The Centration Dilemma in Refractive Corrections: Why Is It Still a Dilemma and How to Cope?

(1) Background: Defining the optimum center for laser refractive corrections is difficult, with many of the available approaches having pros and cons. Decentered ablations result in undesirable side effects like halos, glare, monocular diplopia, and a reduction in visual acuity; (2) Methods: The ide...

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Main Authors: Samuel Arba Mosquera, Shwetabh Verma
Format: Article
Language:English
Published: MDPI AG 2024-08-01
Series:Photonics
Subjects:
Online Access:https://www.mdpi.com/2304-6732/11/9/822
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author Samuel Arba Mosquera
Shwetabh Verma
author_facet Samuel Arba Mosquera
Shwetabh Verma
author_sort Samuel Arba Mosquera
collection DOAJ
description (1) Background: Defining the optimum center for laser refractive corrections is difficult, with many of the available approaches having pros and cons. Decentered ablations result in undesirable side effects like halos, glare, monocular diplopia, and a reduction in visual acuity; (2) Methods: The ideal centration in refractive corrections should fulfil three requirements: covering a scotopic pupil; respecting the visual axis; and minimizing tissue removal. The implications of different centration strategies are discussed and shown graphically; (3) Results: Oversized asymmetric offset ablation faces fewer difficulties in registering static cyclotorsion, features less tissue wastage compared to a symmetric offset, and includes a certain amount of coma (and trefoil) in the profile, benefiting eyes with a pupil offset, which typically present with relevant amounts of coma and trefoil corneal aberrations due to decentered optics; (4) Conclusions: There is a need for a flexible choice of centration in refractive procedures to design customized and non-customized treatments optimally. An ideal optical zone covering the pupil with the widest entrance may be as important as a centration reference.
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spelling doaj-art-6562b702f8b74d2f9eb7fa44a33d51c42025-08-20T01:55:46ZengMDPI AGPhotonics2304-67322024-08-0111982210.3390/photonics11090822The Centration Dilemma in Refractive Corrections: Why Is It Still a Dilemma and How to Cope?Samuel Arba Mosquera0Shwetabh Verma1SCHWIND Eye-Tech-Solutions GmbH, Mainparkstrasse 6-10, D-63801 Kleinostheim, GermanySCHWIND Eye-Tech-Solutions GmbH, Mainparkstrasse 6-10, D-63801 Kleinostheim, Germany(1) Background: Defining the optimum center for laser refractive corrections is difficult, with many of the available approaches having pros and cons. Decentered ablations result in undesirable side effects like halos, glare, monocular diplopia, and a reduction in visual acuity; (2) Methods: The ideal centration in refractive corrections should fulfil three requirements: covering a scotopic pupil; respecting the visual axis; and minimizing tissue removal. The implications of different centration strategies are discussed and shown graphically; (3) Results: Oversized asymmetric offset ablation faces fewer difficulties in registering static cyclotorsion, features less tissue wastage compared to a symmetric offset, and includes a certain amount of coma (and trefoil) in the profile, benefiting eyes with a pupil offset, which typically present with relevant amounts of coma and trefoil corneal aberrations due to decentered optics; (4) Conclusions: There is a need for a flexible choice of centration in refractive procedures to design customized and non-customized treatments optimally. An ideal optical zone covering the pupil with the widest entrance may be as important as a centration reference.https://www.mdpi.com/2304-6732/11/9/822corneal vertex centrationpupil centrationline of sightvisual axisrefractive correctioncentration
spellingShingle Samuel Arba Mosquera
Shwetabh Verma
The Centration Dilemma in Refractive Corrections: Why Is It Still a Dilemma and How to Cope?
Photonics
corneal vertex centration
pupil centration
line of sight
visual axis
refractive correction
centration
title The Centration Dilemma in Refractive Corrections: Why Is It Still a Dilemma and How to Cope?
title_full The Centration Dilemma in Refractive Corrections: Why Is It Still a Dilemma and How to Cope?
title_fullStr The Centration Dilemma in Refractive Corrections: Why Is It Still a Dilemma and How to Cope?
title_full_unstemmed The Centration Dilemma in Refractive Corrections: Why Is It Still a Dilemma and How to Cope?
title_short The Centration Dilemma in Refractive Corrections: Why Is It Still a Dilemma and How to Cope?
title_sort centration dilemma in refractive corrections why is it still a dilemma and how to cope
topic corneal vertex centration
pupil centration
line of sight
visual axis
refractive correction
centration
url https://www.mdpi.com/2304-6732/11/9/822
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