Corneal Vertex Centration

In this LASIK procedure, Dr. Reinstein centers flap creation and laser ablation on the corneal vertex, rather than the pupil center. He argues that centration on the corneal vertex does not contribute to induced coma or cylinder, and ultimately results in a treatment profile that is well-centered along the visual axis.

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Comments (4)

Dear Karen, Centration of myopic ablation is best performed on the corneal vertex (visual axis) for the same reasons that it is logical to do so for hyperopia. Where do you have evidence for saying that vertex centration of myopic ablations produces night vision disturbances? This has certainly not been our experience. In fact we often repair cases of myopic ablation that was performed on the pupil centre where there was a large angle kappa and recentration onto the vertex solves the night vision disturbances. Dan

DZ Reinstein (30 months ago)

Actually it would apply to Myopic ablations for the same reason as it is for hyperopic ablations. If myopic ablations are not centered on the visual axis (approximated by vertex) they will lead to SUBJECTIVE coma, eventhought he OBJECTIVE coma (measured by conventional pupil centered wavefront) would be lower.

DZ Reinstein (38 months ago)

I agree with Dr. Reinstein's final conclusion to center hyperopic treatments on the visual axis, but not myopic. Myopic ablations must be centered on the pupil to prevent night halos and glare from spherical and other aberrations when the pupil dilates.

Karen Heuer (39 months ago)

Interesting and Convincing Concept !!!

Ashish N (41 months ago)