Es erfolgte eine topographische und refraktive Astigmatismusanalyse mittels Vektorenanalyse und Doppelwinkeldiagramme. Material und Methoden: 176 Kataraktoperationen mit simultaner Astigmatismuskorrektur wurden retrospektiv untersucht, davon bei 110 Augen durch periphere clear-cornea Relaxationsinzisionen (PCCRI) und bei 66 Augen durch die Implantation von torischen Hinterkammerlinsen (TIOL). Im Rahmen der Kataraktoperation besteht die Möglichkeit neben der Linsentrübung auch den Astigmatismus zu korrigieren. Astigmatismus ist einer der häufigsten Refraktionsfehlern wobei 15-20% der Bevölkerung einen klinisch relevanten Astigmatismus von > 1,5 Dpt zeigen.
Hintergrund: Die Kataraktoperation ist der am meisten durchgeführte operative Eingriff in der Medizin überhaupt. The 1 limbal relaxing incision of 6 mm aiming to reduce 1 diopter of preoperative astigmatism was not effective, but it did not induce any significant postoperative complications. Two limbal relaxing incisions of 8 and 6 mm aiming to correct preoperative astigmatism of 2 to 3D and 1 to 2D, respectively, were safe and effective with a stable effect in the first postoperative follow-up year. There were also no complications such as postoperative discomfort, glare, aniseiconia, diplopia, incision infection and corneal thinning or ectasia. The 1 limbal relaxing incision of the 6 mm group did not yield significant astigmatism reduction, but there was no significant alteration until de 12th postoperative month.
Significant reduction in preoperative astigmatism was observed in the 1st postoperative month in 2 limbal relaxing incisions of the 6 mm group (57% topographic astigmatism and 87% refractional) and in 2 limbal relaxing incisions of the 8 mm group (50% topographic astigmatism and 65% refractional), maintaining the reduction with no significant alteration until the 12th postoperative month.
They were done in the most curved meridians, determined by preoperative corneal topography. The limbal relaxing incisions were performed according to Gills' modified nomogram (1D - 1 LRI of 6 mm 1-2D - 2 LRI of 6 mm 2-3D - 2 LRI of 8 mm). Sixteen patients who underwent cataract surgery by the phacoemulsification technique with a 5.5 mm escleral incision, at the Altino Ventura Foudation, between April and July of 2002. To evaluate astigmatism variation between preoperative, 1st and 12th postoperative month of patients who underwent cataract surgery with limbal relaxing incisions (LRI) aiming to reduce the preoperative astigmatism.
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