Purpose: To investigate the degree of rotational malposition in eyes undergoing laser in situ keratomileusis.
Design: Prospective observational study.
Methods: We measured the rotational position of 240 eyes of 169 patients who underwent treatment for myopic or hyperopic astigmatism with the Alcon Summit Autonomous (Orlando, Florida) LADARVision excimer laser. Immediately preoperatively, each eye was marked while the patient was seated upright. Rotational position was measured on the supine patient immediately before beginning the laser exposure.
Results: For all 240 eyes, mean +/- standard deviation (SD) torsional misalignment was 4.1 +/- 3.7 degrees (right eye 3.8 +/- 3.7 degrees, left eye 4.2 +/- 3.6 degrees). A total of 20 eyes (8%) had a deviation of greater than 10 degrees.
Conclusions: A 4 degree and 10 degree misalignment would theoretically result in a 14% and 35% undercorrection of astigmatism, respectively. Preoperative marking of the upright patient and subsequent rotational alignment of the supine patient before laser treatment may reduce the error in correction of astigmatism during excimer laser vision correction surgery.