Corneal relaxing incision combined with phacoemulsification and IOL implantation

OBJECTIVE: To analyze the effectiveness and safety of corneal relaxing incisions (CRI) in correcting keratometric astigmatism during cataract surgery. METHODS: A prospective study of two groups: control group and treatment group. A treatment group included 25 eyes of 25 patients who had combined clear corneal phacoemulsification, IOL implantation and CRI. A control group included 25 eyes of 25 patients who had clear corneal phacoemulsification and IOL implantation. Postoperative keratometric astigmatism was measured at 1 week, 1 month, 3 months and 6 months. RESULTS: CRI significantly decreased keratometric astigmatism in patients with preexisting astigmatism compared with astigmatic changes in the control group. In eyes with CRI, the mean keratometric astigmatism was 0.29+/-0.17 D (range 0 to 0.5 D) at 1 week, 0.41+/-0.21 D (range 0 to 0.82 D) at 1 month, respectively reduced by 2.42 D and 2.30 D at 1 week and 1 month postoperatively (P=0.000, P=0.000), and postoperative astigmatism was stable until 6 months follow-up. The keratometric astigmatism of all patients decreased to less than 1.00 D postoperatively. CONCLUSIONS: CRI is a practical, simple, safe and effective method to reduce preexisting astigmatism during cataract surgery. A modified nomogram is proposed. The long-term effect of CRI should be investigated.