Impact Of Pupil-Decentration On Visual And Refractive Outcomes In Patients Undergoing Hyperopic Lasik
Published 2025 - 43rd Congress of the ESCRS
Reference: PP15.14 | Type: Free paper | DOI: 10.82333/2hbk-fg03
Authors: Adir Sommer* 1 , Margarita Safir 2 , Waseem Nasser 1 , Dror Ben Ephraim Noyman 1 , Tzahi Sela 3 , Gur Munzer 3 , Igor Kaiserman 4 , Eyal Cohen 5 , Michael Mimouni 1
1Rambam Health Care Campus,Haifa,Israel, 2Rabin Medical Center,Petah Tikva,Israel, 3Care-Vision Laser Center,Tel Aviv,Israel, 4Barzilai Medical Center,Ashkelon,Israel, 5Tel Aviv Sourasky Medical Center,Tel Aviv,Israel
Purpose
To compare the visual and refractive outcomes of patients undergoing hyperopic laser-assisted in situ keratomileusis (LASIK) surgery with and without pupillary decentration of treatment.
Setting
Care-Vision Laser Centers, Tel-Aviv, Israel.
Methods
Medical files of patients who underwent LASIK surgery between January 2013 and December 2023 were reviewed. The patients were divided into two groups: those for whom the surgeon applied pupil-decentration during surgery and those for whom not. Pre-, intra-, and post-operative parameters were compared between the groups. Adjustments were performed to account for differences in baseline and intraoperative parameters.
Results
This retrospective study included 1,986 eyes from 1,115 patients, with 289 eyes treated using pupil-decentration. These patients had better preoperative UCVA (LogMAR 0.48±0.68 vs. 0.57±0.74, P<0.001), less hyperopia (SEQ 2.26±1.07 vs. 2.53±1.05D, P<0.001), and better BCVA (0.03±1.04 vs. 0.04±1.00, P<0.001). Postoperatively, they showed better UCVA and BCVA (0.05±0.79 vs. 0.07±0.72, P<0.001; 0.03±1.04 vs. 0.05±0.89, P<0.001), less myopia (SEQ -0.09±0.53 vs. -0.14±0.71, P=0.015), lower astigmatism (-0.41±0.36 vs. -0.49±0.41, P=0.001), higher efficacy index (0.95±0.22 vs. 0.92±0.25, P=0.046), and higher safety index (1.02±0.17 vs. 0.97±0.22, P=0.002). Adjusted analyses for baseline and intraoperative differences confirmed these advantages.
Conclusions
Our findings suggest that pupil-decentration during hyperopic LASIK surgery is associated with superior postoperative visual and refractive outcomes, highlighting its potential to enhance surgical precision and safety in refractive treatments.