Higher-order Aberrations In Patients Research Articles

Higher Order Aberrations in Patients with Unilateral Nasolacrimal Duct Obstruction.

To compare corneal higher order aberrations (HOAs) in patients with epiphora caused by unilateral primary acquired nasolacrimal duct obstruction (PANDO) and their fellow eyes. A total of 122 eyes of 61 patients with unilateral PANDO were included. Affected eyes were named as group 1 and contralateral eyes as group 2. The Munk score and fluorescein dye disappearance test (FDDT) were assessed. Corneal topographic and HOAs measurements were taken by Sirius topography. There were 47 female and 14 male patients. The mean keratometry was 43.84 ± 1.4 in group 1 and 43.96 ± 1.4 in group 2 (p = 0.73). The mean corneal topographic astigmatism was 0.81 ± 0.7 in group 1 and 0.78 ± 0.5 in group 2 (p = 0.57). The mean coma-like aberration was 0.19 ± 0.2 in group 1 and 0.10 ± 0.1 in group 2 (p = 0.03). The mean spherical-like aberration was 0.16 ± 0.1 in group 1 and 0.11 ± 0.1 in group 2 (p = 0.04). The mean total corneal HOA was 0.30 ± 0.5 in group 1 and 0.23 ± 0.2 in group 2 (p = 0.04). The mean Munk score was 3.47 ± 1.0 in group 1. There was a positive correlation between the Munk score and both coma-like aberration (r = 0.53, p = 0.003) and total corneal HOAs (r = 0.44, p = 0.010). The mean FDDT grade was 2.60 ± 0.1 in group 1. A positive correlation was observed between the FDDT grade and both coma-like aberration (r = 0.48, p = 0.001) and total corneal HOAs (r = 0.33, p = 0.001). Epiphora in patients with PANDO can affect corneal HOAs. As patients' symptoms and tear pooling were increased as corneal HOA levels increased.

The visual impact of higher-order aberrations in patients with pediatric blepharokeratoconjunctivitis.

To analyze higher-order aberrations (HOAs) and their visual impact in a pediatric blepharokeratoconjunctivitis (PBKC) cohort compared with healthy controls. Prospective case-control study of pediatric patients (≤ 16 years old). Subjects underwent wavefront aberrometry analysis to compare HOAs and their impact on visual quality. A total of 150 eyes from 76 patients were included in the analysis. The PBKC group consisted of 50 eyes and the control group of 100 healthy eyes. Mean age was 10.39 ± 3.81 years for the PBKC group and 10.80 ± 3.61 years for the controls. Mean corrected-distance visual acuity (CDVA) was 0.24 ± 0.21 logMAR in the PBKC group and 0.07 ± 0.1 in the controls (P < 0.001). Mean astigmatism was 1.6 ± 1.98D in the PBKC group vs. 0.67 ± 0.76D in the control group (P = 0.01). Mean RMS of HOAs was 1.05 ± 1.7mm in the PBKC group and 0.41 ± 0.18mm in the controls (P < 0.001). The mean modulation transfer function (MTF) in the PBKC group was significantly lower (16.37 ± 16.32) than controls (30.3 ± 23.57) (P < 0.001). Corneal leukomas, stromal vascularization, peripheral nummular subepithelial scars, and pannus formation are associated with increased HOAs. There was a significant increase in total HOAs of eyes with PBKC compared to healthy controls. Corneal opacity, vascularization, and scarring are associated with increased HOAs. The PBKC eye aberration profile: coma, secondary astigmatism, quadrafoil, and pentafoil, were associated with decreased CDVA and visual quality (PSF and MTF).

Moisture chamber goggles for the treatment of postoperative dry eye in patients receiving SMILE and FS-LASIK surgery

BackgroundThe incidence of refractive surgery-related dry eye disease (DED) is rising due to the increasing popularity of corneal refractive surgery. The moisture chamber goggles (MCGs) have been shown to tear evaporation by increasing local humidity and minimizing airflow. The current study aims to evaluate the efficacy of moisture chamber goggles for refractive surgery-related DED.MethodsIn this nonrandomized open-label controlled study, 78 participants (156 eyes) receiving refractive surgery were enrolled between July 2021 and April 2022, and sequentially allocated to MGC and control groups. 39 participants were allocated to the MGC groups, of which 53.8% received small-incision lenticule extraction (SMILE) and 46.2% received femtosecond laser-assisted in situ keratomileusis (FS-LASIK), and were instructed to wear MCGs for the duration of 1 month postoperatively, in addition to the standard postoperative treatment received by the control groups (56.4% SMILE, 43.6% FS-LASIK). Participants underwent full ophthalmic examinations, including visual acuity, manifest refraction, DED evaluations, and higher-order aberrations (HOAs), both preoperatively and at routine follow-ups 1 day, 1 week, and 1 month after surgery. DED parameters included non-invasive tear film break-up time (NIBUT), tear meniscus height (TMH), conjunctival congestion, lipid layer thickness (LLT), and ocular surface disease index (OSDI) questionnaires. Student’s t-test was used for comparisons between control and MCG groups, and between preoperative and postoperative parameters within groups.ResultsPostoperative NIBUT decreased in both SMILE and FS-LASIK control groups 1 day after the surgery (SMILE, P = 0.001; FS-LASIK, P = 0.008), but not in the corresponding MCG groups (SMILE, P = 0.097; FS-LASIK, P = 0.331). TMH in the MCG group was significantly higher at 1 week (P = 0.039) and 1 month (P = 0.015) in SMILE, and 1 day (P = 0.003) in FS-LASIK groups. In FS-LASIK participants, significantly lower HOAs and coma levels in the MCG group were observed 1 day (total HOAs, P = 0.023; coma, P = 0.004) and 1 week (total HOAs, P = 0.010, coma, P = 0.004) after surgery. No consistent statistically significant intergroup difference was observed between MCG and control groups in conjunctival congestion, LLT, and OSDI.ConclusionsMCGs effectively slowed tear evaporation, increased tear film stability, and improved HOAs in patients receiving SMILE and FS-LASIK surgeries. MCG is an effective adjuvant therapy in the comprehensive management of refractive surgery-related DED.

Интрастромальная фемтокератопластика с имплантацией роговичных сегментов в коррекции аберраций высшего порядка у пациентов с кератоконусом

Aim. To evaluate the potential of femtosecond laser assisted intrastromal keratoplasty (FLAIK) with implantation of corneal ring segments in the correction of higher order aberrations in patients with stage I–II keratoconus. Material and methods. 15 patients (14 men and 1 woman) were examined and treated surgically, in total of 17 eyes, with stage I and II keratoconus (according to the classification of Izmailova S.B., 2014). All patients underwent FLAIK with implantation of corneal ring segments. Results. The change in the estimated parameters at an average follow-up period of 4.7 months showed that after FLAIK with implantation of corneal ring segments, best corrected visual acuity increased statistically significantly (p &lt; 0.05) in all cases and increased by an average of 0.29 ± 0.09. In addition, there was a statistically significant (p &lt; 0.05) decrease in the total level of higher order aberrations by 1.5 times (by 0.69 ± 0.4 D), a decrease in the level of coma aberration by 1.7 times (by 0.74 ± 0.4 D), a decrease in the level of spherical aberration by 1.6 times (by 0.07 ± 0.12 D). Conclusions. FLAIK with implantation of corneal ring segments is an effective method for correcting higher-order aberrations in patients with keratoconus of stage I–II. FLAIK with keratoconus with implantation of corneal ring segments makes it possible to achieve a significant increase in BCVA in patients with stage I–II keratoconus. Key words: keratoconus, higher order aberrations, corneal segments, refractive surgery

Characteristics and influencing factors of corneal higher-order aberrations in patients with cataract

PurposeTo observe the distribution characteristics of corneal higher-order aberrations (HOAs) in cataract patients, and analyze the relationship of HOAs with patients’ age and ocular biometric parameters.MethodsThis retrospective study reviews the patients with cataract in Wuhan Aier Eye Department from January to August 2022. Root mean square (RMS) of the total HOA (tHOA), spherical aberration (SA), coma and trefoil aberration of the anterior cornea at central 4 and 6 mm optic zone were measured by the Wavefront Aberrometer (OPD-Scan III; Nidek Inc, Tokyo, Japan). The biometric parameters including axial length (AL), keratometry (K), central corneal thickness (CCT) and lens thickness (LT) were measured by swept-source coherence laser interferometry (OA-2000; TOMEY Corp, Aichi, Japan). Subgroup analyses and multiple linear regression analyses were used to determine whether HOAs were associated with age and ocular biometric parameters.ResultsA total of 976 patients (976 eyes) were included, averagely aged 65 years. At central 4 and 6 mm optic zone, the mean RMS of tHOA were respectively 0.20 and 0.65 μm, the SA were 0.06 and 0.30 μm, the coma aberration were 0.11 and 0.35 μm, and the trefoil aberration were 0.12 and 0.30 μm. The tHOA decreased with age until 60 years and then started to increase afterwards. The tHOA, coma and trefoil aberration increased with corneal astigmatism. The tHOA, SA, and coma aberration differ among different AL groups, and emmetropes had the smallest tHOA, SA, and coma aberration.ConclusionsWith increasing age, the value of tHOA decrease first and started increasing at 60 years. The trends of corneal HOAs are consistent with corneal low-order aberrations. The values of tHOA, SA and coma aberration were the smallest in emmetropic eyes.

Effect of preoperative pupil offset on corneal higher-order aberrations after femtosecond laser-assisted in situ keratomileusis

BackgroundThis study aimed to investigate the relationship between multiple higher-order aberrations (HOAs) subgroups and pupil offset, as well as to analyze the factors affecting postoperative corneal HOAs in patients with different degrees of refractive errors.MethodsWe enrolled 160 patients (316 eyes) aged ≥ 18 years who had undergone femtosecond laser-assisted in situ keratomileusis (FS-LASIK) treatment. Based on the relationship between the preoperative pupil offset and the postoperative ΔHOAs, all patients were divided into two groups: group I (pupil offset ≤ 0.20 mm) and group II (pupil offset > 0.20 mm). All of the eyes had low to high myopia with or without astigmatism (manifest refraction spherical equivalent (MRSE) < -10.00 D). Uncorrected distance visual acuity, corrected distance visual acuity, MRSE, pupil offset, central corneal thickness, corneal HOAs, vertical coma (Z3−1), horizontal coma (Z31), spherical aberration (Z40), trefoil 0° (Z33), and trefoil 30° (Z3−3) over a 6 mm diameter central corneal zone diameter were evaluated preoperatively and at 1 and 3 months postoperatively.ResultsOur result revealed significant differences in postoperative corneal total root mean square (RMS) HOAs, RMS vertical coma, RMS horizontal coma, RMS spherical aberration, and RMS trefoil 30° between group I and group II. ΔMRSE was found to be an effective factor for ΔRMS HOAs (R2 = 0.383), ΔRMS horizontal coma (R2 = 0.205), and ΔRMS spherical aberration (R2 = 0.397). In group II, multiple linear regression analysis revealed a significant correlation between preoperative pupillary offset and Δtotal RMS HOAs (R2 = 0.461), ΔRMS horizontal coma (R2 = 0.040), and ΔRMS trefoil 30°(R2 = 0.089). The ΔRMS vertical coma effect factor is the Y-component, and the factor influencing ΔRMS spherical aberration was ΔMRSE (R2 = 0.256).ConclusionA small pupil offset was associated with a lower induction of postoperative corneal HOAs. Efforts to optimize centration are critical for improving surgical outcomes in patients with FS-LASIK.

Corneal topography and higher-order aberrations in patients with type 2 diabetes mellitus

Background: Changes in blood sugar levels cause alterations in the anterior segment and retina of the eye. This study was aimed at evaluating corneal topography, aberrometry, and corneal asphericity in patients with treatment-naive type 2 diabetes mellitus (T2DM).&#x0D; Methods: Participants with treatment-naive T2DM were enrolled in this cross-sectional study. The inclusion criteria were glycated hemoglobin A1c (Hb A1c) greater than or equal to 7.5% and absence of other ocular or systemic diseases. Patients who refused to participate or had a history of topical or systemic steroid use, hyperlipidemia, hypertension, anemia, prior ocular disorder or surgery, diabetic retinopathy, glaucoma, cataract, active ocular inflammatory or infectious disease, or contact lens use were excluded. All participants underwent a comprehensive ophthalmic examination. The Pentacam HR Scheimpflug tomography system (Pentacam High Resolution; Oculus, Wetzlar, Germany) was used to measure the anterior-segment parameters.&#x0D; Results: Sixty eyes of 30 patients with a male-to-female ratio of 1:1 were included; the mean (standard deviation [SD]) age and Hb A1c were 51.63 (6.73) years and 8.82% (1.31%), respectively. The mean (SD) values of central corneal thickness, root mean square (RMS) of total aberration, RMS of lower-order aberrations, RMS of higher-order aberrations, spherical aberration, 0° coma, 90° coma, flat anterior keratometry (K), steep anterior K, mean anterior K, anterior topographic astigmatism, flat posterior K, steep posterior K, mean posterior K, posterior topographic astigmatism, anterior corneal asphericity, and posterior corneal asphericity were 540.22 (24.47) µm, 1.72 (0.73) µm, 1.63 (0.73) µm, 0.51 (0.17) µm, + 0.31 (0.09) µm, - 0.06 (0.15) diopters (D), 0.003 (0.21) D, 43.87 (1.49) D, 44.69 (1.50) D, 44.28 (1.44) D, + 0.82 (0.83) D, - 6.25 (0.27) D, - 6.55 (0.31) D, - 6.40 (0.28) D, - 0.30 (0.15) D, - 0.32 (0.12) Q-value, and - 0.47 (0.17) Q-value, respectively.&#x0D; Conclusions: We presented the mean values of Pentacam parameters for aberrometry, keratometry, and corneal asphericity in patients with treatment-naive T2DM. These values could serve as a baseline for prospective monitoring of the ocular health status of this cohort and for comparison with future cohorts of patients with well-controlled T2DM. Further studies are required to assess the presence and applicability of ocular changes following intensive blood glucose control in T2DM and further understand the related pathophysiology.

Effect of corneal collagen cross-linking on higher-order aberrations in patients with early keratoconus

Background and aim Collagen cross-linking (CXL) is the available treatment to arrest the progression of keratoconus (KC). It consists of photopolymerization of collagen induced by combined action of a photosensitizing substance, and ultraviolet-A light. The aim of the study is to assess higher-order aberrations (HOAs) of cornea in patients with early KC before and after cross-linking using the Bausch &amp; Lomb Zywave II aberrometer. Patients and methods In total, 30 patients (nine males and 21 females), aged 19–35-years old with mild KC. HOAs examination was done using Zywave device before and after corneal CXL and followed up 1, 3, and 6 months postoperative. Results Preoperative and postoperative 1-month Root Mean Square (RMS) of the total HOA differences was statistically insignificant with P value of 0.102, however, preoperative and postoperative 3 and 6 months showed higher significance with P value of 0.007 and P value less than 0.001, respectively. Preoperative and postoperative 1-month RMS of total coma-order aberration differences was statistically insignificant (P=0.211), however preoperative and postoperative 3 and 6 months showed higher significance with P value of 0.024 and value less than 0.001, respectively. Preoperative and postoperative 1- and 3-month secondary astigmatism-aberration differences were statistically insignificant (P=0.070 and 0.216, respectively), however preoperative and postoperative 6 months showed higher significance with P value less than 0.001. Conclusion There is reduction in the parameters of HOAs after CXL in patients with KC, especially total HOA, coma, and secondary astigmatism aberrations.

Comparative analysis on the effects of three surgical methods on postoperative visual quality and higher-order aberrations in patients with refractive errors

Comparative analysis on the effects of three surgical methods on postoperative visual quality and higher-order aberrations in patients with refractive errors

Effects of SMILE and FS-LASIK on early postoperative corneal higher order aberrations in patients with high myopia

Effects of SMILE and FS-LASIK on early postoperative corneal higher order aberrations in patients with high myopia

Comparative assessment of functional outcomes of different endothelial keratoplasty techniques

Comparative analysis of the higher-order aberrations (HOA) of the cornea after endothelial keratoplasty (EK) using DSAEK and DMEK techniques; evaluation of the correlation between higher-order corneal aberrations and functional outcomes of the treatment. The study included 47 patients (59 eyes). The main group consisted of 35 patients (35 eyes) with bullous keratopathy and Fuchs' endothelial dystrophy; among them, 19 patients underwent endothelial keratoplasty using the DSAEK technique and 16 - DMEK technique. The control group included 12 patients (24 eyes) of corresponding age without corneal pathology. Standard and special examination tests were performed before, as well as 6 and 12 months after the operation, including computed tomography and aberrometry of the cornea using the Pentacam HR system. Same tests were performed in the control group. The values of the main HOA of the anterior corneal surface: RMS coma (Z3±1, Z5±1), RMS spherical aberration (SA; Z40, Z60) and RMS HOA (Z3-6) 6 months after different EK techniques were statistically significantly higher than in the control group. A statistically significantly lower induction of aberrations of the posterior corneal surface after DMEK technique was revealed. Analysis of the final aberration pattern 6 months after surgery did not reveal any statistically significant differences in the values of the main (RMS coma, RMS SA, RMS HOA) total corneal aberrations after DSAEK and DMEK. A negative correlation was revealed between the best corrected visual acuity (BCVA) and HOA; however, it was statistically significant only for individual aberration values: RMS HOA (Z3-6) of the posterior corneal aberrations after DMEK (r= -0.634, p=0.049), and RMS coma (Z3±1, Z5±1) of the cornea after DSAEK (r= -0.57, p=0.042). Comparative analysis of total corneal HOA did not reveal a statistically significant difference in the main parameters: RMS coma, RMS SA, RMS HOA in patients after DSAEK and DMEK surgeries. Correlation analysis did not reveal any statistically significant effects of most aberrations on the functional outcomes of the treatment.

Optical Quality in Keratoconus Is Associated With Corneal Biomechanics.

To evaluate the correlations between corneal biomechanical indices from dynamic Scheimpflug assessment and optical quality assessed as higher-order aberrations (HOAs) using a Hartmann-Shack ocular wavefront sensor in patients with keratoconus (KC). In this prospective, observational case series, the eyes with KC or KC suspect (KCS) from Osaka University Hospital, Osaka, Japan, were analyzed. Corneal biomechanical assessment was performed using Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany), and ocular wavefront aberrations were measured using the KR-1W (Topcon Corp, Tokyo, Japan). Correlations between the biomechanical indices and ocular HOAs were assessed. Corneal biomechanical indices included the deformation amplitude ratio within 2 mm, integrated radius, stiffness parameter at the first applanation, and the linear Corvis Biomechanical Index. Wavefront data of the central 4-mm region were expanded up to the sixth order of Zernike polynomials. The magnitudes of trefoil, coma, tetrafoil, secondary astigmatism, and spherical aberration were calculated by Zernike vector analysis and then used as ocular HOA parameters along with total HOAs. Thirty-four KC eyes and 37 KCS eyes were included. KC eyes showed significant correlations between ocular HOAs and biomechanics, whereas there were few significant correlations in KCS eyes. In KC eyes, deformation amplitude ratio within 2 mm, integrated radius, and Corvis Biomechanical Index beta showed stronger correlations with coma among the wavefront parameters. Corneal biomechanical indices correlated with ocular HOAs in patients with KC. In particular, there was a strong association with the increase in coma caused by inferosuperior asymmetry of the shape of the cornea in patients with KC.

Effect of trabeculectomy on ocular higher-order aberrations in patients with open angle glaucoma.

OBJECTIVE:The aim of this study was to evaluate the effect of trabeculectomy on ocular higher-order aberrations following surgery in a group of patients with open angle glaucoma.METHODS:In this prospective study, patients with primary open angle glaucoma underwent wavefront aberrometry before trabeculectomy with mitomycin-C. Coma-like, spherical-like, and total ocular higher-order aberrations were measured as root mean square values. The measurements were repeated 1 month and 3 months after the procedure.RESULTS:A total of 20 eyes from 20 patients were examined. There was a significant decrease in intraocular pressure following surgery at 1 month and 3 months postoperatively. However, there was no statistically significant change in the spherical equivalent of the eyes. One month after surgery, a significant change in coma-like, spherical-like, and total higher-order aberrations of the eyes was observed. However, the repeated measurements performed 3 months after procedure revealed no significant difference compared to the baseline values.CONCLUSION:Ocular higher-order aberrations increased 1 month following trabeculectomy surgery. However, this effect seems to be transient, as the values returned to the preoperative measurement 3 months after the procedure.

Ocular higher-order aberrations in patients with various refractive errors

Introduction:. Higher-order aberrations (HOAs) are small optical irregularities or imperfections of the eye which cannot be corrected by simple sphere and cylinder corrections. Many authors believe that HOAs are the reason many patients complain of halo, glare and decreased contrast sensitivity after successful corneal refractive surgery.(Baily et al., 2003) Many studies in the past showed significant variability of HOAs among the individuals of same population. Popularization of laser corneal refractive surgery and its potential to induce or remove optical aberrations (both low order and higher order aberrations) is the main reason behind better understanding of the nature of aberrations as well as their influence on visual quality. (Bisneto et al., 2007) Aim of the work:To measure and evaluate the distribution of HOAs among various refractive errors in individuals screened for refractive surgery and compare them .correlation with errors. Patients and Methods: prospective cross sectional analytical study was conducted at ophathalmology center for refactive surgery ,sohag started in February 2016. two hundred eyes of patients with age ranging from 18-40 years were included in the study. Results: Patients in hypermetropia group had statistically significant higher amount of HOA than other three groups followed by mixed group.No significant correlation of HOAs with amount of refractive error in all the groups except in mixed error group. Conclusion: In overall comparison we noticed the mean RMS of total HOAs were significantly higher in hypermetropia group and there was a statistically significant correlation between SE of Mixed group and RMS of Total HOAs.

Higher-order aberration 4 years after corneal collagen cross-linking.

Purpose:Corneal collagen cross-linking (CXL) is a treatment strategy used in keratoconic eyes. Evaluation of long-term changes of higher-order aberrations (HOAs) after CXL is useful in understanding the efficacy of this procedure in improving optical, refractive, and visual acuity. This study aims to investigate the long-term effect of CXL on ocular HOA in patients with progressive keratoconus (KC).Methods:Using an OPD-Scan II aberrometer, ocular HOAs measurements of 56 eyes of 56 patients that underwent CXL was evaluated at the baseline, 1, 2, and 4 years after the procedure. All OPD-Scan measurements were decomposed into Zernike coefficients from 3rd to 6th order.Results:The results revealed that except for a few parameters, most of the aberration parameters continuously decreased during the study. In the 4-year postoperative period, a statistically significant improvement in all HOA parameters except 5th order Zernike polynomials (Z51, Z5−1, Z53, Z5−3, Z55, and Z5−5) was observed. All the values significantly decreased compared to the preoperative measurements (P < 0.05). The mean ± standard deviation (SD) root mean square of the 3rd, 4th, and the 5th order as well as coma, coma like, and total HOA parameters were significantly decreased compared to both preoperative and previous visits (P < 0.001). There were significant correlations between preoperative measurements of HOAs parameters with best-corrected visual acuity (BCVA) including Z31, Z3−1, Z40, Z51, and Z42. Moreover, all the HOAs parameters in 4 years after the CXL were significantly correlated with BCVA (P < 0.05).Conclusion:CXL is effective in improving HOA parameters in eyes with progressive KC during a long-term follow-up.

Corneal Higher-Order Aberrations in Infectious Keratitis

To characterize the corneal higher-order aberrations (HOAs) in eyes with Acanthamoeba keratitis (AK), bacterial keratitis (BK), and fungal keratitis (FK). Retrospective consecutive case series. This retrospective study includes 18 normal subjects and 63 eyes of 62 consecutive patients with corneal scarring due to AK (20 eyes), BK (35 eyes), and FK (8 eyes) from 2010 to 2016. HOAs of the anterior and posterior surfaces and the total cornea were analyzed by anterior segment optical coherence tomography. Corneal HOA patterns were assigned on the basis of corneal topography maps. Corneal opacity grading was assigned on the basis of slit-lamp examinations. We evaluated corneal HOAs, corneal opacity grading, and their correlation with visual acuity. HOAs of the total cornea within a 4-mm diameter were significantly larger in eyes with infectious keratitis (AK, 1.15 ± 2.06μm; BK, 0.91 ± 0.88μm; FK, 1.39 ± 1.46μm) compared with normal controls (0.09 ± 0.01μm, all, P < .001). Asymmetric pattern was the most common topographic pattern (30% in AK, 51.4% in BK, and 37.5% in FK), followed by the protrusion patterns (10% in AK, 20% in BK, and 12.5% in FK). The visual acuity significantly correlated with HOAs (anterior surface: R= 0.764, P < .0001; posterior surface: R= 0.745, P < .0001; total cornea: R= 0.669, P< .0001). Larger corneal HOAs in patients with infectious keratitis were associated with poorer visual acuity values. Asymmetric pattern was the most common topographic pattern in infectious keratitis.

Effects of 3% diquafosol sodium ophthalmic solution on higher-order aberrations in patients diagnosed with dry eye after cataract surgery.

PurposeTo evaluate the effects of diquafosol sodium ophthalmic solution 3% (DQS) and artificial tears (AT) on higher-order aberrations (HOAs) in patients with dry eye after cataract surgery.DesignThis was a post hoc analysis of a previously conducted randomized clinical study.MethodsFifty-nine eyes from 42 patients (17 males and 25 females, aged 72.6±8.0 years) with verified or suspected dry eye at 4 weeks after cataract surgery were evaluated. The dry eye patients were randomly assigned to receive DQS or AT for 4 weeks. Tear breakup time (BUT), corneal and conjunctival fluorescein staining scores, and HOAs were analyzed before and after instillation. HOAs were measured consecutively for 10 seconds with a wavefront analyzer. Average HOAs, HOA fluctuations (fluctuation index [FI]) and changes in HOAs (stability index [SI]) were compared within and between the two groups.ResultsAfter 4 weeks of instillation, BUT significantly increased (P=0.001) compared with preinstillation values in the DQS group, but not in the AT group. This increase in BUT in the DQS group was significantly greater than in the AT group (P=0.014). Corneal and conjunctival fluorescein staining scores after instillation significantly improved compared with preinstillation values in the DQS group (P=0.018). In HOAs, the cornea aberration changed from an upward curve (a sawtooth pattern) to an almost constant value (a stable pattern) in the DQS group, but not in the AT group. In FI and SI, there were no significant changes in either group; however, FI and SI were significantly lower in the DQS group than in the AT group (both, P=0.004).ConclusionThe dry eye patients after cataract surgery had a visual dysfunction in HOAs. DQS is effective to treat dry eye disease after cataract surgery with improvement of visual function.

Comparison of the Clinical Outcomes of Two Types of Toric Intraocular Lens

Purpose: In this study evaluated clinical outcomes and higher-order aberrations in patients with implanted Tecnis ZCT toric intraocular lens (IOL) (Abbott Medical Optics Inc., Santa Ana, CA, USA) and the Zeiss AT TORBI toric IOL (Carl Zeiss Meditec AG, Jena, Germany) in eyes with low to moderate corneal astigmatism. Methods: We conducted a retrospective study of 32 consecutive eyes of 26 patients with a visually significant cataract and moderate corneal astigmatism (higher than 1.25 diopter [D] and lower than 4.5 D) undergoing cataract surgery with implantation of the aspheric Tecnis ZCT toric IOL (Abbott Medical Optics Inc.) and the Zeiss AT TORBI toric IOL (Carl Zeiss Meditec AG). Phacoemulsification was performed by the same experienced surgeon using 2.2 mm temporal incision. Visual, refractive and aberrometric changes were evaluated during a 3-month follow-up. Power vector analysis of Cartesian astigmatism (J0) and oblique astigmatism (J45) was performed. Results: At the 3-month follow-up, corrected distance visual acuity (CDVA) and residual astigmatism showed no statistically significant differences between groups (p = 0.203 and p = 0.364, respectively). Preand postoperative J0 were 0.71 ± 0.84 and 0.05 ± 0.39 in the Tecnis Toric group and, 0.88 ± 1.27 and -0.02 ± 0.16 in the AT TORBI group, respectively, which showed statistically significant differences (p = 0.029 and p = 0.032, respectively). Preand post-operative differences of J0 and J45 were not statistically significant (p = 0.234 and p = 0.603, respectively). No eye had IOL rotation ≥10°. Ocular aberrometry values were statistically significantly differenct between the groups, except for spherical aberration, which was higher in the AT TORBI group (p = 0.0047). Conclusions: Both IOLs showed good postoperative uncorrected distance visual acuity, CDVA and refractive results in this study. Rotational stability was excellent for both IOLs until the 3-month follow-up. J Korean Ophthalmol Soc 2016;57(2):200-207

Postoperative wavefront analysis and contrast sensitivity of the multifocal RestorTM IOL versus the AcrylisaTM IOL

Abstract Purpose To compare visual acuity, total and high order wavefront aberrations (coma, spherical aberration, and other terms of high order aberration), and contrast sensitivity in eyes implanted with the multifocal Restore IOL versus the multifocal Acrylisa IOL. Methods Patients were divided in two groups: group 1 (8 patients, 16 eyes implanted with Restor) and group 2 (15 patients / 30 eyes implanted with Acrylisa). All eyes were targeted for emmetropia. Complete ophthalmological examination, including uncorrected visual acuity (UCVA), best spectacle‐corrected visual acuity (BSCVA) was performed. Contrast sensitivity evaluation,and wavefront analysis, were performed with the Imagine Eyes IRX3 wavefront aberrometer. Measurements with the IRX3 were performed in triplicate in order to verify the robustness of the data. Results All eyes in all groups had BSCVA &gt; or = 20/20 postoperatively. Measurements with the IRX3 were easily obtained. The triplicate measurements confirmed the robustness of the data. Mean total aberration root‐mean‐square (RMS) values and higher order aberrations (HOA) value were not significantly different between the two groups. Residual spherical aberration values were comparable in both groups and appeared inferior if to the ones previously obtained with non aspheric standard monofocal IOLs. Mean contrast sensitivity values were comparable in both groups. Conclusion The measurement of higher order aberrations in patients implanted with multifocal IOLs is easy and reproducible with the IRX3. There is no statistical difference between the values obtained in the 2 groups regarding RMS and HOA. Contrast sensitivity revealed similar values in both groups.

Characteristics of ocular higher-order aberrations in patients with pellucid marginal corneal degeneration

To evaluate the characteristics of higher-order aberrations (HOAs) in eyes with pellucid marginal corneal degeneration (PMCD). Department of Ophthalmology, Osaka University Medical School, Osaka, Japan. Ocular HOAs were measured by aberrometry in 20 eyes with PMCD (PMCD group), 76 eyes with keratoconus (KC group), and 105 normal eyes (control group) with a 4.0 mm pupil. The magnitudes and axes of trefoil, coma, tetrafoil, and secondary astigmatism and the magnitude of spherical aberration were compared between the 3 groups using vector analysis of Zernike terms. The mean axes of coma in the PMCD group (85.5 degrees) and KC group (82.5 degrees) were opposite the axis in the control group (253.7 degrees). The magnitude of coma was significantly lower in the PMCD group (0.27 microm +/- 0.19 [SD]) than in the KC group (0.70 +/- 0.37 microm) (P < .05). The mean axes of trefoil in the PMCD group (27.1 degrees) and control group (35.4 degrees) were opposite the axis in the KC group (93.8 degrees). The magnitude of spherical aberration was significantly higher in the PMCD group (0.086 +/- 0.10 microm) than in the KC group (-0.030 +/- 0.13 microm) (P < .05); the spherical aberration signs were opposite in the groups. Although PMCD and KC are categorized as noninflammatory corneal thinning disorders, the HOA patterns in the 2 groups differed, possibly due to differences in the positions of the corneal apex. PMCD and KC may cause distinctively different deterioration in the quality of vision.