Aberrations induced in wavefront-guided laser refractive surgery due to shifts between natural and dilated pupil center locations
Aberrations induced in wavefront-guided laser refractive surgery due to shifts between natural and dilated pupil center locations
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DOI：
10.1016/j.jcrs.2005.10.027
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发表时间：
2006-01-01
影响因子：
2.8
通讯作者：
Williams, DR
中科院分区：
文献类型：
--
作者：
Porter, J;Yoon, G;Williams, DR
目得：确定波前引导激光屈光手术中由于瞳孔中心位置从术前测量像差时的偏移而引起的像差（在一个扩大的瞳孔），当他们被纠正手术单位：美国纽约，罗切斯特，罗切斯特大学，视觉科学中心和眼科系。在65只接受波前引导激光原位角膜磨镶术（Technolas 217 z，Bausch & Lomb）治疗的近视眼中，测量了扩张的盐酸苯乙奎醚（Neo-Synetamine [2.5%]）和非药物性中间视条件下的瞳孔中心移位。每例患者的术前和术后6个月波像差在散瞳测量。计算波前引导消融偏心引起的理论像差，并与术后6个月测量的像差（6.0 mm瞳孔）进行比较。结果：瞳孔中心移位的平均幅度为0.29 mm +/- 0.141（SD），通常发生在鼻下方向，因为瞳孔放大。根据移位的大小，理论上可能由瞳孔中心偏心引起的高阶术后均方根波前误差的分数是高度可变的（平均值0.26 +/- 0.20 mm）。有计算和6个月的术后波前之间的相关性很小，最有可能是因为瞳孔中心clecentrations只有一个几个潜在的来源术后aberrations.Conclusions：测量像差超过一个新Synetrach-散瞳和治疗他们在一个未散瞳通常会导致在一个转移的波前引导消融superotemporal方向和诱导高阶像差。参考关于眼睛上的固定特征的像差测量和治疗的方法将降低由于瞳孔中心的移位而引起像差的可能性。
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 clecentrations 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.