Xu Wenhao, Jia Fali, Liu Jingting, Li Jiahao, Zhao Jian, Lin Shuhua, Jia Yujie, Li Yingjun
Ophthalmology, Fuyang People's Hospital of Anhui Medical University, Fuyang, China.
Ophthalmology, Enshi Huiyi Ophthalmology Hospital, Enshi, China.
Klin Monbl Augenheilkd. 2025 Jan;242(1):62-69. doi: 10.1055/a-2184-4260. Epub 2023 Sep 29.
To investigate the differences between dominant and nondominant eyes in a predominantly young patient population by analyzing the angle kappa, pupil size, and center position in dominant and nondominant eyes.
A total of 126 young college students (252 eyes) with myopia who underwent femtosecond laser-combined LASIK were randomly selected. Ocular dominance was determined using the hole-in-card test. The WaveLight Allegro Topolyzer (WaveLight Laser Technologies AG, Erlangen, Germany) was used to measure the pupil size and center position. The offset between the pupil center and the coaxially sighted corneal light reflex (P-Dist) of the patients was recorded by the x- and y-axis eyeball tracking adjustment program of the WaveLight Eagle Vision EX500 excimer laser system (Wavelight GmbH). The patient's vision (uncorrected distance visual acuity [UDVA], best-corrected visual acuity (BCVA), and refractive power (spherical equivalent, SE) were observed preoperatively, 1 week, 4 weeks, and 12 weeks postoperatively, and a quality of vision (QoV) questionnaire was completed.
Ocular dominance occurred predominantly in the right eye [right vs. left: (178) 70.63% vs. (74) 29.37%; p < 0.001]. The P-Dist was 0.202 ± 0.095 mm in the dominant eye and 0.215 ± 0.103 mm in the nondominant eye (p = 0.021). The horizontal pupil shift was - 0.07 ± 0.14 mm in dominant eyes and 0.01 ± 0.13 mm in nondominant eyes (p = 0.001) (the temporal displacement of the dominant eye under mesopic conditions). The SE was negatively correlated with the P-Dist (r = - 0.223, p = 0.012 for the dominant eye and r = - 0.199, p = 0.025 for the nondominant eye). At 12 weeks postoperatively, the safety index (postoperative BDVA/preoperative BDVA) of the dominant and nondominant eyes was 1.20 (1.00, 1.22) and 1.20 (1.00, 1.20), respectively, and the efficacy index (postoperative UDVA/preoperative BDVA) was 1.00 (1.00, 1.20) and 1.00 (1.00, 1.20), respectively; the proportion of residual SE within ± 0.50 D was 98 and 100%, respectively.
This study found that ocular dominance occurred predominantly in the right eye. The pupil size change was larger in the dominant eye. The angle kappa of the dominant eye was smaller than that of the nondominant eye and the pupil center of the dominant eye was slightly shifted to the temporal side under mesopic conditions. The correction of myopia in the dominant and nondominant eyes exhibits good safety, efficacy, and predictability in the short term after surgery, and has good subjective visual quality performance after correction. We suggest adjusting the angle kappa percentage in the dominant eye to be lower than that of the nondominant eye in individualized corneal refractive surgery in order to find the ablation center closest to the visual axis.
通过分析主导眼和非主导眼的卡帕角、瞳孔大小及中心位置，研究以年轻患者为主的群体中主导眼与非主导眼之间的差异。
随机选取126例接受飞秒激光联合准分子原位角膜磨镶术（LASIK）的近视年轻大学生（252只眼）。采用卡片孔试验确定眼优势。使用威视 Allegro Topolyzer（德国埃尔朗根威视激光技术公司）测量瞳孔大小和中心位置。通过威视鹰视 EX500 准分子激光系统（威视有限公司）的 x 轴和 y 轴眼球跟踪调整程序记录患者瞳孔中心与同轴视轴角膜光反射之间的偏移（P-Dist）。术前、术后1周、4周和12周观察患者的视力（未矫正远视力[UDVA]、最佳矫正视力[BCVA]和屈光力[等效球镜，SE]），并完成视觉质量（QoV）问卷。
眼优势主要发生在右眼[右与左：（178只）70.63%对（74只）29.37%；p＜0.001]。主导眼的P-Dist为0.202±0.095mm，非主导眼为0.215±0.103mm（p = 0.021）。主导眼的水平瞳孔移位为-0.07±0.14mm，非主导眼为0.01±0.13mm（p = 0.001）（主导眼在中间视觉条件下向颞侧移位）。SE与P-Dist呈负相关（主导眼r = -0.223，p = 0.012；非主导眼r = -0.199，p = 0.025）。术后12周，主导眼和非主导眼的安全指数（术后最佳矫正视力/术前最佳矫正视力）分别为1.20（1.00，1.22）和1.20（1.00，1.20），疗效指数（术后未矫正远视力/术前最佳矫正视力）分别为1.00（1.00，1.20）和1.00（1.00，1.20）；±0.50D内残余SE的比例分别为98%和100%。
本研究发现眼优势主要发生在右眼。主导眼的瞳孔大小变化更大。主导眼的卡帕角小于非主导眼，且主导眼的瞳孔中心在中间视觉条件下略向颞侧移位。主导眼和非主导眼近视矫正术后短期内具有良好的安全性、有效性和可预测性，矫正后主观视觉质量表现良好。我们建议在个体化角膜屈光手术中，将主导眼的卡帕角百分比调整得低于非主导眼，以便找到最接近视轴的消融中心。
