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Static cyclotorsion registration during excimer laser surgery: reliability and repeatability.

Ignacio Almorín-Fernández-Vigo1, Inés Sánchez-Guillén2, José I Fernández-Vigo3

  • 1Centro Internacional de Oftalmología Avanzada, Badajoz, Spain.

Archivos De La Sociedad Espanola De Oftalmologia
|February 24, 2026
PubMed
Summary
This summary is machine-generated.

Static cyclotorsion measurements using the WaveLight EX500 excimer laser are highly repeatable. However, registry errors increase significantly after flap lifting during LASIK surgery.

Keywords:
Astigmatism correctionCiclorotaciónCiclotorsiónCirugía con láser excímerCorrección del astigmatismoCorrección visual con láserCyclorotationCyclotorsionExcimer laser surgeryEyetrackerLaser vision correctionSistema de seguimiento ocular (eyetracker)

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Area of Science:

  • Ophthalmology
  • Surgical Technology
  • Refractive Surgery

Background:

  • Accurate cyclotorsion measurement is crucial for successful refractive surgery outcomes.
  • The WaveLight EX500 excimer laser platform is widely used for LASIK procedures.
  • Understanding measurement repeatability and error rates is essential for optimizing surgical protocols.

Purpose of the Study:

  • To assess the repeatability of static cyclotorsion registration using the WaveLight EX500 excimer laser.
  • To evaluate the reliability and error rates of cyclotorsion measurements during different phases of LASIK surgery.

Main Methods:

  • Prospective, descriptive study involving 135 eyes of 80 subjects undergoing LASIK.
  • Cyclotorsion measurements were taken in three phases: pre-blepharostat, post-flap creation, and post-flap lifting.
  • Repeatability was assessed using intraclass correlation coefficient (ICC) and error percentages.

Main Results:

  • Static cyclotorsion measurements demonstrated high repeatability with an ICC of 0.960 in Phase 1.
  • Measurement errors increased progressively through surgical phases: 2.9% (Phase 1), 20.7% (Phase 2), and 23% (Phase 3).
  • Twenty percent of patients who had valid measurements in earlier phases failed to achieve a valid measurement after flap lifting.

Conclusions:

  • Static cyclotorsion measurements by the WaveLight EX500 are highly repeatable.
  • The likelihood of registry errors significantly increases after the flap lifting phase in LASIK surgery.
  • Surgical protocols may need adjustment to mitigate errors during later stages of the procedure.