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Centration axis in refractive surgery.

Samuel Arba Mosquera1, Shwetabh Verma2, Colm McAlinden3

  • 1SCHWIND eye-tech-solutions, Kleinostheim, Germany ; Recognized Research Group in Optical Diagnostic Techniques, University of Valladolid, Valladolid, Spain ; Department of Ophthalmology and Sciences of Vision, University of Oviedo, Oviedo, Spain.

Eye and Vision (London, England)
|November 26, 2015
PubMed
Summary

Centering laser ablation in refractive surgery is complex due to the eye's asymmetry. Different methods, like line-of-sight and corneal vertex, offer varying clinical outcomes, necessitating flexible excimer laser system choices.

Keywords:
AlphaAngle KappaAsymmetric offsetCentrationCorneal light reflexCorneal vertexLambdaLine of sightNeural axisOptical axisPupil centrationRefractive surgery

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Area of Science:

  • Ophthalmology
  • Optics
  • Biomedical Engineering

Background:

  • The human eye is an asymmetric optical system, with individual optical and neural axes for each component.
  • Accurate centering for laser ablation is challenging due to multiple available reference axes.

Purpose of the Study:

  • To explain various centration approaches in refractive surgery based on reference axes.
  • To review the clinical outcomes associated with different centration methods.
  • To highlight the need for flexible centration choices in excimer laser systems.

Main Methods:

  • Review of established centration approaches: line-of-sight (LOS) and corneal vertex (CV).
  • Discussion of the stability and clinical relevance of pupil centration versus CV.
  • Analysis of hybrid approaches balancing manifest refraction and higher-order aberrations.

Main Results:

  • Line-of-sight (LOS) is recommended for whole-eye wavefront aberrations but pupil centration can be unstable.
  • Corneal vertex (CV) offers a stable morphological reference, approximating visual axis alignment.
  • A compromise approach uses CV for manifest refraction and pupil center for higher-order aberrations.

Conclusions:

  • Optimal centration for laser ablation requires careful consideration of different reference axes.
  • Current methods like LOS and CV have limitations impacting clinical outcomes.
  • Flexible centration options in excimer laser systems are crucial for optimizing customized and non-customized treatments.