Comparison of wavefront-guided aspheric laser in situ keratomileusis for myopia: coaxially sighted corneal-light-reflex versus line-of-sight centration.
OBJECTIVE
To compare refractive outcomes, higher-order aberrations (HOAs), and contrast sensitivity of myopic wavefront-guided aspheric laser in situ keratomileusis centered on the coaxially sighted corneal light reflex or on the line of sight.


METHODS
Okamoto Eye Clinic, Ehime, Japan.


METHODS
Comparative case series.


METHODS
Data at 3 months were compared based on the distance between the coaxially sighted corneal light reflex and the line of sight (P-distance) as follows: distance greater than 0.25 mm (high-distance group), distance greater than 0.15 mm and less than 0.25 mm (intermediate-distance group), and distance less than 0.15 mm (low distance group).


RESULTS
The chart review included 317 eyes in the corneal-light-reflex group and 269 eyes in the line-of-sight group. The mean postoperative manifest refraction spherical equivalent was +0.123 diopter (D) ± 0.378 (SD) and +0.187 ± 0.480 D, respectively (P = .07). The safety and efficacy indices were significantly higher in the corneal-light-reflex group, including the high-distance subgroup and eyes with a P-distance less than 0.25 mm (P<.05, all cases). The HOAs (P<.001) and coma (P = .001) were significantly higher in the line-of-sight group (P<.001 and P = .001, respectively). The line-of-sight group had a significantly greater change in contrast sensitivity (P = .026).


CONCLUSIONS
Centration on the coaxially sighted corneal light reflex resulted in better safety, effectiveness, and contrast sensitivity than line-of-sight centration. Centration on the coaxially sighted corneal light reflex was safer for myopic eyes with P-distances greater than 0.25 mm.


BACKGROUND
No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.
Okamoto Eye Clinic, Ehime, Japan. okamoto@eyemd.jp
Shigeki
S
Okamoto
Kaku
K
Kimura
Masakazu
M
Funakura
Nobuo
N
Ikeda
Hiroyuki
H
Hiramatsu
Harkaran S
HS
Bains
D057128:Aberrometry; D000328:Adult; D001767:Blinking / Q000502:physiology* / Q000528:radiation effects; D015350:Contrast Sensitivity / Q000502:physiology; D019781:Corneal Topography; D057108:Corneal Wavefront Aberration / Q000503:physiopathology; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008027:Light; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011680:Pupil / Q000528:radiation effects*; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology