Preexisting astigmatism correction combined with cataract surgery: Corneal relaxing incisions or toric intraocular lenses?

Corneal relaxing incisions combined with microincisions cataract surgery allow correction of preexisting congenital astigmatism. Limbal relaxing incisions and opposite clear corneal incisions were the main surgical techniques in use during last decade. However, corneal wound healing variations particularly at epithelial level are associated with poor refractive results predictability. New generations of toric intraocular lenses have a good stability in the capsular bag with less risks of secondary rotation. Well positioned in the right axis, toric intraocular lenses have potentially better accuracy and predictability than relaxing corneal surgery to correct preexisting congenital astigmatism. Combined corneal surgery progressively lost its indications for a simple refractive microincision cataract surgery with implantation of toric intraocular lenses. (C) 2012 Elsevier Masson SAS. All rights reserved.