Is there any place for relaxing incisions in cataract surgery?

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The advent of toric IOls has certainly reduced the place of relaxing incisions. On the other hand, the use of femtosecond has significantly improved the easiness, the predictability and safety of the incisional procedure. Moreover the recent innovation of the “femtocataract” offers on some platforms the opportunity to combined relaxing incisions at the time of the crystalline lens removal. We will remind the different modalities for performing these incisions and will focus on disparities concerning the popularity of this surgery from one country to the other. The review of literature will provide the demonstration of the efficacy of incisions for correction of astigmatism especially in case of large cylindrical component such secondary astigmatism after triple procedure graft and cataract removal. We will also underline the interest of femtosecond laser in the refinement of the final outcome and will compare transepithelial versus intrastromal incisions. Of course the debate will be opened with toric IOls and photablation, that in some cases can be more complementary rather than competitive.

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