction in Pseudophakic Patients From a Low-Income Population

Sunday, April 19, 2015: 4:02 PM
Room 5B (San Diego Convention Center)
Iran Guimar„es Sr., MD
Isaac C. Ramos, MD
Bruno M. Fontes, MD, PhD

Purpose
To assess the safety, effectiveness, and visual results of limbal relaxing incisions to correct astigmatism in pseudophakic patients from a low-income population.

Methods
This was a prospective, randomized, comparative interventional study. Patients underwent corneal incisional surgery, as planned by the Donnenfeld nomogram, under topical anesthesia. Complete preoperative and postoperative ocular evaluation included dynamic refraction, visual acuity assessment, slit-lamp examination, corneal pachymetry, and topography measurements. Preoperative measurements were compared to those obtained 3 months postoperatively.

Results
A total of 26 eyes for 26 pseudophakic patients with residual astigmatism of ≥0.61 Diopters (D) were enrolled and followed for 3 months. No surgical or postoperative complications such as best-corrected visual loss, wound gaping, or corneal infection were noted. Significant reductions in preoperative and postoperative corneal and refractive astigmatism were found (from -1.74 ± 0.62 D to -0.84 ± 0.34 D [p < 0.0001] and -2.36 ± 0.84 D to -0.82 ± 0.34 D [p < 0.0001], respectively). Uncorrected distance visual acuity (LogMar) improved from 0.67 ± 0.39 to 0.39 ± 0.32 (p < 0.0001). A negative correlation was found when comparing corneal thickness and astigmatism reduction with corneal incisions.

Conclusion
Limbal relaxing incisions were found to be safe and effective for astigmatism correction in pseudophakic patients from a low-income population and improved these patients’ uncorrected visual acuity.