Prospective randomized trial of limbal relaxing incisions combined with microincision cataract surgery.

PURPOSE To evaluate clinical outcomes of limbal relaxing incision (LRI) combined with bimanual phacoemulsification and insertion of an intraocular lens (IOL) developed for bimanual microincision cataract surgery (MICS). METHODS In a prospective, single-center study, eyes with > or = 0.75 diopters (D) of keratometric astigmatism were randomly assigned to two surgical techniques: 1) bimanual MICS (non-LRI group) or 2) LRI combined with bimanual MICS (LRI group). Postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), postoperative refractive error, corneal topography, and vector analysis of keratometric change between pre- and postoperative eyes were compared. RESULTS In all cases of astigmatism in the LRI group, incisions for phacoemulsification and IOL insertion did not overlap or affect the LRIs. Uncorrected distance visual acuity was significantly higher in the LRI group (mean: 0.94) than in the non-LRI group (mean: 0.71, P = .009), although no difference was seen in CDVA in either group. Postoperative cylindrical error was significantly lower in the LRI group than in the non-LRI group (0.56 D and 1.51 D, respectively, P = .0004). Cravy analysis showed that the vector change in cylinder was 1.44 D in the LRI group and 0.18 D in the non-LRI group (P = .0007). CONCLUSIONS Limbal relaxing incision with bimanual MICS is an easy-to-follow combined surgery to correct preexisting astigmatism with predictable accuracy.