Ablation centration in myopic laser in situ keratomileusis: comparing the Visx S3 ActiveTrak and the Visx S2

Abstract

Purpose To compare ablation centration and outcome measurements in myopic laser in situ keratomileusis (LASIK) using the eye-tracking Visx S3 ActiveTrak and the nontracking Visx S2 excimer lasers. Setting University-based refractive surgery practice. Methods In a retrospective study, 71 consecutively treated myopic eyes that had LASIK with the Visx Star S3 ActiveTrak were compared to 71 control-matched eyes treated with the Visx Star S2 without pupil tracking. Primary outcome variables including ablation centration, uncorrected visual acuity, best spectacle-corrected visual acuity, manifest refraction, complications, and induced cylinder analyzed by vector analysis were evaluated 3 months postoperatively. Results The myopia ranged from –1.50 to –11.25 diopters (D) and the cylinder, from +0.25 to +2.75 D. Ninety-four of 142 eyes (66%) were available for analysis at 3 months; 50 eyes could be used to analyze ablation centration. At 3 months, the mean decentration of the ablation zone from the entrance pupil was 0.22 mm ± 0.20 (SD) in tracked eyes (n = 25) and 0.21 ± 0.26 mm in nontracked eyes (n = 25) ( P = .88). Three eyes (12%) in the tracked group were decentered 0.5 to 1.0 mm, and 1 eye (4%) in the nontracked group was decentered more than 1.0 mm. All other eyes were decentered less than 0.5 mm. There was an association in the tracked group between greater decentrations and higher levels of myopia ( r = 0.67), but this association did not exist in the nontracked group ( r = −0.03). Conclusion Comparable ablation centration as well as visual and refractive outcomes can be achieved with and without active eye tracking during myopic and astigmatic myopic LASIK.