CORNEAL TOPOGRAPHY OF PHASE-III EXCIMER-LASER PHOTOREFRACTIVE KERATECTOMY - OPTICAL ZONE CENTRATION ANALYSIS

被引：60

作者：

SCHWARTZGOLDSTEIN, BH ^{[1
]}

HERSH, PS ^{[1
]}

DURRIE, D ^{[1
]}

CAVANAUGH, T ^{[1
]}

HUNKELER, J ^{[1
]}

MICHELSON, M ^{[1
]}

OWEN, J ^{[1
]}

GORDON, M ^{[1
]}

STEINERT, R ^{[1
]}

PULIAFITO, C ^{[1
]}

RAIZMAN, M ^{[1
]}

PEPOSE, J ^{[1
]}

机构：

[1] MONTEFIORE MED CTR,ALBERT EINSTEIN COLL MED,DEPT OPHTHALMOL,CORNEA CONSULTAT SERV,BRONX,NY 10467

来源：

OPHTHALMOLOGY | 1995年 / 102卷 / 06期

关键词：

D O I：

10.1016/S0161-6420(95)30928-1

中图分类号：

R77 [眼科学];

学科分类号：

100212 ;

摘要：

Purpose: To determine the amount of optical zone decentration in patients who have undergone excimer laser photorefractive keratectomy (PRK) and assess associations of both decentration and optical zone size with clinical outcomes. Methods: Optical zone centration in 185 patients after PRK was analyzed using computer-assisted videokeratography. A comparison of decentration among the five study centers was performed. Associations of clinical outcomes with procedure decentration and optical zone size were assessed. Results: Decentration from the pupil center ranged from 0.00 to 1.44 mm (mean, 0.46 mm): 21.8% were decentered 0.25 mm or less, 42.5% > 0.25 mm and less than or equal to 0.50 mm, and 97.1% less than or equal to 1.00 mm. In both eyes, the average decentration from the pupil center was located inferonasally. Decentrations among the five study centers were significantly different. Decentration was associated with attempted refractive correction, change in keratometric cylinder, and patient satisfaction. There was a trend toward worse postoperative uncorrected visual acuity with greater decentration but no association with best-corrected vision, predictability, or refractive astigmatism. No significant relation was found between decentration and glare/halo ranking; however, three of six patients with 1.00 mm or greater of decentration demonstrated a high glare/halo grade. Although optical zone size was not associated with glare or halo, subjective patient satisfaction was greater with a 5.0-mm optical zone than with a 4.5-mm optical zone. Conclusions: Centration is an important surgeon-controlled variable in excimer laser PRK. Decentration of excimer laser refractive procedures was found to be nonrandom and may be influenced by preoperative pupil management. Moreover, the amount of decentration may influence clinical outcomes. Improved techniques and centering procedures on nonmiotic pupils may improve future results.

引用

页码：951 / 962

页数：12

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