PURPOSE
To compare refractive outcomes of myopic LASIK with
centration on the coaxially sighted corneal light reflex (CSCLR) to centration
on the center of the pupil (line of sight [LOS]).
METHODS
The NIDEK CXIII excimer laser was used to treat 268 eyes
with centration on the CSCLR (CSCLR group) and 288 eyes with centration on the
LOS (LOS group). For the CSCLR group, the laser ablation was delivered 80%
closer to the visual axis. One-month postoperative outcomes were compared.
RESULTS
Preoperative manifest refraction spherical equivalent (MRSE)
was –4.88±1.55 diopters (D) (range: –8.50 to –1.25 D) in
the CSCLR group and –5.05±1.63 D (range: –9.75 to –1.50
D) in the LOS group. The postoperative MRSE was 0.17±0.39 D (range:
–1.38 to +1.25 D) in the CSCLR group and 0.19±0.48 D (range:
–1.63 to +1.88 D) in the LOS group. Safety (1.18) and efficacy (1.047)
indices were statistically significantly higher in the CSCLR group compared to
the LOS group (1.138 and 0.997, respectively) (P<.05). This trend was
accentuated in a subgroup analysis of patients with >0.25-mm difference
between the CSCLR and LOS, favoring the CSCLR group. A statistically
significantly greater induction of higher order aberrations (P=.04) and
coma (P<.01) was noted in the LOS group postoperatively.
CONCLUSIONS
Myopic LASIK centered on the CSCLR was significantly safer
and more effective than LASIK centered on the pupil (LOS), with significantly
lower induction of coma and total higher order aberrations. [J Refract
Surg. 2009;25:S944-S950.]
doi:10.3928/1081597X-20090915-09
AUTHORS
From Okamoto Eye Clinic, Ehime (Okamoto, Kimura); and NIDEK
Co Ltd, Gamagori (Funakura, Ikeda, Hiramatsu, Bains), Japan.
Drs Okamoto and Kimura do not have a proprietary interest in
the materials presented herein. Messers Funakura, Ikeda, and Hiramatsu are
employees of NIDEK Co Ltd, and Mr Bains is a consultant to NIDEK Co Ltd.
Correspondence: Shigeki Okamoto, MD, Okamoto Eye Clinic,
2-7-17 Ootemachi, Matsuyama 790-0067, Ehime, Japan. Tel: 81 89 941 4838; Fax:
81 89 933 9805; E-mail: okamoto@eyeMD.jp
