[Reduction of decentration after LASIK using a modified eye tracker ring for the MEL-70 excimer laser]

The aim of this study was to determine and compare the rate of eccentric laser ablation after LASIK depending on the eye tracker ring used.

All LASIK treatments were carried out using the MEL-70 flying spot excimer laser (Zeiss-Meditec, Jena). The flap was produced using a Corneal Shaper trade mark or Hansatome trade mark Microkeratome (B and L Surgical, Heidelberg). Initially we used an 11 mm eye tracker ring without hinge protector. At the end of February 2001 this ring was replaced by a 10 mm and a 9.5 mm ring with built-in hinge protector. An additional modification was introduced by us: at 1 mm separations little teeth-like spikes were engraved into the eyeward side of the ring, thus stabilising the position of the ring on the globe and allowing free liquid to flow through the spaces between each spike. The built-in calibration system of the corneal topography (TMS 3, Tomey, Erlangen) from patients with a follow-up of one month or longer was used to determine the distance between the centre of the ablation zone from the fixation point.

In group I patients (old ring) 42 eyes were treated. In 4 eyes ablation was perfect, in 21 eyes the ablation centre was located 0.1 to 0.49 mm from the fixation point, in 11 eyes 0.51 to 0.99 mm and in 5 eyes 1.1 to 1.49 mm whereas one eye showed a decentred ablation of 1.53 mm. In group II (new ring) 42 eyes were investigated also. In 11 eyes ablation was perfect, in 20 eyes the ablation centre was located 0.1 to 0.49 mm from the fixation point, in 10 eyes 0.5 to 0.99 mm and one eye had an eccentric ablation of 1.28 mm from the fixation point.

The further development of our eye tracker ring for the MEL-70 laser considerably reduced the rate of decentred ablations. An enhanced grip of the ring onto the globe reduces a slow slide during the laser procedure.