Image-Guided Limbal Relaxing Incisions Enhance Outcomes of Cataract Surgery with Trifocal Intraocular Lenses Implantation.

PURPOSE: : To assess the efficacy of image-guided limbal relaxing incisions (LRIs) in enhancing outcomes of cataract surgery with trifocal intraocular lenses (IOLs) implantation.

METHODS

This prospective cohort study included consecutive cataract patients with predicted postoperative corneal astigmatism of 0.5-1.0 D and intended for cataract surgery with trifocal IOL implantation. The enrolled subjects were randomized into the non-LRI group, manual-marked LRI group and image-guided LRI group. Correction effect of corneal astigmatism, as well as visual outcomes at 3 months after surgery were compared among the three groups.

RESULTS

Finally, 30 eyes of 30 patients in every group were included. The image-guided LRI group showed more corneal astigmatism correction (0.81 ± 0.32 D vs. 0.17 ± 0.22 D vs. 0.48 ± 0.37 D, p < .001) and less refractive postoperative cylinder (0.33 ± 0.29 D vs. 0.90 ± 0.25 D vs. 0.65 ± 0.31 D, p < .001) than the non-LRI group and manual-marked LRI group. The uncorrected near visual acuity and uncorrected intermediate visual acuity were significantly better in the image-guided LRI group and manual-marked LRI group than the non-LRI group (all p < .05). The image-guided LRI group also displayed significantly better ocular modulation transfer functions than the other two groups (all p < .05).

CONCLUSION

LRIs, especially image-guided LRIs, can effectively reduce corneal astigmatism and improve both near and intermediate vision, as well as visual quality of patients undergoing trifocal IOLs implantation.