Predictive factor analysis for successful performance of iris recognition-assisted dynamic rotational eye tracking during laser in situ keratomileusis

Am J Ophthalmol. 2010 Feb;149(2):229-237.e2. doi: 10.1016/j.ajo.2009.08.021. Epub 2009 Nov 6.

Abstract

Purpose: To analyze the predictive factors associated with success of iris recognition and dynamic rotational eye tracking on a laser in situ keratomileusis (LASIK) platform with active assessment and correction of intraoperative cyclotorsion.

Design: Interventional case series.

Methods: Two hundred seventy-five eyes of 142 consecutive candidates underwent LASIK with attempted iris recognition and dynamic rotational tracking on the Technolas 217z100 platform (Techolas Perfect Vision, St Louis, Missouri, USA) at a tertiary care ophthalmic hospital. The main outcome measures were age, gender, flap creation method (femtosecond, microkeratome, epi-LASIK), success of static rotational tracking, ablation algorithm, pulses, and depth; preablation and intraablation rotational activity were analyzed and evaluated using regression models.

Results: Preablation static iris recognition was successful in 247 eyes, without difference in flap creation methods (P = .6). Age (partial correlation, -0.16; P = .014), amount of pulses (partial correlation, 0.39; P = 1.6 x 10(-8)), and gender (P = .02) were significant predictive factors for the amount of intraoperative cyclodeviation. Tracking difficulties leading to linking the ablation with a new intraoperatively acquired iris image were more with femtosecond-assisted flaps (P = 2.8 x 10(-7)) and the amount of intraoperative cyclotorsion (P = .02). However, the number of cases having nonresolvable failure of intraoperative rotational tracking was similar in the 3 flap creation methods (P = .22).

Conclusions: Intraoperative cyclotorsional activity depends on the age, gender, and duration of ablation (pulses delivered). Femtosecond flaps do not seem to have a disadvantage over microkeratome flaps as far as iris recognition and success of intraoperative dynamic rotational tracking is concerned.

MeSH terms

  • Aberrometry
  • Adult
  • Corneal Stroma / surgery
  • Corneal Topography
  • Eye Movements*
  • Female
  • Humans
  • Intraoperative Complications*
  • Iris Diseases / diagnosis*
  • Iris Diseases / etiology
  • Keratomileusis, Laser In Situ*
  • Lasers, Excimer / therapeutic use*
  • Male
  • Myopia / surgery*
  • Prospective Studies
  • Refraction, Ocular / physiology
  • Surgical Flaps
  • Torsion Abnormality / diagnosis*
  • Torsion Abnormality / etiology
  • Visual Acuity