Limbal Relaxing Incisions

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Last updated 10/8/2019
Limbal Relaxation Incision, Assil Eye Institute Los Angeles

What are Limbal Relaxing Incisions?

Limbal Relaxing Incisions (LRI for short) are partial thickness incisions made at the outer (non-seeing) edge of the cornea called the limbus, in folks with astigmatism, in order to reduce or even eliminate their need for distance glasses or contacts.

 

The incisions are strategically placed at the limbus to “relax” the steepest part of the cornea’s curvature, making it more evenly round and thereby correct the astigmatism.

 

LRI is often performed during surgery for cataracts or implantation of intraocular lenses, or can also be done following Corneal transplantation.

Who is Limbal Relaxing Incisions good for?

 

This procedure is often ideal for patients who:

  • Are age 50 or older
  • Have mild to moderate Astigmatism
  • Wish to reduce the need for glasses or contact lenses
  • Are planning cataract surgery and wish to correct their astigmatism at the same time
  • Have undergone prior eye surgery and have residual astigmatism 

 

After performing a comprehensive eye exam, your surgeon will discuss whether this option is the best fit for you. It is important for patients to be in good overall health and to have realistic expectations before undergoing this procedure. While most patients typically experience significant improvements to their vision after an LRI, some may still require vision correction in the form of glasses or contacts.

 

What are the risks of having an LRI?

The limbal relaxing incision procedure is remarkably safe and complications are extremely rare. That said, possible complications of LRI's can include infection, over-correction, under-correction, micro-perforation of the cornea, induced astigmatism, discomfort and decreased corneal sensation.

 

What happens during an LRI procedure?

An LRI procedure performed at AEI takes about five minutes per eye. It is performed with anesthetic eye drops, does not require stitches and you can go home the same day following a brief examination in the recovery room. Prior to surgery, your doctor uses a special computer to produce a topographical map of your eye and create a template that will guide your procedure.

 

Here’s what takes place during a LRI procedure:

  1. After your eyes are cleansed, your doctor applies numbing eye drops and puts on a device that keeps you from blinking during the procedure.

  2. Next, you are asked to look into a light while a femtosecond laser or a Diamond scalpel make precise incisions in your cornea using the template designed to address the specific amount of vision correction you need.

    AEI’s Treatment System includes a laser guided measurement system which provides real-time feedback of the vision change achieved, thus enabling the surgeon to refine the incisions immediately, until the desired vision correction is achieved.

  3. Once the tiny arc-shaped incisions have been completed, antibiotic drops are placed in your eye and the eyelid holder is removed. 

  4. You will be fitted with eye shields to protect your eyes.
  5. Following the procedure, you are taken to the recovery area where you will receive a final eye check prior to going home.

What can I expect after getting Limbal Relaxing Incisions?

Some patients may experience the following post-operative symptoms for a few days following the procedure:

  • Light Sensitivity
  • Tearing
  • Redness

 

Any post-operative discomfort will be managed with over-the-counter pain medication such as Tylenol.

 

Most patients are able to return to work and their regular routine the day after surgery. Vision will likely improve significantly within the first day, although there are a few patients who may experience blurry vision for several weeks after the procedure.

 

Why choose AEI for Limbal Relaxing Incision surgery

At AEI, our LRIs are guided in real time with Intraoperative Aberrometry (a laser guided system which measures the eye’s focusing power). This system enables us to titrate the astigmatism correction with exquisite refinement, ensuring that the relaxing incisions have the precise angle, depth, and length and are placed in the exact optical zone needed to safely correct your astigmatism.

 

Because AEI was the first center in the world to introduce this technology (Wavetec Ora Aberrometer), we have the most extensive experience with this device.

 

1. Roberts HW, Wagh VK, Sullivan DL, et al. Refractive outcomes after limbal relaxing incisions or femtosecond laser arcuate keratotomy to manage corneal astigmatism at the time of cataract surgery. J Cataract Refract Surg. 2018;44(8):955-63.

Schedule your consultation to learn if LRI is right for you.

 

  • Dr. Kerry Assil, Beverly Hills LASIK and Cataract Surgeon

    Kerry K. Assil, MD, is regarded as one of the world’s foremost experts in refractive surgery, having made significant advances in the field with his numerous inventions. Additionally he has the unique distinction of having trained thousands of eye surgeons in the latest refractive surgical techniques.

     

    Dr. Assil has authored more than one hundred textbooks, textbook chapters and articles on refractive surgery and has appeared regularly on major television network news programs as a pioneer in refractive surgery. He also leads educational forums for other eye care professionals, which have included featured lectureships at Harvard University, Johns Hopkins University and Tokyo University.

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