TY - JOUR
T1 - Aberrations induced in wavefront-guided laser refractive surgery due to shifts between natural and dilated pupil center locations
AU - Porter, Jason
AU - Yoon, Geunyoung
AU - Lozano, Diana
AU - Wolfing, Jessica
AU - Tumbar, Remy
AU - MacRae, Scott
AU - Cox, Ian G.
AU - Williams, David R.
PY - 2006/1
Y1 - 2006/1
N2 - PURPOSE: To determine the aberrations induced in wavefront-guided laser refractive surgery due to shifts in pupil center location from when aberrations are measured preoperatively (over a dilated pupil) to when they are corrected surgically (over a natural pupil). SETTING: Center for Visual Science and Department of Ophthalmology, University of Rochester, Rochester, New York, USA. METHODS: Shifts in pupil center were measured between dilated phenylephrine hydrochloride (Neo-Synephrine [2.5%]) and nonpharmacological mesopic conditions in 65 myopic eyes treated with wavefront-guided laser in situ keratomileusis (Technolas 217z, Bausch & Lomb). Each patient's preoperative and 6-month postoperative wave aberrations were measured over the dilated pupil. Aberrations theoretically induced by decentration of a wavefront-guided ablation were calculated and compared with those measured 6 months postoperatively (6.0 mm pupil). RESULTS: The mean magnitude of pupil center shift was 0.29 mm ± 0.141 (SD) and usually occurred in the inferonasal direction as the pupil dilated. Depending on the magnitude of shift, the fraction of the higher-order postoperative root-mean-square wavefront error that could be due theoretically to pupil center decentrations was highly variable (mean 0.26 ± 0.20 mm). There was little correlation between the calculated and 6-month postoperative wavefronts, most likely because pupil center decentrations are only 1 of several potential sources of postoperative aberrations. CONCLUSIONS: Measuring aberrations over a Neo-Synephrine-dilated pupil and treating them over an undilated pupil typically resulted in a shift of the wavefront-guided ablation in the superotemporal direction and an induction of higher-order aberrations. Methods referencing the aberration measurement and treatment with respect to a fixed feature on the eye will reduce the potential for inducing aberrations due to shifts in pupil center.
AB - PURPOSE: To determine the aberrations induced in wavefront-guided laser refractive surgery due to shifts in pupil center location from when aberrations are measured preoperatively (over a dilated pupil) to when they are corrected surgically (over a natural pupil). SETTING: Center for Visual Science and Department of Ophthalmology, University of Rochester, Rochester, New York, USA. METHODS: Shifts in pupil center were measured between dilated phenylephrine hydrochloride (Neo-Synephrine [2.5%]) and nonpharmacological mesopic conditions in 65 myopic eyes treated with wavefront-guided laser in situ keratomileusis (Technolas 217z, Bausch & Lomb). Each patient's preoperative and 6-month postoperative wave aberrations were measured over the dilated pupil. Aberrations theoretically induced by decentration of a wavefront-guided ablation were calculated and compared with those measured 6 months postoperatively (6.0 mm pupil). RESULTS: The mean magnitude of pupil center shift was 0.29 mm ± 0.141 (SD) and usually occurred in the inferonasal direction as the pupil dilated. Depending on the magnitude of shift, the fraction of the higher-order postoperative root-mean-square wavefront error that could be due theoretically to pupil center decentrations was highly variable (mean 0.26 ± 0.20 mm). There was little correlation between the calculated and 6-month postoperative wavefronts, most likely because pupil center decentrations are only 1 of several potential sources of postoperative aberrations. CONCLUSIONS: Measuring aberrations over a Neo-Synephrine-dilated pupil and treating them over an undilated pupil typically resulted in a shift of the wavefront-guided ablation in the superotemporal direction and an induction of higher-order aberrations. Methods referencing the aberration measurement and treatment with respect to a fixed feature on the eye will reduce the potential for inducing aberrations due to shifts in pupil center.
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U2 - 10.1016/j.jcrs.2005.10.027
DO - 10.1016/j.jcrs.2005.10.027
M3 - Article
C2 - 16516775
AN - SCOPUS:33644688197
SN - 0886-3350
VL - 32
SP - 21
EP - 32
JO - Journal of cataract and refractive surgery
JF - Journal of cataract and refractive surgery
IS - 1
ER -