Changes in Wavefront Aberration by Limbal Relaxing Incision After Cataract Surgery

Abstract

Purpose: : To investigate the changes in wavefront aberration by limbal relaxing incision (LRI) after cataract surgery.

Methods: : Eighteen eyes of 18 cases after cataract surgery and intraocular lens implantation were included in this study. Their age ranged from 60 to 87 years (75.3±7.2 years), and there were 10 males and 8 females. The patients had astigmatism of 2 diopters (D) or larger, and logMAR uncorrected visual acuity (UCVA) was 0.10 or worse. LRI was performed by a single surgeon (KM). A 550 µm depth incision was created by a diamond knife along the corneal limbus in the steepest meridian. UCVA, best corrected visual acuity (BCVA), mean spherical equivalent (MSE), cylindrical refraction, and wavefront aberration were examined before and 1 month after surgery. Corneal and ocular wavefront aberration was measured with the Hartmann–Schack Wavefront analyzer KR–9000PW (Topcon Inc. Japan).

Results: : By LRI, logMAR UCVA improved from 0.388 to 0.079 (p<0.0001). LogMAR BCVA changed from –0.041 to –0.071. MSE showed a hyperopic shift from –0.43±0.62D to 0.04±0.64D (p=0.0019). Refractive astigmatism was reduced from –2.90±1.20D to –0.90±0.92D (p<0.0001). Third order (p=0.0093), fourth order (p<0.0001), and total higher–order (p=0.0030) aberration of the cornea significantly increased. Ocular fourth order (p=0.0038) and total higher–order (p=0.0498) aberration significantly increased by LRI.

Conclusions: : LRI after cataract surgery improved astigmatism and UCVA, but both corneal and ocular wavefront aberration significantly increased by surgery.

Keywords: refractive surgery • astigmatism