title: Limbal relaxing incisions at the time of apodized diffractive multifocal intraocular lens implantation to reduce astigmatism with or without subsequent laser in situ keratomileusis.
abstract: OBJECTIVE
  To evaluate the visual and refractive outcomes of limbal relaxing incisions (LRIs) to reduce astigmatism at the time of apodized diffractive multifocal intraocular lens (IOL) implantation.
  
  
  METHODS
  University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.
  
  
  METHODS
  This retrospective review comprised consecutive patients who had LRIs at the time of lens extraction and AcrySof ReSTOR IOL implantation. A subgroup of patients had subsequent laser in situ keratomileusis (LASIK) for residual refractive error correction.
  
  
  RESULTS
  The study evaluated 73 eyes (59 patients); 21 eyes (28.7%) of 59 patients had further LASIK (LRI+LASIK). The mean follow-up was 13.2 months +/- 6.4 (SD). The mean keratometric astigmatism decreased from 1.49 +/- 0.71 diopters (D) preoperatively to 0.56 +/- 0.57 D at the last follow-up (P<.001). Although the LRI+LASIK group had significantly greater corneal astigmatism than the LRI-only group preoperatively (P = .005) and 1 month (P = .030) and 6-months (P = .014) postoperatively, there was no statistically significant difference between the 2 groups at the last follow-up (P = .528). At the last follow-up, the uncorrected distance visual acuity was 20/25 or better and the uncorrected near visual acuity was J1 or better in 32 (76%) of 42 eyes in the LRI-only group and in 17 (81%) of 21 eyes in the LRI+LASIK group.
  
  
  CONCLUSIONS
  Limbal relaxing incisions at the time of apodized diffractive multifocal IOL implantation, with or without subsequent LASIK, were effective and safe in reducing astigmatism.
authors.affiliation: University of Texas Southwestern Medical Center, Department of Ophthalmology, Dallas, Texas 75390-9057, USA.
authors.forename: Orkun
authors.initials: O
authors.lastname: Muftuoglu
authors.forename: Lori
authors.initials: L
authors.lastname: Dao
authors.forename: H Dwight
authors.initials: HD
authors.lastname: Cavanagh
authors.forename: James P
authors.initials: JP
authors.lastname: McCulley
authors.forename: R Wayne
authors.initials: RW
authors.lastname: Bowman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use*; D019654:Lens Implantation, Intraocular; D016850:Limbus Corneae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology