Effect Of Wavefront Aberration Guided Fs-LASIK On Diopter And Visual Quality In Two Kappa Angle-Adjusted Modes

Objective: To analyze the distribution of the offset between the pupil center and the coaxially sighted corneal light reflex(P-Dist),and by giving 75%,100% angle kappa adjustments to investigate the effects on refractive and visual quality in patients with moderate myopia.Methods : Selected 129 patients(129 eyes,left eyes)with moderate myopia who underwent wavefront-guided femtosecond lasercombined LASIK at the Affiliated Hospital of Yanbian University in2021 from January to October.The efficacy and visual quality were measured preoperatively,6 months postoperatively.The main examinations contain subjective visual quality and objective visual quality.The subjective visual quality includes uncorrected visual acuity(UCVA)).Standard logarithmic visual acuity chart was used in visual acuity examination,which was converted into log MAR during data analysis.Objective visual quality includes the pupil size and center position which were measured by the Wave Light ALLEGRO Topolyzer,and contrast sensitivity was measured by the visual function tester(OPTEC 6500).The wavefront sensor was used to measure the Higherorder aberrations(HOA).The P-Dist of the patients was recorded by the x-and y-axis eyeball-tracking adjustment program of the Wave Light Eagle Vision EX500 excimer laser system during the operation.Results:1.The P-Dist was 0.225±0.104 mm(range: 0.035-0.540mm)of the total sample.The P-Dist was(0.218±0.093)mm in the 75% group.The P-Dist was(0.232 ± 0.113)mm in the 100% group,and the difference between the two groups was not statistically significant(t=-0.772,P=0.440).2.The movement of the pupil center in the light and mesopic condition: there was no significant difference in the X-axis and Yaxis direction of the left pupil center in the 75% and 100% groups under the light and shade conditions.3.Postoperative cylinder: When P-Dist>0.225 mm,the postoperative residual cylinder was 0.27±0.33 D in 75% adjustment group and there was 0.41 ± 0.27 D in 100% adjustment group,which was significantly higher than that in the 75% adjustment group(t=-2.063,P=0.045).4.Postoperative coma: when P-Dist>0.225 mm,The coma in 100%adjustment group was 0.31 ± 0.27,and that in 75% adjustment group was 0.22 ± 0.17,which was significantly lower than that in 100%adjustment group(t=-2.317,P=0.028).In the 100% adjustment group,when P-Dist≤0.225 mm the coma was 0.23 ± 0.12 and when P-Dist>0.225 mm the coma was 0.31 ± 0.27.The coma in P-Dist>0.225 mm group was significant higher than P-Dist≤0.225 mm group(t=-1.954,P=0.048)。5.At the 1.5c/d spatial frequency,contrast sensitivity in the100% compensation group was significantly lower than that in the 75%compensation group under visual glare conditions(t=3.625,P = 0.042).Conclusion:1.Good postoperative visual quality can be obtained by adjusting75% and 100%.2.In the individualized operations for those with moderate myopia and large angle Kappa in which 75% adjustment is chosen may could obtain better visual quality effect than 100% adjustment.3.Factors such as dynamic changes in the pupil center may be involved.