Original Article
Limbal Relaxing Incisions Using a Reference Point and Corneal Topography for Intraoperative Identification of the Steepest Meridian
Kazunori Miyata, MD, PhD; Takashi Miyai, MD; Keiichiro Minami, PhD; Hiroko Bissen-Miyajima, MD, PhD; Naoyuki Maeda, MD, PhD; Shiro Amano, MD, PhD
Journal of Refractive Surgery
May 2011 - Volume 27 · Issue 5: 339-344
DOI: 10.3928/1081597X-20101005-02
PURPOSE
To examine the efficacy and safety of topography-based limbal relaxing
incision (LRI) surgery.
METHODS
Forty-four eyes of 36 consecutive patients who underwent cataract
surgery more than 1 month previously, had refractive against-the-rule
astigmatism of >2.00 diopters (D), and were scheduled to undergo LRI
surgery were enrolled in the study. Patients were randomized into two
groups—a topography-based LRI group (19 eyes of 14 patients) and a
conventional LRI group (25 eyes of 22 patients). The topography-based LRI
procedure comprised 3 steps: placing a mark on the cornea and conjunctiva,
identifying this mark in the topographic image, and performing LRI based on the
location of the mark. In the conventional LRI group, the horizontal meridian
was marked under a slit lamp and LRIs were made based on the position of the
horizontal mark.
RESULTS
Corneal astigmatism in the topography-based LRI group before and 1
month after surgery was 2.03±0.92 D and 1.33±0.69 D, respectively
(P=.014). Corneal astigmatism in the conventional LRI group before and 1
month after surgery was 2.36±0.77 D and 0.93±0.70 D, respectively
(P<.0001). Fourier harmonic analysis of the topography data
demonstrated that regular astigmatism was significantly decreased in the two
groups. The mean regular astigmatism was not significantly different before and
after LRI between groups, whereas the variances (mean of the deviation squared
from its mean) of regular astigmatism were significantly different between
groups 1 month after LRI.
CONCLUSIONS
Compared with conventional LRI surgery, a topography-based procedure may
reduce the deviation of the effect of LRIs. [J Refract Surg.
2011;27(5):339-344.]
doi:10.3928/1081597X-20101005-02
ABOUT THE AUTHORS
From Miyata Eye Hospital, Miyazaki (Miyata, Miyai, Minami); Department
of Ophthalmology, Tokyo Dental College, Suidobashi Hospital, Tokyo
(Bissen-Miyajima); Department of Ophthalmology, Osaka University Medical
School, Osaka (Maeda); and Department of Ophthalmology, University of Tokyo
School of Medicine, Tokyo (Amano), Japan.
The authors have no commercial or proprietary interest in the materials
presented herein.
Correspondence: Shiro Amano, MD, PhD, 7-3-1 Hongo, Bunkyo-ku, Tokyo,
113-8655 Japan. Tel: 81 35800 5109; Fax: 81 35600 5109; E-mail:
amanos-tky@umin.ac.jp
Received: December 2, 2009; Accepted: August 27, 2010
Posted online: October 15, 2010
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