What Is a Limbal Relaxing Incision (LRI)?

Why Limbal Relaxing Incisions Are Done

LRIs are typically used when a patient has low to moderate corneal astigmatism and wants clearer unaided vision after surgery.

• Reduce astigmatism at the time of cataract surgery
• Improve uncorrected distance vision in selected cases
• Decrease reliance on glasses for distance tasks

How the Procedure Works

1. The steep corneal axis is identified using measurements such as keratometry or corneal topography.
2. Incision length and depth are planned, often guided by pachymetry to avoid cutting too deep.
3. One or two arcuate incisions are made near the limbus using a blade or a laser system, depending on the setting.
4. The corneal curvature gradually shifts as the incisions heal and relax the steep meridian.

Recovery and Expected Results

Mild irritation, dryness, and light sensitivity can occur early and usually improve with prescribed drops and lubrication. Vision may fluctuate for a short period while the cornea stabilizes. LRIs often reduce astigmatism but may not eliminate it completely, so glasses may still be needed for the sharpest vision. Follow-up checks confirm healing and refractive outcome.

Risks and Alternatives

Complications are uncommon, but they can occur, especially if corneal measurements or incision depth are inaccurate.

• Undercorrection or overcorrection of astigmatism
• Irregular astigmatism or reduced best-corrected vision in rare cases
• Infection, inflammation, or delayed healing
• Corneal perforation risk if the incision is too deep

Alternatives include toric intraocular lenses, laser vision correction, or wearing glasses or toric contact lenses.