Posters

Pupil vs vertex-centred ablation for myopic refractive surgery: should we centre treatment on the pupil or on the visual axis?

Poster Details

First Author: M.Mimouni CANADA

Co Author(s):    A. Nemet   I. Kaiserman                 

Abstract Details

Purpose:

To compare pupil versus vertex centered ablation for myopic laser refractive surgery.

Setting:

Care-Vision Laser Centers, Tel-Aviv, Israel

Methods:

This retrospective comparative study consisted of the right eyes of consecutive myopic patients undergoing either photorefractive keratectomy (PRK) or laser-assisted in situ keratomileusis (LASIK) with either pupil or vertex centered ablation from January 2018 to April 2018. During the first two months all eyes received pupil centered treatment and during the last two months all eyes received vertex centered treatment. The primary outcomes were postoperative efficacy index, safety index and distance from target.

Results:

Overall 258 eyes were included of which 50% received vertex-centered ablation. There were no significant differences in baseline parameters between groups in either LASIK or PRK. There were no significant differences between the vertex versus pupil centered group in efficacy index (LASIK: 1.02 versus 1.01, p=0.86; PRK: 1.00 versus 0.99, p=0.61), safety index (LASIK: 1.02 versus 1.01, p=0.70; PRK:1.02 versus 1.02, p=0.97) and remnant cylinder (D) (LASIK: 0.26 versus 0.23, p=0.65; PRK:0.37 versus 0.39, p=0.78). In a mixed effect model accounting for amount of pupil decentration there were still no significant differences between vertex and pupil centered treatment.

Conclusions:

In myopic refractive LASIK or PRK performing ablation centered on the vertex or on the pupil leads to similar outcomes regardless of the amount of pupillary decentration. Future studies may consider assessing pupil decentration correction in cases of high astigmatism and hyperopia.

Financial Disclosure:

None