Limbal Relaxing Incisions (LRIs)

Astigmatism has to do with the cornea (window of the eye) being oval shaped and not spherical. A limbal relaxing incision (“LRI”) can be used to help decrease astigmatism. A limbal relaxing incision is made with a diamond tipped microsurgical instrument that makes a tiny incision (usually about 3 to 4 mm in length.) at the edge of the cornea (where the colored part of the eye meets the white part). This has the effect of relaxing tension on that area of the cornea to help round out an oval shaped cornea, and thereby decreasing the astigmatism. LRI`s are performed by the surgeon at the start of cataract surgery under the operating microscope. Topical (numbing drop) anesthesia is used to numb the eye. The LRI procedure adds several minutes to the cataract procedure. It is not as accurate as laser vision correcting techniques such as LASIK or PRK, but it often (although not always) helps to decrease some of the astigmatism. This helps to minimize one`s dependence on eyeglasses. Some patients who desire to decrease their dependence on eyeglasses, but do not want to spend as much money as required for LASIK or PRK, or who do not want to have LASIK or PRK elect to have LRI`s performed at the time of cataract surgery.
 LRI`s go approximately 95% into the depth of the cornea. Rarely they can go all the way through, and a microscopic stitch will be required at the time of surgery.  LRI`s are created close to the white, vascularized part of the eye, so they usually heal quite strongly. However, it is possible with severe blunt trauma for the incision site to open. It is rare, but possible for the LRI incision site to become infected, so care should be taken as with regular cataract surgery to avoid allowing germ containing contaminates to touch the eye for several weeks after surgery. The routine antibiotic eye drops used postoperatively for cataract surgery will also help prevent  infection in the LRI incisions.
It should be noted that LRI`s only help decrease astigmatism. After cataract surgery a refractive error such as nearsightedness or farsightedness may exist. These can for a cost be corrected with LASIK or PRK. If significant astigmatism exists after LRI`s are performed, no further LRI`s will be performed and no refund will be given. Any residual astigmatism can usually be successfully reduced by LASIK or PRK.