Correction of high astigmatism with astigmatic keratotomy combined with laser in situ keratomileusis

Güell, José L.; Vázquez, Mercedes

doi:10.1016/s0886-3350(00)00406-5

Cited by 34 publications

(8 citation statements)

References 23 publications

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“…Astigmatism higher than 6 D is probably best treated with topographic-guided relaxing incisions to lower SAI and SRI values, convert an asymmetric bowtie perhaps into a symmetric bowtie pattern, and bring the residual astigmatism within the range of current excimer software before performing excimer ablation. 57 …”

Section: Discussionmentioning

confidence: 99%

Arcuate Relaxing Incisions Guided by Corneal Topography for Postkeratoplasty Astigmatism

Geggel

2006

Cornea

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Section: Discussionmentioning

confidence: 99%

Arcuate Relaxing Incisions Guided by Corneal Topography for Postkeratoplasty Astigmatism

Geggel

2006

Cornea

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“…To acquire good postoperative, uncorrected visual acuity, the astigmatism should be minimized. Refractive surgical procedures for eyes with astigmatism include incisional technique (arcuate keratotomy, corneal relaxing incisions, limbal relaxing incisions, or even on-axis phacoemulsification incision), laser vision technique (photorefractive keratectomy, LASIK, and toric IOLs), and a combination of techniques [12, 13]. Arcuate keratotomies or corneal relaxing incisions have limited predictability and often result in overcorrection, especially in eyes with low and moderate astigmatism.…”

Section: Discussionmentioning

confidence: 99%

Effect of Limbal relaxing incisions during implantable collamer lens surgery

Han

et al. 2017

BMC Ophthalmol

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BackgroundThe 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.MethodsA prospective analysis reviewing consecutive cases of corneal astigmatism that had either independent ICL surgery (control group) or combined with LRIs (LRIs group). The study population consisted of 45 patients, 85 eyes, with high myopia and regular corneal astigmatism more than 0.50 diopter (D) and less than 3.00 D. The first group received ICL surgery combined with LRIs (limbal relaxing incisions); the control group received only ICL surgery alone. The outcomes considered were uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCVA), refraction, keratometry, slit lamp biomicroscopy, indirect ophthalmoscopy, corneal topography, corneal astigmatism, endothelial cell count, and patient satisfaction. The follow-up period covered 12 months.ResultsThe mean uncorrected distance visual acuity (UDVA) and the best corrected visual acuity (BCVA) demonstrated statistically significant improvement after surgery in both groups. At the end of the follow-up period, the UCVA was statistically better for the patients with LRIs compared with those underwent ICL surgery alone. The LRIs group showed significant reduction in the mean topographic astigmatism from 1.48 ± 0.35 D preoperatively to 0.37 ± 0.14 D postoperatively (P < .0001) after one month. The control eyes did not show a statistically significant change (P > 0.05). The mean magnitude of the surgically induced astigmatism (SIA) read 1.10 ± 0.35 D,1.13 ± 0.34D,1.13 ± 0.34D,1.11 ± 0.35D by the end of the 1st, the 3rd, the 6th and the 12th month postoperatively in LRIs group, which was slightly lower than the target-induced astigmatism (TIA). The difference in SIA between the LRI and the control group was statistically significant by the end of the 1st, the 3rd, the 6th and the 12th month postoperatively (P < 0.001). The mean correction index (CI) was less than 1, which indicated undercorrection effect of limbal relaxing incision. No difference was observed in the postoperative endothelial cell count between the two groups. There was no intraoperative and postoperative ocular or systemic complication.ConclusionLimbal relaxing incision is an effective method in reducing corneal astigmatism during implantable collamer lens surgery.Trial registrationThe trial was retrospectively registered in 14 April 2017. (NO:ChiCTR-ONR-17011147).Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-017-0458-7) contains supplementary material, which is available to authorized users.

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“…Ведущим способом коррекции астигматизма величиной до 10 Дптр, в том числе после кератопластики, долгое время оставалась астигматическая кератотомия, позволяющая корректировать большую астигматическую ошибку, которую нельзя устранить посредством эксимерного лазера [26]. Однако у нее имеется и существенное ограничение: непредсказуемость роговичных разрезов, выполненных вручную, обуславливает вариабельность их глубины, повышает риск перфорации роговицы, недокоррекции и возникновения индуцированного неправильного астигматизма, а иногда даже увеличивает имеющийся астигматизм [30,43].…”

Section: фемтолазерная коррекция астигматизмаunclassified