Cyclotorsional eye movements during a simulated PRK procedure

PURPOSE: Eye alignment is a serious concern when performing corneal surface ablation. Although several excimer lasers monitor horizontal and vertical movements, little is known about the potential impact of cyclotorsional movements. Dynamic cyclotorsions have been measured on 10 emmetropic subjects during a simulated PRK treatment. METHODS: Cyclotorsional eye movements were measured using a 3D videoculographic system (SMI) in 10 emmetropic subjects in upright and supine position. The subjects were wearing an eyelid speculum and were asked to fixate on a 1 degrees red spot. The fixation target was either in focus or optically degraded by electronic filters. Data were collected at the University Eye Clinic, Torino, Italy, and the different setting measurements were compared using Student's t-test for paired data. RESULTS: Cyclotorsions were significantly higher when subjects were fixating an optically degraded stimulus (upright: P=0.04; supine: P=0.0002). The cyclotorsional movements ranged from -13 to 17 degrees. A significant difference in eye orientation was present when changing from the upright to the supine position (P=0.03). Even when correcting for this positional error, significantly higher cyclotorsional movements were detected in the supine position (in focus: P=0.0043; optically degraded: P=0.0008). The torsional range was from -14.85 to 14.55 degrees. CONCLUSIONS: The high range of cyclotorsional eye movements during a simulated PRK procedure suggests that 3D tracking could improve surface ablation results when treating high astigmatism or when wavefront guided.