Single and dual limbal relaxing incisions in correcting corneal astigmatism during cataract surgery

Abstract

Introduction: Correcting astigmatism during cataract surgery to achieve optimal visual outcomes is important. Various techniques, such as limbal relaxing incisions (LRIs), are used to correct astigmatism. LRIs are effective for mild to moderate astigmatism but have limitations in correcting larger astigmatism. This study aimed to review the effectiveness of single and dual LRI in correcting astigmatism during cataract surgery. Methods: This literature review utilized databases from 2010 until 2022. The keywords “corneal astigmatism”, “limbal relaxing incision”, and “cataract surgery” were used to collect 12 journals that had relevant topics. Results: LRIs are a form of partial-thickness keratotomy used to correct astigmatism during cataract surgery. The incisions for LRIs are made in the peripheral cornea, following a nomogram based on the patient's astigmatism, age, and the location of the steep axis of astigmatism. LRIs can be performed as single or dual incisions, with dual LRIs offering greater astigmatism correction. In the case of irregular astigmatism, LRIs can be adjusted to the topography of the cornea because the lengths of coupled incisions can vary. Conclusion: The effectiveness between single and dual LRIs was the same, but paired LRIs have a superior effect in correcting greater astigmatism. LRIs remain a valuable tool for cataract surgeons to manage astigmatism and improve visual outcomes in cataract surgery patients.