Influence of peripheral corneal relaxing incisions during cataract surgery for corneal astigmatism up to 2.5 dioptres on corneal densitometry

Abstract

To assess the effect of peripheral corneal relaxing incisions (PCRI) for astigmatism between 0.75 and 2.5 dioptres during cataract surgery on corneal densitometry (CD). Methods: In this prospective, randomised study, 80 eyes (80 patients), received either tIOL or PCRI. Assessment at preoperative and 1, 3, 6, 12 months post-operative visit included uncorrected (UCDVA) and best-corrected distance visual acuity (BCDVA), spherical equivalent (SEQ) (only post-operatively), mean anterior and posterior keratometric astigmatism (K A) and CD with Schiempflug system. CD was analysed in four concentric radial zones from centre to periphery (Zone 1 to 4) and in 3 layers (anterior, mid-stromal and posterior). Results: Comparing tIOLs vs. PCRIs, there was no significant difference in the UCDVA, BCDVA and SEQ. In PCRI group, anterior K A decreased at 1 month and remained stable thereafter. For zones 1, 2 and 3, CD significantly reduced after 3 months with tIOLs whereas with PCRIs, it reduced 1 month onwards. For zone 4, CD reduced only at 12 months with tIOLs compared to 3 months onwards with PCRIs. In both groups CD was higher in the zone 4 and anterior layer. Significant reduction in CD was found in all three layers of cornea after 3 months in tIOL and after first month in PCRI groups, respectively. Conclusions: Cataract surgery alone reduces the CD. Reducing keratometric astigmatism with PCRIs shows significant differences in CD from early post-operative period for central and anterior corneal layer.

Corneal astigmatic outcomes after femtosecond laser-assisted cataract surgery combined with surface penetrating arcuate keratotomies

“…As such the aim of modern cataract surgery is not just confined to the restoration of vision, but also to the neutralization of spherical refractive error, and corneal astigmatism (CA) to diminish postoperative dependence on spectacles [2][3][4][5] . Peripheral corneal relaxing incisions (PCRIs) have been employed for decades to reduce CA at the time of cataract surgery and have been accompanied by the development of multiple nomograms and methodologies to optimize their efficacy [6][7][8][9][10][11] . With the advent of femtosecond laser, femtosecond laser-assisted arcuate keratotomies (FAKs) have been advocated to reduce CA at the time of cataract surgery and optimize unaided visual acuity [6,[12][13][14][15][16] .…”