Abstract

PurposeTo investigate the capability of Zernike polynomials fitting to reconstruct corneal surfaces as measured by Pentacam HR tomographer, Medmont E300 Placido-disc and Eye Surface Profiler (ESP). MethodsThe study utilised a collection of clinical data of 527 participants. Pentacam HR raw elevation data of 660 eyes (430 healthy and 230 keratoconic) were fitted to Zernike polynomials of order 2 to 20. Same analyses were carried out on 158 eyes scanned by Medmont E300 Placido-disc and 236 eyes were scanned by ESP for comparison purposes. The Zernike polynomial ​fitting was carried out using a random 80% of each individual eye surface's data up to a corneal radius of 5 mm and the root means squared fitting error (RMS) was calculated for the unused 20% portion of the surface data. The process was carried out for the anterior and posterior surfaces of the corneal measurements of the Pentacam HR and the anterior surfaces only with the ESP and the Medmont E300 measurements. ResultsStatistical significances in reduction of RMS were noticed up to order 14 among healthy participants (p < 0.0001 for right eyes, p = 0.0051 for left eyes) and up to order 12 (p < 0.0001 for right eyes, p = 0.0002 for left eyes) in anterior surfaces measured by the Pentacam. Among keratoconic eyes, statical significance was noticed up to order 12 in both eyes (p < 0.0001 for right eyes, p = 0.0003 for left eyes). The Pentacam posterior corneal data, both right and left, healthy and keratotic eyes recorded significance (p < 0.0001) in reduction of RMS up to order 10 with same RMS values of 0.0003 mm with zero standard deviation. RMS of fitting Zernike polynomials to Medmont data up to order 20 showed a consistent reduction in RMS with the increase of the fitting order with no rise at high fitting orders. Minimum RMS = 0.0047 ± 0.0021 mm, 0.0046 ± 0.0019 mm for right and left eyes respectively were recorded at order 20 and were more than 15 times the minimum RMS of the Pentacam. RMS of fitting Zernike polynomials to ESP data also showed a consistent reduction in RMS with the increase of the fitting order with no sign of any rise at high fitting orders. Similar to the Medmont, minimum RMS of 0.0005 ± 0.0003 mm, 0.0006 ± 0.0003 mm was recorded at order 20 for right and left eyes respectively and was 2 times the minimum RMS of the Pentacam for right eyes and 1.7 times the minimum RMS of the Pentacam for left eyes. ConclusionsOrders 12 and 10 Zernike polynomials almost perfectly matched the raw-elevation data collected from Pentacam for anterior and posterior surfaces, respectively for either healthy or keratoconic corneas. The Zernike fitting could not perfectly match the data collected from Medmont E300 and ESP.

Highlights

  • Several instruments reconstruct anterior eye features in the market with good repetitions in terms of accuracy and repeatability, the common recommendation from the literature is not to use measured values interchangeably among these instruments [1, 2]

  • The results showed that the Pentacam anterior surface Zernike polynomial fitting root means squared fitting error (RMS) decreased with the increase of the fitting order, Table 1, the small values of the RMS error from order 10 (RMS 1⁄4 0.0004 Æ 0.0001 mm for right eyes, RMS 1⁄4 0.0005 Æ 0.0002 mm for left eyes) to 15 (RMS 1⁄4 0.0003 Æ 0.0001 mm for right eyes, RMS 1⁄4 0.0004 Æ 0.0015 mm for left eyes) were notable in healthy subjects

  • The same phenomenon was noticed in keratoconic patients between order 10 (RMS 1⁄4 0.0005 Æ 0.0002 mm for right eyes, RMS 1⁄4 0.0005 Æ 0.0002 mm for left eyes) and order 15 (RMS 1⁄4 0.0003 Æ 0.0002 mm for right eyes, RMS 1⁄4 0.0004 Æ 0.0003 mm for left eyes)

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Summary

Introduction

Several instruments reconstruct anterior eye features in the market with good repetitions in terms of accuracy and repeatability, the common recommendation from the literature is not to use measured values interchangeably among these instruments [1, 2]. The Pentacam captures sets of cross-sectional images using the Scheimpflug camera, while the Medmont Placido-disc analyses the reflected image of concentric rings, and the Eye Surface Profiler (ESP) captures sinusoidal grating projected images using a charge-coupled device (CCD) camera. Due to these differences, the measured object does not directly represent corneal topography or tomography. DSP involves enhancement, representation, reconstruction and, in some cases, interpretation of signals

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