Eyeworld

18 | EYEWORLD | APRIL 2022 ASCRS NEWS Contact Arteaga: aartea7@uic.edu MacIntosh: pmacint1@uic.edu References 1. Budak K, et al. Limbal relaxing incisions with cataract surgery. J Cataract Refract Surg. 1998;24:503–508. 2. Khan MI, Muhtaseb M. Preva- lence of corneal astigmatism in patients having routine cataract surgery at a teaching hospital in the United Kingdom. J Cataract Refract Surg. 2011;37:1751–1755. 3. Yeu E, et al. Resident surgical experience with lens and corneal refractive surgery: survey of the ASCRS Young Physicians and Residents membership. J Cataract Refract Surg. 2013;39:279–284. The ASCRS Journal Club highlighted the importance of having multiple options to im- prove astigmatism and refractive outcomes after cataract surgery. LRIs are a safe and cost-effec- tive option to correct low-grade astigmatism. Also, it was discussed how to introduce this skill during residency. All agreed in the importance of wet lab time to practice and master the surgi- cal technique. Conclusion The results of the study showed that resi- dent-performed LRIs are safe and effective regardless of the magnitude or location of the astigmatism and were stable over time. The surgical curriculum model described is an objec- tive and useful option to introduce LRIs to the surgical curriculum of residency programs. POM1 and POM12, respectively. Patients were divided into groups for the analysis depending on the steep meridian location (with-the-rule, against-the-rule, or oblique astigmatism) and depending on the magnitude of the astigmatism (<1 D, 1–2 D, and >2 D). All groups demon- strated a statistically significant reduction of the keratometric astigmatism postoperatively that was sustained during the follow-up time. Under correction of astigmatism was seen in all patients. This is most likely due to healing and remodeling of the cornea that mainly occurs 10 weeks postoperatively. The highest change was seen at the POM1 timepoint, but there was not much difference at POM3 and POM12, in- dicating that the majority of the corneal healing occurs before the first 3 months postoperatively. After the third month changes are minimal. continued from page 16 Refractive and keratometric outcomes of supervised novice surgeon-performed limbal relaxing incisions: 1-year results Kamran Riaz, MD, Li Wang, MD, PhD, Blake Williams, MD, Justin Dvorak, PhD, Carolyn Kloek, MD, Asim Farooq, MD, Douglas Koch, MD J Cataract Refract Surg. 2021;47(10):1319–1326 n Purpose: To report refractive and keratometric astigmatism outcomes of resident-performed limbal relaxing incisions (LRIs) during cataract surgery. n Setting: Tertiary care academic teaching hospital. n Design: Retrospective case series. n Methods: The length, location, and number of LRIs were determined preoperatively using an online calculator. Variables studied were preoperative keratometry and postoperative uncorrected and best-corrected distance visual acuity, refraction, and keratometry at 1-month, 3-month, and 12-month visits (POM1, POM3, and POM12, respectively). Subgroup analysis was performed on amount and type of astigmatism. The astigmatism double-angle plot tool and analysis of with-the-wound and against-the-wound (WTW-ATW) changes were used to assess the effect of astigmatism correction at POM1, POM3, and POM12 visits. n Results: In 118 eyes, a higher percentage of eyes demonstrated refractive astigmatism ≤0.25 D, ≤0.50 D, ≤0.75 D, and ≤1.0 D at POM1 and POM12 (all P<0.05) compared to preoperative keratometric astigmatism. Subgroup analysis showed improvement in all groups and types of astigmatism (p<0.01). Patients achieved a statistically significant reduction of keratometric astigmatism at POM1, POM3, and POM12 (all p≤0.0001) relative to baseline, and changes differed significantly based on the preoperative amount of astigmatism (all p≤0.0001, with greater reductions associated with higher baseline astigmatism), but not by location of the steep meridian. There were significant WTW-ATW changes at POM1, POM3, and POM12. Regression of effect after 1 month was approximately 0.11 D. n Conclusion: Resident-performed LRIs achieved effective and sustained reduction of both refractive and keratometric astigmatism regardless of meridian or magnitude of astigmatism for at least 1 year after surgery.

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