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P.-J. Pisella, D. Marotte, A. Denoyer; Influence of the Compensation for Pupil Decentration and Ocular Rotation on the Residual Ocular Aberrations in Myopic Astigmatic Patients After Wavefront-Guided Refractive Surgery. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2907. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate if compensating ocular misalignments during wavefront-guided excimer ablation could improve the postoperative ocular wavefront profile.
Sixty-nine eyes with myopic astigmatism superior to 1D were included. 32 eyes underwent wavefront-guided (WG) excimer ablations (15 LASIK and 17 PRKs) with iris-guided compensation (IGC) for pupil decentration and ocular rotation (VISX Star S4-IR and CustomVue, VISX, USA), and the others underwent WG surgery (18 LASIK and 19 PRKs) without IGC, as controls. Ocular lower- and higher-order wavefront aberrations were measured before and six months after the surgery. Data were computed, rescaled for pupil size, and vectorial analyses were performed to evaluate the surgically-induced changes in main aberrations (astigmatism, coma, and trefoil).
Mean intraoperative misalignments were 0.2±0.1 mm for pupil decentration and 3±1.9 degrees for rotation. Residual magnitude of the 2nd-order astigmatism was lower in IGC group (p<0.001), so was the error of treatment axis (p=0.01). Postoperative root mean square of higher-order aberrations was inferior in IGC group (p=0.005) than in controls. Surgically-induced changes in coma and trefoil aberrations have been detailed for magnitude and axis.
Compensating ocular misalignments during WG refractive surgery reduces the residual astigmatism, and optimises the treatment of higher-order aberrations in myopic astigmatic patients.
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