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Limbal relaxing incision

Connor J Baharozian, Christian Song, Kathryn M Hatch, Jonathan H Talamo
PURPOSE: The purpose of this study was to determine an arcuate incision (AI) nomogram to treat astigmatism during femtosecond laser-assisted cataract surgery. METHODS: This is a retrospective, cohort study. Femtosecond laser (FSL)-assisted transepithelial AIs were created at a 9.0 mm optical zone, 80% depth, centered on the limbus. We modified the manual Donnenfeld limbal relaxing incision nomogram to 70% for with-the-rule (WTR), 80% for oblique (OBL), and 100% for against-the-rule (ATR) astigmatism...
2017: Clinical Ophthalmology
Soosan Jacob, Amar Agarwal, Athiya Agarwal, Saijimol Ai
PURPOSE: To report a new technique called relaxing Descemetotomy for treatment of bullous Descemet detachment (BDD) secondary to accidental hydroseparation of Descemet membrane (DM) during stromal hydration in cataract surgery. METHODS: A clear corneal keratome entry was created close to the limbus extending inward to create a relaxing cut (ab externo relaxing Descemetotomy) on taut DM, thus creating an egress route for supra-Descemetic fluid (SDF). This was followed by pneumodescemetopexy to drain SDF internally...
October 17, 2017: Cornea
Zhen Li, Yu Han, Budan Hu, Huibin Du, Gengsheng Hao, Xiaoxi Chen
BACKGROUND: The limbal relaxing incisions (LRIs) technique is a safe and an inexpensive procedure, which is simple for experts to perform. It can effectively reduce astigmatism and result in a rapid visual rehabilitation. But there are few reports about reducing pre-existing corneal astigmatism by LRI in ICL surgery. Our research was aimed to study the effect of limbal relaxing inci sions during implantable collamer lens (ICL) surgery. METHODS: A prospective analysis reviewing consecutive cases of corneal astigmatism that had either independent ICL surgery (control group) or combined with LRIs (LRIs group)...
May 8, 2017: BMC Ophthalmology
Aravind Haripriya, Anand Smita
We report a case of keratitis associated with limbal relaxing incision (LRI). The patient presented with progressive loss of vision with best-corrected visual acuity 20/40. Immature cataract with 1.43D against the rule astigmatism was noted. Prophylactic topical antibiotic was administered before surgery. He underwent uneventful phacoemulsification with intraocular lens implantation with LRI. On the 33rd postoperative day (POD), he presented with infiltrate along LRI site with mild iritis. Corneal scraping was positive for Staphylococcus aureus...
December 2016: Indian Journal of Ophthalmology
Jeihoon Lee, Hun Lee, David Sung Yong Kang, Jin Young Choi, Eung Kweon Kim, Tae Im Kim
PURPOSE: To compare the effectiveness of toric foldable iris-fixated phakic intraocular lens (pIOL) implantation and non-toric foldable iris-fixated pIOL implantation with limbal relaxing incisions (LRIs) for correcting moderate-to-high astigmatism in myopic eyes. MATERIALS AND METHODS: The medical records of 146 patients (195 eyes) with myopic astigmatism who underwent toric foldable iris-fixated pIOL implantation (toric group; 94 eyes) or non-toric foldable iris-fixated pIOL implantation with concurrent LRIs (LRI group; 101 eyes) were retrospectively reviewed...
November 2016: Yonsei Medical Journal
Hossein Mohammad-Rabei, Elham Mohammad-Rabei, Goldis Espandar, Mohammad Ali Javadi, Mohammad Reza Jafarinasab, Seyed Javad Hashemian, Sepehr Feizi
PURPOSE: To compare the safety and efficacy of three methods for correcting pre-existing astigmatism during phacoemulsification. METHODS: This prospective, comparative, non-randomized study was conducted from March 2010 to January 2011, and included patients with keratometric astigmatism ≥1.25 D undergoing cataract surgery. Astigmatism was corrected using the following approaches: limbal relaxing incisions (LRI) on the steep meridian, extension and suturing of the phaco incision created at the steep meridian (extended-on-axis incision, EOAI), and toric intraocular lens (tIOL) implantation...
April 2016: Journal of Ophthalmic & Vision Research
Allister Gibbons
PURPOSE: We report the surgical management of a patient with glaucoma undergoing cataract surgery with high preexisting astigmatism. A combination of techniques was employed for her astigmatism management. METHODS: A 76-year-old female with 5.5 dpt of corneal astigmatism underwent surgery in her left eye consisting of one-site trabeculectomy, phacoemulsification, toric intraocular lens implantation and a single inferior limbal-relaxing incision. RESULTS: Intraocular pressure control was achieved with no medication at 11 mm Hg; before the filtering procedure, the pressure was 16 mm Hg on two topical drugs...
January 2016: Case Reports in Ophthalmology
Shaowei Li, Xu Chen, Yanwei Kang, Na Han
PURPOSE: To describe a 43-year-old man who presented with a nuclear cataract in the right eye after a previous collamer lens (Visian Implantable Collamer Lens [ICL]; STAAR Surgical, Monrovia, CA) implantation procedure. METHODS: Case report. RESULTS: Before the ICL was removed, femtosecond-laser-assisted capsulotomy, crystalline lens fragmentation, and limbal relaxing incisions were performed sequentially. After explantation of the ICL, the phacoemulsification procedure was performed simultaneously with intraocular lens implantation...
April 2016: Journal of Refractive Surgery
Tamer F Eliwa, Mona K Abdellatif, Ismail I Hamza
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...
March 2016: Journal of Refractive Surgery
Alexander C Day, Julian D Stevens
PURPOSE: To evaluate the factors associated with the efficacy of femtosecond laser intrastromal astigmatic keratotomy (AK). SETTING: Moorfields Eye Hospital, London, United Kingdom. DESIGN: Prospective case series. METHODS: Eyes having intrastromal AK for corneal cylinder correction were analyzed. Preoperative biometric parameters included axial length, anterior chamber depth, central corneal thickness, and Ocular Response Analyzer corneal hysteresis (CH) and corneal resistance factor (CRF)...
February 2016: Journal of Cataract and Refractive Surgery
Takahisa Koga, Tomoyo Koga
PURPOSE: To investigate the preoperative factors affecting postoperative uncorrected visual acuity (UCVA) equal to or more than 20/20. SUBJECTS AND METHODS: One hundred sixty seven eyes receiving apodized diffractive multifocal intraocular lenses (SN6AD1) were included in this study. In the eyes with corneal astigmatism of less than 1.0 D, a 2.4 mm clear temporal corneal incision was created. In those equal to or more than 1.0 D, 4.1 mm steepest meridian clear corneal incisions and/or limbal relaxing incisions were conducted...
December 2015: Nippon Ganka Gakkai Zasshi
Dilraj S Grewal, Tim Schultz, Surendra Basti, H Burkhard Dick
Femtosecond laser-assisted cataract surgery (FLACS) putatively offers several advantages over conventional phacoemulsification. We review the current status of FLACS and discuss the evolution of femtosecond lasers in cataract surgery and the currently available femtosecond laser platforms. We summarize the outcomes of FLACS for corneal wound creation, limbal relaxing incisions, capsulotomy, and lens fragmentation. We discuss surgical planning, preoperative considerations, clinical experiences including the learning curve and postoperative outcomes with FLACS, and also the cost effectiveness of FLACS...
March 2016: Survey of Ophthalmology
Gaspare Monaco, Antonio Scialdone
PURPOSE: To compare the final changes in corneal wavefront aberration by limbal relaxing incisions (LRIs) after cataract surgery. METHODS: This prospective cumulative interventional nonrandomized case study included cataract and astigmatic patients undergoing LRIs and phaco with intraocular lens implantation. LRIs were planned using Donnenfeld nomogram. The root mean square of corneal wave aberration for total Z(n,i)(1≤n≤8), astigmatism Z(2,±1), coma Z(3-5-7,±1), trefoil Z(3-5-7,±2), spherical Z(4-6-8,0), and higher-order aberration (HOA) Z(3≤n≤8) was examined before and 3 years after surgery (optical path difference-Scan II [OPD-Scan II)]...
2015: Clinical Ophthalmology
Pia Leon, Marco Rocco Pastore, Andrea Zanei, Ingrid Umari, Meriem Messai, Corrado Negro, Daniele Tognetto
AIM: To evaluate and compare aspheric toric intraocular lens (IOL) implantation and aspheric monofocal IOL implantation with limbal relaxing incisions (LRI) to manage low corneal astigmatism (1.0-2.0 D) in cataract surgery. METHODS: A prospective randomized comparative clinical study was performed. There were randomly recruited 102 eyes (102 patients) with cataracts associated with corneal astigmatism and divided into two groups. The first group received toric IOL implantation and the second one monofocal IOL implantation with peripheral corneal relaxing incisions...
2015: International Journal of Ophthalmology
Douglas K T Lam, Vanissa W S Chow, Cong Ye, Paul Ka-Fai Ng, Zheng Wang, Vishal Jhanji
PURPOSE: To compare the visual outcomes of aspheric toric intraocular lens (IOL) implantation and limbal relaxing incisions (LRI) for management of coexisting age-related cataracts and astigmatism. METHODS: In this prospective study, sixty eyes of 60 patients with visually significant cataract and coexisting corneal astigmatism ≤3 dioptres (D) were randomised to undergo phacoemulsification with either aspheric toric IOL or aspheric monofocal IOL with LRI. The main outcome measures were postoperative 3-month uncorrected visual acuity (UCVA), contrast sensitivity, rotational stability of the toric IOL and spectacle independence...
February 2016: British Journal of Ophthalmology
Noel Alpins, James K Y Ong, George Stamatelatos
PURPOSE: To evaluate the performance of corneal topographic astigmatism (CorT) based on total corneal power measurements. METHODS: Anterior, posterior, and total corneal power measurements of 526 virgin eyes obtained using the CSO Sirius tomographer (Costuzione Strumenti Oftalmici, Scandicci, Florence, Italy) were analyzed. Individual CorTs were created from each set of data. These CorTs were assessed using ocular residual astigmatism (ORA), which quantifies corneo-refractive differences...
March 2015: Journal of Refractive Surgery
Rongxuan Lim, Edmondo Borasio, Luca Ilari
PURPOSE: To study the keratometric stability of limbal relaxing incisions (LRIs) performed during cataract surgery. SETTING: Princess Royal University Hospital, Kent, United Kingdom. DESIGN: Retrospective case series. METHODS: Medical notes of patients who had small-incision cataract surgery combined with LRIs between November 2006 and December 2010 were reviewed. Keratometric astigmatism was measured using Scheimpflug pachymetry (Pentacam)...
October 2014: Journal of Cataract and Refractive Surgery
Giuliano Oliveira Freitas, Joel Edmur Boteon, Mario José Carvalho, Rogerio Melo Costa Pinto
PURPOSE: To compare the effectiveness of limbal relaxing incisions (LRI) with that of toric intraocular lens (IOL) implantation for the treatment of astigmatism during phacoemulsification using nonvectorial (predictability, safety, and efficacy) and vectorial analyses. METHODS: This longitudinal observational case series assessed 62 eyes of 31 consecutive cataract patients with preoperative corneal astigmatism of 0.75-2.50 diopters (D) in both eyes. Patients were randomly assigned to 2 groups: a toric IOL group, which received toric IOLs in both eyes, and an LRI group, which received spherical IOLs associated with LRI placement in both eyes...
January 2014: Arquivos Brasileiros de Oftalmologia
Masayuki Ouchi
Clinical outcomes were compared between high-cylinder toric intraocular lens (IOL) implantation and the combined surgery of low-cylinder toric IOL implantation and limbal relaxing incision (LRI) for correcting preexisting high-amplitude corneal astigmatism. Fifty-seven eyes with preexisting corneal astigmatism of 2.5 diopter (D) or greater were divided into the following two groups: (1) eyes that underwent Alcon AcrySof® IQ Toric T6, T7, T8, or T9 IOL implantation (toric group); and (2) eyes that underwent the combined surgery of AcrySof® IQ Toric T5 IOL implantation and LRI (LRI group)...
2014: Clinical Ophthalmology
Kathryn M Hatch, Jonathan H Talamo
PURPOSE OF REVIEW: The use of the femtosecond laser (FSL) in cataract surgery may represent the largest advancement in the field since the inception of phacoemulsification. The goal of this review is to outline the benefits of and barriers to this technology. RECENT FINDINGS: There are several significant potential benefits of the FSL in cataract surgery over conventional manual cataract surgery: precise capsulotomy formation, clear corneal and limbal relaxing incision construction, lens fragmentation, and lens softening...
January 2014: Current Opinion in Ophthalmology
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