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Clinical outcomes of corneal refractive surgery comparing centration on the corneal vertex with the pupil center: a meta-analysis

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Abstract

Purpose

To compare the visual and refractive outcomes between centration on the corneal vertex and the pupil center in corneal refractive surgery.

Methods

A comprehensive literature search was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane Library to identify relevant studies. The primary outcomes were the postoperative spherical equivalent (SE), effectiveness [uncorrected distance visual acuity (UDVA) ≥ 20/20, eyes within ± 0.50 diopter (D) of target refraction], and safety [loss ≥ 2 lines of corrected distance visual acuity (CDVA)]. Higher-order aberrations were considered secondary outcomes.

Results

Seven studies describing a total of 1964 eyes were included in this meta-analysis. A statistical significance in postoperative SE was found between the two centration methods for the correction of myopia that favor the CV-centered method (p < 0.001). No significant differences were observed in the proportion of eyes with UDVA ≥ 20/20 or loss ≥ 2 lines of CDVA postoperatively. However, the proportion of eyes within ± 0.50 D was slightly higher (p = 0.02) and the coma aberration was much lower in the corneal vertex-centered method (p < 0.001).

Conclusion

Preferable visual and refractive outcomes could be achieved with either centering on the corneal vertex or pupil center in corneal refractive surgery; however, the corneal vertex-centered method has shown partial benefits in some clinical indices. In order to obtain higher quality of clinical evidences, more randomized controlled trials (RCTs) are required in further investigations.

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Funding

This study was supported by the National Natural Science Foundation of China (No. 81670884).

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Authors and Affiliations

  1. Tianjin Eye Hospital, Tianjin, China

    Jiamei Zhang, Yan Wang, Xiaoqin Chen & Wenjing Wu

  2. Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin, China

    Jiamei Zhang, Yan Wang, Xiaoqin Chen & Wenjing Wu

Authors
  1. Jiamei Zhang
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  2. Yan Wang
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  3. Xiaoqin Chen
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  4. Wenjing Wu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by JZ, XC, WW, and YW. The first draft of the manuscript was written by JZ, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yan Wang.

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Conflict of interest

Author Jiamei Zhang declares that she has no conflicts of interest. Author Yan Wang declares that she has no conflicts of interest. Author Xiaoqin Chen declares that she has no conflicts of interest. Author Wenjing Wu declares that she has no conflicts of interest.

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Zhang, J., Wang, Y., Chen, X. et al. Clinical outcomes of corneal refractive surgery comparing centration on the corneal vertex with the pupil center: a meta-analysis. Int Ophthalmol 40, 3555–3563 (2020). https://doi.org/10.1007/s10792-020-01506-1

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  • DOI: https://doi.org/10.1007/s10792-020-01506-1

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