Peripheral corneal relaxing incisions after excimer laser refractive surgery

Abstract

Purpose: To evaluate the effectiveness of peripheral corneal relaxing incisions (PCRIs) for correcting corneal astigmatism after excimer laser refractive surgery. Setting: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. Methods: In this retrospective case series, PCRIs were performed in 33 eyes (30 patients) that had residual astigmatism after photorefractive keratectomy or laser in situ keratomileusis according to a nomogram based on age and preoperative refractive astigmatism. Uncorrected visual acuity (UCVA) and refractive and keratometric astigmatism were evaluated, and vector analysis using the Holladay-Cravy-Koch formula was performed. Results: The percentage of eyes with a UCVA of 20/20 or better increased significantly from 6% (2/33) preoperatively to 61% (20/33) postoperatively ( P<.001). Refractive astigmatism was reduced significantly, and the effect was stable up to 1 year after PCRIs. The percentage of eyes within ±0.5 diopter (D) and ±1.0 D of cylinder increased by 73% and 52%, respectively (both P<.001). No eye lost 1 or more lines of best spectacle-corrected visual acuity. Conclusion: Peripheral corneal relaxing incisions are an effective approach for correcting low amounts of corneal astigmatism in eyes that have had excimer laser refractive surgery.