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Study recommends corneal-light-reflex centration for myopic LASIK
J Cataract Refract Surg. 2011; 37(11):1951-1960.
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Myopic wavefront-guided aspheric LASIK with centration on the coaxially sighted corneal light reflex yielded better safety, effectiveness and contrast sensitivity compared to centration on the line of sight, a study found.
The chart review included 317 eyes in the corneal-light-reflex centration group and 269 eyes in the line-of-sight centration group. The researchers compared data at 3 months for three distances between the coaxially sighted corneal light reflex and the line of sight: greater than 0.25 mm, 0.15 mm to 0.25 mm, and less than 0.15 mm.
Safety and efficacy indices were significantly higher in the corneal-light-reflex group (P < .05). In the line-of-sight group, the researchers found significantly greater higher-order aberrations (P < .001), coma (P = .001) and change in contrast sensitivity (P = .026).
"Laser ablation centration in myopic eyes should not default to line of sight," the study authors said. "To avoid suboptimal refractive outcomes and diminished visual quality, surgeons should determine the difference in the pupil center and the coaxially sighted corneal light reflex and consider centering the excimer laser ablation on the coaxially sighted corneal light reflex once the difference is 0.15 mm or larger."