- Home
- Cataract surgery
- Astigmatism (LRI)
Limbal Relaxing Incisions for Astigmatism
Limbal relaxing incisions (LRI) are tiny, precisely placed incisions at the edge of the cornea that correct mild to moderate astigmatism. At Insight Eye Center in Mentor, Dr. Michael E. Rom places them during cataract surgery, so the cataract and the astigmatism are treated in one procedure with one recovery, and most patients depend far less on glasses afterward.
What are limbal relaxing incisions?
Limbal relaxing incisions (LRI) are small, precisely placed incisions made around the edge of the cornea, near the limbus, to treat mild to moderate astigmatism. They relax the steeper curve of the cornea so light focuses at one point instead of two. LRI is minimally invasive and is usually done during cataract surgery, in the same sitting.
Astigmatism means the cornea is curved unevenly — steeper in one direction than the other — so vision is blurred or distorted at every distance. Cataract surgery with a standard lens removes the cataract but leaves the astigmatism, which then needs glasses. LRI reduces the astigmatic error itself, so the result of cataract surgery is sharper and there is less need for glasses or contacts afterward.
Dr. Rom places the incisions at exact positions determined by your pre-operative measurements. With laser-assisted surgery, the LenSx® laser can make them with computer-guided precision.
Who is a candidate for limbal relaxing incisions?
LRI suits patients with a mild to moderate degree of astigmatism who are having cataract surgery and want to reduce or eliminate their need for glasses or contacts afterward. Patients should be in good general health and understand what the procedure can and cannot do. Larger amounts of astigmatism usually respond better to a toric lens implant.
While limbal relaxing incisions achieve a significant improvement in most cases, some patients may still need glasses or contacts for the sharpest vision. Dr. Rom works with you at your evaluation to determine your vision needs and how to meet them successfully — LRI, a toric lens, or occasionally both.
- a mild to moderate degree of corneal astigmatism
- a desire to reduce or eliminate glasses or contacts for distance
- cataracts — LRI is performed during the same surgery
- good general health and realistic expectations
Limbal relaxing incisions — mild to moderate astigmatism.
Toric lens implant — more significant astigmatism. Compare the lens options.
How long do limbal relaxing incisions take to heal?
Most patients return to work and normal activities the day after the procedure. Vision is usually significantly improved within 24 hours, although some blurriness can come and go for several days as the cornea settles. Mild discomfort, tearing, slight swelling and sensitivity to light are typical for a short time and can be managed with over-the-counter pain relief if needed.
What not to do after LRI
- 24 hoursBathing and showering can resume as normal. No eye makeup for at least 24 hours — and if you wear it the next day, use new, unopened products, since opened makeup can harbor bacteria.
- 1 weekNo swimming, hot tubs, steam rooms or saunas.
- As prescribedUse your post-operative drops on schedule and keep your follow-up visits.
Why have LRI with Dr. Rom?
Dr. Michael E. Rom is a board-certified ophthalmologist who has performed tens of thousands of cataract procedures over more than 30 years, many with accompanying astigmatism correction. Because he measures your eyes himself and performs the surgery himself, the incision plan is matched to your cornea, and he makes a thoughtful recommendation rather than a one-size-fits-all one.
I had cataract and astigmatism correction surgery on my right eye in February and the same to the left eye in March. Dr. Rom was outstanding before, during and after the procedure. After 35 years of wearing corrective lenses to be able to see, I have 20/20 vision and a clarity that I never thought I would have again.Tim G. · cataract surgery with astigmatism correction
Common questions about LRI
Short answers to the questions patients ask most often. For anything specific to your eyes, ask Dr. Rom at your visit or call the office at (440) 286-1188.
Is LRI painful?
No. The incisions are made under the same numbing drops as cataract surgery. Afterward some patients notice mild scratchiness or light sensitivity for a day or two, which over-the-counter pain relief manages.
Is LRI covered by insurance?
Astigmatism correction is considered elective, so LRI is an out-of-pocket addition to cataract surgery, which itself is covered by Medicare and most plans subject to your deductible and coinsurance.
LRI or a toric lens — which is better?
It depends on the amount of astigmatism. LRI treats mild to moderate amounts; a toric lens implant handles larger amounts and is more predictable for them. Your pre-operative measurements decide, and sometimes Dr. Rom uses both.
Can LRI be done without cataract surgery?
It can be, but at Insight Eye Center it is offered as part of cataract surgery, where it improves the outcome of the lens implant. Ask Dr. Rom if you have astigmatism without a cataract.
Will I be glasses-free after LRI?
Many patients need glasses much less for distance. Reading glasses are still needed for close work with a standard lens, and some patients still use glasses for the sharpest distance vision.
Astigmatism and cataracts, treated together.
Request a cataract evaluation with Dr. Rom in Mentor. Your measurements show whether limbal relaxing incisions or a toric lens will correct your astigmatism.
