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Changes in the corneal wavefront aberration of limbal relaxing incisions during cataract surgery
Session Title: Quality of vision evaluation techniques
Session Date/Time: Tuesday 08/10/2013 | 14:00-16:00
Paper Time: 15:16
Venue: Elicium 2 (First Floor)
First Author: : A.Scialdone ITALY
Co Author(s): : F. De Gaetano G. Monaco
To investigate the changes in corneal indices and wavefront aberration by limbal relaxing incisions (LRI) during cataract surgery.
Fatebenefratelli e Oftalmico Hospital, Milan, Italy.
This single-center, prospective study evaluated 52 eyes of 46 patients with cataract and corneal astigmatism that underwent LRI, phacoemulsification and intraocular lens implantation. The patients had astigmatism of 0.6 diopters (D) or larger. LRI were performed by a single surgeon (AS) using a diamond knife (preset 600 micron-depth) along the corneal limbus in the steepest meridian. An online calculator (www.LRIcalculator.com) was used preoperatively to plan for the LRI taking into account the vector from the phaco incision. Uncorrected (UCVA) and best corrected visual acuities (BCVA), simulated keratometric cylinder (CYL), axis shift (AS), obtained versus expected CYL, surface regularity index (SRI), standard deviation of corneal power (SDP), corneal higher-order aberrations (cHOAs) and Strehl ratio (order of aberrations calculated: 3?n?8), coma Z(3,G1), trefoil Z(3,G2) and spherical aberration Z(4,G0) were examined before and 3 month after surgery using the OPD-Scan II (Nidek, Gamagori, Japan).
The age population ranged from 92 to 42 years (70.6±8.4 years), and there were 19 males and 27 females. By LRI, logMAR UCVA improved from 0.361 to 0.141 (p<0.001). Mean postop LogMAR BCVA was 0.05. CYL was reduced from 2.00±0.46D to 1.26±0.87D (p=0.01) without a significant AS. The difference between obtained and expected CYL was -1.31 D (P=0.0001). No difference was seen in SRI, SDP, cHOAs, Strehl ratio, coma, trefoil and spherical aberration at 3-months follow up.
In this study, we showed that LRI don"t affect visual optical quality as demonstrated by the analysis of both corneal wavefornt aberrations and topography indices. Yet, even though LRI have confirmed an improvement of astigmatism and UCVA, the target CYL has not been reached.