Partial versus Full Thickness Limbal Relaxing Incisions for Treating With-the-Rule Astigmatism: A Randomized Trial
Journal of Ophthalmic and Optometric Sciences,
Vol. 9 No. 4 (2025),
23 Mehr 2025
,
Page 31-40
Abstract
Purpose: To compare the efficacy of partial thickness versus full thickness limbal relaxing incisions performed during phacoemulsification for the treatment of with-the-rule astigmatism in elderly cataract patients.
Methods: All participants underwent phacoemulsification with intraocular lens implantation. In the partial thickness group, limbal relaxing incisions were made with a guarded stainless-steel knife preset at 550 microns according to ASCRS guidelines. In the full thickness group, paired limbal incisions were created with a 2.8 mm MANI phaco knife. Postoperative follow-ups were conducted at one, three, and six months, assessing best-corrected visual acuity, uncorrected visual acuity, residual astigmatism, spectacle independence, photophobia, foreign body sensation, and patient satisfaction.
Results: At one month, the partial thickness group achieved significantly better uncorrected visual acuity (P = 0.011) and best-corrected visual acuity (P = 0.012) than the full thickness group, but these differences were not significant at six months. Residual astigmatism was slightly lower in the partial thickness group, though not statistically significant. Spectacle independence, foreign body sensation, and patient satisfaction were similar between groups. Photophobia occurred more often in the full thickness group (22.7% vs. 9.1%), but the difference was not statistically significant (P = 0.080). No surgical complications, including leakage or infection, were observed.
Conclusions: Full thickness limbal relaxing incisions do not provide superior correction of with-the-rule astigmatism compared with partial thickness incisions. Although technically simpler, faster, and more cost-effective, their penetrating nature carries potential risks. Partial thickness limbal relaxing incisions remain the safer and more effective technique during cataract surgery.
- Cataract
- Partial
- Full Thickness
- Limbal Relaxing
- Incision
- Astigmatism
How to Cite
References
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