Incisiones limbares relajantes y cirugía de la catarata: nuestra experiencia

Abstract

RESUMENObjetivo: Evaluar la reducción del astigmatismo corneal preexistente en la cirugía de catarata mediante incisiones limbares relajantes (ILRs). Método: Estudio prospectivo de dos grupos de pacientes (tratamiento y control) con astigmatismo prequirúrgico ≥1D. Los 30 pacientes del grupo control fueron sometidos a facoemulsificación por incisión temporal en córnea clara y los 32 pacientes del grupo tratamiento a ILRs junto a facoemulsificación por incisión temporal en córnea clara. Se usó el test de Holladay para valorar la eficacia del tratamiento. Asimismo, presentamos un pequeño estudio de la prevalencia y distribución del astigmatismo en nuestra población de trabajo. Resultados: El seguimiento promedio de los 62 pacientes fue de 3 meses, con un cambio astigmáti-co medio a los 3 meses de -0.55D (-0,75 a -0,35) en el grupo tratamiento y de 0.04D (-0,3 a 0,3) en el grupo control (p<,000). ARTÍCULO ORIGINAL ABSTRACTPurpose: To evaluate the reduction of pre-existing corneal astigmatism at the time of cataract surgery with limbal relaxing incisions (LRIs). Methods: A prospective study of two groups of patients (treatment and control) with pre-existing astigmatism ≥1D was performed. The 30 patients in the control group had a temporal clear corneal phacoemulsification and the 32 patients of treatment group had combined temporal clear corneal phacoemulsification and LRIs. Holladay analysis was used to assess the efficacy of treatment. An astigmatism distribution and prevalence study in our population is also presented. Results: Three months after surgery, the mean astigmatism change was -0.55D (-0.75 to -0.35) in the treatment group and 0.04D (-0.3 to 0.3) in the control group (p<.0001). Conclusions: LRI is a simple, safe and effective method not only for reducing pre-existing astigma-

Comparison of toric intraocular lenses and peripheral corneal relaxing incisions to treat astigmatism during cataract surgery

“…8 However, the amount of astigmatism that can be corrected and the predictability and stability of the correction are controversial. [8][9][10][11][12] Moreover, studies of recently introduced toric IOLs 13-17 show them to be a promising option with excellent outcomes. Given the improvement in the rotational stability of toric IOLs, 13,14 it is import to ascertain whether the results exceed those with conventional incision techniques.…”

“…It is estimated that approximately 50% of the population older than 60 years has more than 1.00 diopter (D) of astigmatism 1 and that up to 22% of cataract surgery candidates have preexisting astigmatism exceeding 1.50 D. [2][3][4] Although not firmly established, the level of cylindrical defect that can be considered clinically significant is approximately 0.50 to 1.00 D. 5 Treatment options to address preoperative astigmatism include positioning or enlarging the main incision, performing astigmatic keratotomy, [6][7][8][9][10][11] creating opposite clear corneal incisions, using laser ablative procedures, and implanting a toric intraocular lens (IOL). 12-17,A In eyes with low to moderate astigmatism, creating peripheral corneal relaxing incisions, also known as limbal relaxing incisions, is one of the most widespread techniques.…”

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“…[8][9][10] Coloma-González I et al reported LRI as a safe as well as an effective way to reduce any pre-existing astigmatism during cataract surgery and importantly it provides good unaided visual acuity. 10 Lim R et al further evaluated the long term stability of keratometric effects of LRI and reported that the keratometric effects of LRI were stable at 10 weeks to 3 years after the surgery. 11 Sharma and Kumar study evaluated LRI when done along with cataract surgery and concluded that LRI can reduce preoperative astigmatism effectively and with a good predictability of the angle.…”