To evaluate the effect of the amount of cylindrical correction on the accuracy of geometric corneal center-adjusted ablation centration selected by the surgeon in advanced surface ablation-photorefractive keratectomy (ASA-PRK).

Ninety-five myopic eyes of 62 patients who underwent ASA-PRK were divided into three groups based on the amount of myopic cylindrical correction: Group 1 <-0.50 D, 22 eyes; Group 2 ≥-0.50 D and <-1.00 D, 45 eyes; Group 3 ≥-1.00 D, 28 eyes. The distances and distribution of the ablation centers from the entrance pupil center were analyzed by corneal topography at one month after ASA-PRK. Risk factors for decentration (>0.3 mm) were determined from patient-related factors such as gender, age, laterality, central corneal thickness, and order of procedure and surgery-related factors such as amount of spherical correction, ablation depth, vertical scale bar percentage, and learning effect of surgeon.

Mean decentration was 0.26 ± 0.15 mm (0.04 to 0.83 mm). There was no statistically significant difference in the amount of decentration among the three groups ( p = 0.879). Superior-nasal displacement (53.7%) of the ablation center most frequently occurred after ASA-PRK. The amount of decentration among the three groups was not dependent on either patient-related or surgery-related factors.

ASA-PRK using the surgeon-selected ablation center with adjustment toward the geometric corneal center was found to be highly accurate in ablation centration and did not influence the amount of ablation decentration regardless of the amount of myopic cylindrical correction.