Purpose: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.
Methods: 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 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.The patient’s vision [uncorrected distance visual acuity (UDVA), best corrected visual acuity (BCVA)], 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.
Results: 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 spherical equivalent 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 non-dominant eyes were 1.20 (1.00, 1.22) and 1.20 (1.00, 1.20), respectively, and the efficacy index (postoperative UDVA/preoperative BDVA) were 1.00 (1.00, 1.20) and 1.00 (1.00, 1.20), respectively; the proportion of residual SE within ± 0.50D was 98% and 100%, respectively.
Conclusions: 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 is smaller than that of the nondominant eye and the pupil center of the dominant eye is slightly shifted to the temporal side under mesopic conditions. The correction of myopia in the dominant and nondominant eyes has 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 to find the ablation center closest to the visual axis.