Limbal marking fails to boost LASIK, LASEK outcomes for myopic astigmatism

J Refract Surg. 2010;26(7):505-511.

Preoperative marking of the limbus failed to improve refractive outcomes of LASIK and LASEK in eyes with myopic astigmatism, a study showed.

The retrospective study included 108 eyes; 47 eyes had limbal markings and a control group of 61 eyes were unmarked. Mean patient age was 34 years.

The Technolas 217 excimer laser (Bausch + Lomb) was used to perform all ablations. In the marked eye group, 23 eyes underwent LASIK and 24 eyes underwent LASEK. In the unmarked eye group, 31 eyes underwent LASIK and 30 eyes underwent LASEK.

Mean distance uncorrected visual acuity increased from 0.07 in both groups to 0.81 in the marked eye group and 0.77 in the unmarked group at 12 months. No statistically significant differences in UCVA between groups were reported.

At 12 months, mean refractive astigmatism had improved from 1.3 D to 0.31 D in the marked group and from 1.09 D to 0.41 D in the unmarked group. Refractive astigmatism was less than 0.5 D in 62% of marked eyes and 52% of unmarked eyes. There were no statistically significant differences between groups, the authors said.

Failure of the marking technique was attributed to continuous eye rotation during surgery, lack of consensus among surgeons concerning laser alignment with the axis of refractive astigmatism or the axis of corneal astigmatism, and imprecise positioning of limbal markings, the authors said.

"Further investigation in automated alignment methods, using dynamic iris pattern recognition, offers hope for better results," the study authors said.

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