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Decentered Ablation

Ablation of cornea not aligned with visual axis during Lasik, Bladeless Lasik, PRK, LASEK, or Epi-Lasik.

Image of topographical map showing decentered ablation.  
A decentered ablation will cause a shift in the refractive error across the visual axis, resulting in poor vision quality.  
Decentered ablation is when the area reshaped by the laser in PRK, LASEK, Lasik, Epi-Lasik, and other laser assisted refractive surgery techniques is not centered to the eye's visual axis. This often means the edge of the ablation zone is within the visual axis, producing ghosting, starbursts, and/or halos. It is possible that an enhancement will correct the decentered ablation, but that process may increase refractive error and make you overcorrected.

Excimer lasers that use high frequency eye tracking systems significantly reduce the probability of a decentered ablation, however a decentered ablation can occur even with a tracker. It is important for the patient to fixate on the target within the laser during surgery.

An ablation that corrects only the decentered portion of the original ablation is most desirable, but is limited by technology. CWR may resolve a decentered ablation. If you have a decentered ablation, discuss the current technology and techniques with your doctor.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

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If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

Recent Decentered Ablation Medical Journal Articles...

Corneal Topograph-guided Laser Subepithelial Keratomileusis (LASEK) Corrects Decentered Ablation after Laser in situ.

Yan Ke Xue Bao. 2012 Dec;27(4):202-4

Authors: Yu KM, Zhang J, Luo HH

PURPOSE: Corneal topograph-guided laser subepithelial keratomileusis (LASEK) can effectively correct decentered ablation occurring post laser in situ keratomileusis (LASIK) and to enhance our understanding and diagnosis of decentered ablation following LASIK.
METHODS: Previous studies in the relevant literature are reviewed, and a case report is provided.
RESULTS: A patient with high myopia undergoing LASIK in both eyes presented with distorted vision in the left eye, which interfered with the vision in the right eye and caused blurred vision in both eyes. The patient was unable to see objects with both eyes. After receiving corneal topography-guided LASEK, the signs of distorted vision in the left eye and bilateral blurred vision were significantly alleviated, and the patient could see objects with both eyes simultaneously.
CONCLUSION: Clinical ophthalmologists should be aware of the occurrence of decentered ablation after LASIK. Corneal topography-guided LASEK is an efficacious tool for correcting decentered ablation.

PMID: 23225843 [PubMed - in process]


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