Abstract
PurposeTo compare the measurements of lower and higher order aberrations (HOA) of 4 commonly used aberrometers.SettingMassachusetts Eye & Ear Infirmary, Boston, USA.DesignProspective, cross-sectional study, in a controlled, single-blinded fashion.MethodsMultiple readings were obtained in 42 eyes of 21 healthy volunteers, at a single visit, with each of the following aberrometers: Alcon LADARWave®, Visx WaveScan®, B & L Zywave®, and Wavelight Allegro Analyzer®. Results were compared and analyzed in regards to the lower and HOA, to the different wavefront sensing devices and software, Tscherning and Hartmann–Shack and between the Fourier and Zernike algorithms. Statistical analysis included Bland-Altman plots, Intraclass Correlation Coefficient (ICC), multiple comparison tests with Analysis of Variance and Kruskal-Wallis. Significant level was set to p<0.05 and alpha level correction was adjusted under the Bonferroni criteria.ResultsMost measurements of all 4 aberrometers were comparable. However, statistically significant differences were found between the aberrometers in total HOA (tHOA), spherical aberration (SA), horizontal coma and astigmatism (2,2). LADARwave and Wavescan showed significant differences in tHOA (P<0.001, ICC = 0.549, LoA = 0.19±0.5) and in SA (P<0.001, ICC = 0.733, LoA = 0.16±0.37). Wavescan showed a significant difference compared to Zywave (p<0.001, ICC = 0.920, LoA = 0.09±0.13) in SA. Comparisons between Allegro Analyzer and Zywave demonstrated significant differences in both Horizontal Coma (3,1) (p<0.001, ICC = −0.207, LoA = −0.15±0.48) and Astigmatism (2,2) (P = 0.003, ICC = −0.965, LoA = 0.2±2.5). Allegro Analyzer also differed from Wavescan in Horizontal Coma (3,1) (P<0.001, ICC = 0.725, LoA = −0.07±0.25).ConclusionsAlthough some measurements were comparable predominately in the lower order aberrations, significant differences were found in the tHOA, SA, horizontal coma and astigmatism. Our analysis suggests that sensor design contributes to agreement in lower order aberrations, and Fourier and Zernike expansion might disagree in higher order aberrations. Therefore, comparison between aberrometers was generally possible with some exceptions in higher order measurements.
Highlights
Last decade technological advancements in aberrometry have revolutionized wavefront-based corneal refractive surgery [1,2]
Statistically significant differences were found between the aberrometers in total higher order aberrations (HOA), spherical aberration (SA), horizontal coma and astigmatism (2,2)
Wavescan showed a significant difference compared to Zywave (p,0.001, Intraclass Correlation Coefficient (ICC) = 0.920, LoA = 0.0960.13) in SA
Summary
Last decade technological advancements in aberrometry have revolutionized wavefront-based corneal refractive surgery [1,2]. Companies designing wavefront aberrometers for the clinical setting implement some of these techniques and methods [3] Such systems are routinely used as part of the refractive surgery consultation and decision making process [6]. The most common metric in use today is the Root Mean Square (RMS) wavefront error, which is defined as the root square of the wavefront variance over the pupil size of interest [9]. Some visual disturbances such as night vision halos and glare have been associated with highly aberrated eyes [10]. The ability to measure and correct these wavefront abnormalities can provide a benefit in customizing a refractive procedure and in the enhancement of iatrogenically induced aberrations after surgery [11]
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