- 作者：Jason Porter ; Geunyoung Yoon ; Diana Lozano ; Jessica Wolfing ; Remy Tumbar ; Scott MacRae ; Ian G. Cox and David R. Williams
- 刊名：Journal of Cataract and Refractive Surgery
- 出版年：2006
- 出版时间：January 2006
- 年：2006
- 卷：32
- 期：1
- 页码：21-32
- 全文大小：521 K
Purpose
To determine the aberrations induced in wavefront-guided laser refractive surgery due to shifts in pupil center location from when aberrations are measured preoperatively (over a dilated pupil) to when they are corrected surgically (over a natural pupil).Setting
Center for Visual Science and Department of Ophthalmology, University of Rochester, Rochester, New York, USA.
Methods
Shifts in pupil center were measured between dilated phenylephrine hydrochloride (Neo-Synephrine [2.5 % ]) and nonpharmacological mesopic conditions in 65 myopic eyes treated with wavefront-guided laser in situ keratomileusis (Technolas 217z, Bausch & Lomb). Each patient's preoperative and 6-month postoperative wave aberrations were measured over the dilated pupil. Aberrations theoretically induced by decentration of a wavefront-guided ablation were calculated and compared with those measured 6 months postoperatively (6.0 mm pupil).
Results
The mean magnitude of pupil center shift was 0.29 mm ± 0.141 (SD) and usually occurred in the inferonasal direction as the pupil dilated. Depending on the magnitude of shift, the fraction of the higher-order postoperative root-mean-square wavefront error that could be due theoretically to pupil center decentrations was highly variable (mean 0.26 ± 0.20 mm). There was little correlation between the calculated and 6-month postoperative wavefronts, most likely because pupil center decentrations are only 1 of several potential sources of postoperative aberrations.
Conclusions
Measuring aberrations over a Neo-Synephrine-dilated pupil and treating them over an undilated pupil typically resulted in a shift of the wavefront-guided ablation in the superotemporal direction and an induction of higher-order aberrations. Methods referencing the aberration measurement and treatment with respect to a fixed feature on the eye will reduce the potential for inducing aberrations due to shifts in pupil center.