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Patient positioning may affect astigmatic surgical results

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BOSTON — Patients eyes, marked when they are sitting upright, can shift alignment when the patient lies down to undergo astigmatic LASIK, a study here found. A 10° misalignment of the astigmatic axis could result in a 35% undercorrection of astigmatism, the study authors said.

Preoperative marking of the upright patient and subsequent rotational alignment of the supine patient before LASIK may reduce the error in correction of astigmatism.

Anil Swami, MD, and colleagues measured the rotational position of 240 eyes of 169 patients who underwent LASIK for myopic or hyperopic astigmatism. Immediately before the surgery, each eye was marked while the patient was seated upright. Then rotational position was measured on the supine patient immediately before laser exposure.

The mean torsional misalignment was 4.1°, with 20 eyes (8%) having a deviation of greater than 10°.

The study is published in American Journal of Ophthalmology.