Outcomes of peripheral corneal relaxing incisions for residual astigmatism in patients after cataract surgery

Abstract

Purpose: To evaluate the outcomes of peripheral corneal relaxing incisions (PCRIs) for correcting residual astigmatism in eyes after cataract surgery. Setting: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas. Design: Retrospective case series. Methods: Retrospectively, we reviewed all consecutive cases that had previous cataract surgery and subsequent PCRIs by 1 surgeon. The PCRI length was determined according to a nomogram based on age and manifest refractive astigmatism. Visual acuity and manifest refractive astigmatism before and after the PCRIs were compared. Vector analysis was performed, and net refractive changes along the incision meridian were calculated. Results: Criteria were met by 111 eyes. After the PCRIs, mean uncorrected visual acuity was significantly improved, and the percentage of eyes with uncorrected distance visual acuity of ≥20/20 increased significantly by 36%; the mean refractive astigmatism magnitude decreased significantly, and the percentages of eyes with refractive cylinder of ≤0.25 diopters (D) and ≤0.50 D increased significantly by 63% and 75%, respectively (all P < .05). The vector magnitude difference between pre- and post-operative refractive astigmatism was 0.88 ± 0.38 D. The postoperative refractive astigmatism had significantly smaller centroid and variance values than the preoperative refractive astigmatism (P < .05). Conclusions: PCRIs are an effective approach for correcting low amounts of residual astigmatism in patients after cataract surgery.