Errors in Treatment of Lower-order Aberrations and Induction of Higher-order Aberrations in Laser Refractive Surgery

Kligman, Brad E.; Baartman, Brandon; Dupps, William J.

doi:10.1097/iio.0000000000000113

Cited by 25 publications

(15 citation statements)

References 110 publications

(149 reference statements)

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“…This is a paradox finding, as coma is well known to cause a ‘smearing’ effect or comet like tails on a perceived image and is regarded as one of the HOAs most detrimental to perceived image quality (Kligman et al 2016). Surprisingly, the commonly purported association between spherical aberration and halo perception (Kligman et al 2016) was not confirmed in the present study. In light of these counterintuitive findings, the fact that all calculated correlation coefficients were very weak (ranging between −0.180 and 0.164) and, moreover, a plethora of correlation analyses was conducted (thereby significantly increasing the risk for type I errors) we hypothesize that these statistically significant associations may be regarded as clinically negligible.…”

Section: Discussionmentioning

confidence: 99%

“…blurred vision) surpassed the predefined level of statistical significance suggesting a protective effect of increased coma induction on postoperative visual quality. This is a paradox finding, as coma is well known to cause a ‘smearing’ effect or comet like tails on a perceived image and is regarded as one of the HOAs most detrimental to perceived image quality (Kligman et al 2016). Surprisingly, the commonly purported association between spherical aberration and halo perception (Kligman et al 2016) was not confirmed in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…On the one hand, topography-guided excimer laser systems link the patient's individual corneal topography data to the ablation profile, thereby specifically targeting surface elevations. On the other hand, wavefront-guided platforms incorporate the patient's individual ocular wavefront into a customized ablation profile (Kligman et al 2016).…”

Section: Introductionmentioning

confidence: 99%

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Corneal wavefront aberrations and subjective quality of vision after small incision lenticule extraction

Schmelter

Schworm

Mayer

et al. 2020

Acta Ophthalmologica

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To analyse in depth the associations between objectively measured corneal higher-order aberrations (HOAs) and subjectively perceived visual quality after small incision lenticule extraction (SMILE) as quantified with the standardized and clinically validated quality of vision (QOV) questionnaire. Methods: This cross-sectional study included patients after bilateral simultaneous SMILE for the treatment of myopia and/or myopic astigmatism with plano target refraction. Scheimpflug imaging (Pentacam HR; Oculus Optikger€ ate GmbH, Wetzlar, Germany) was used to objectively quantify corneal HOAs. The standardized and validated QOV questionnaire was employed to gauge patients' subjectively perceived visual quality regarding frequency, severity and bothering effect of visual disturbances. Results: A total of 394 eyes of 197 patients with a mean age of 32.4 AE 7.7 years and a mean postoperative follow-up of 24.3 AE 14.1 months were included. SMILE induced a statistically significant (p < 0.001) increase in spherical aberration (0.074 AE 0.131 µm), coma (0.142 AE 0.179 µm), trefoil (0.018 AE 0.067 µm) as well as in total HOAs (0.191 AE 0.176 µm). Surgically induced and postoperative levels of HOA showed no correlation with the three QOV scores representative of overall visual symptom frequency, severity and bothering effect (all R 2 values ≤ 0.016). In addition, the associations between specific visual symptoms (e.g. starburst) and singular HOA terms (e.g. haloes) were very weak (all Rho values ≤ 0.164). Conclusions: Small incision lenticule extraction induced significant amounts of corneal HOAs that, however, showed no clear relationships to patient-reported QOV or specific long-term visual symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Corneal wavefront aberrations and subjective quality of vision after small incision lenticule extraction

Schmelter

Schworm

Mayer

et al. 2020

Acta Ophthalmologica

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“…These eye disorders were treated by using an excimer laser to modify the shape of the cornea and therefore its refractive state. Despite the success of the refractive surgery, patients complained about glare, halos, and starburst in both day and night vision [ 2 , 3 ]. The clinical data showed that higher-order aberrations (HOAs) were induced by laser refractive surgery [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Advanced Optical Wavefront Technologies to Improve Patient Quality of Vision and Meet Clinical Requests

et al. 2022

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Adaptive optics (AO) is employed for the continuous measurement and correction of ocular aberrations. Human eye refractive errors (lower-order aberrations such as myopia and astigmatism) are corrected with contact lenses and excimer laser surgery. Under twilight vision conditions, when the pupil of the human eye dilates to 5–7 mm in diameter, higher-order aberrations affect the visual acuity. The combined use of wavefront (WF) technology and AO systems allows the pre-operative evaluation of refractive surgical procedures to compensate for the higher-order optical aberrations of the human eye, guiding the surgeon in choosing the procedure parameters. Here, we report a brief history of AO, starting from the description of the Shack–Hartmann method, which allowed the first in vivo measurement of the eye’s wave aberration, the wavefront sensing technologies (WSTs), and their principles. Then, the limitations of the ocular wavefront ascribed to the IOL polymeric materials and design, as well as future perspectives on improving patient vision quality and meeting clinical requests, are described.

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“…In recent years, advances in ocular diagnostic and treatment modalities have brought corneal higher order aberrations to the forefront of ophthalmologists and optometrists in enhancing visual quality. The ability to measure wavefront aberrations of the eye and incorporation of this data into treatment pro les has led to a signi cant improvement in the quality of vision following refractive surgery and the ability to correct surgical-induced HOAs, in addition to lower order aberrations (sphere and cylinder) (2,3). Furthermore, evaluation of HOAs in the normal eyes has been demonstrated to be helpful in the early detection of pathologic conditions such as keratoconus (KC) (4,5,6).…”

Section: Introductionmentioning

confidence: 99%

Corneal higher order aberrations by Sirius topography and their relation to different refractive errors

Salman

Kailani

Ghabra

et al. 2022

Preprint

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Purpose: to compare the root mean square (RMS) of anterior corneal higher-order aberrations (HOAs) in patients with refractive errors.Methods: This retrospective observational study was conducted at Department of Ophthalmology, Tishreen University Hospital, Latakia, Syria. The eyes were divided into four groups based on refractive error: mild-to-moderate myopia, hypermetropia, myopic astigmatism, and emmetropic eyes as controls. The following anterior corneal HOAs were evaluated using the Scheimpflug-Placido Sirius (CSO, Italy) topographer over 6 mm pupil: Root mean square (RMS) total corneal HOAs, RMS trefoil, RMS coma and RMS spherical aberrations. Results: RMS values of total HOAs, trefoil and coma showed a statistically significant difference in all four groups (P < 0.05, all). They were lowest in the control group (0.18± 0.09, 011± 0.08 and 0.09± 0.08 μm, respectively) and highest in the myopic astigmatism group (0.31± 0.16, 0.15± 0.12, 0.17± 0.14 μm, respectively). RMS spherical aberration was lowest in the astigmatism group (0.00± 0.16 μm) with a statistically significant difference from that in the control groups (0.05± 0.07 μm, P = 0.049).Conclusion: The mean RMS values of total HOAs, trefoil and coma were highest in the astigmatism group and lowest in the control group. However, spherical aberration was minimal in the astigmatism group.

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Errors in Treatment of Lower-order Aberrations and Induction of Higher-order Aberrations in Laser Refractive Surgery

Cited by 25 publications

References 110 publications

Corneal wavefront aberrations and subjective quality of vision after small incision lenticule extraction

Corneal wavefront aberrations and subjective quality of vision after small incision lenticule extraction

Advanced Optical Wavefront Technologies to Improve Patient Quality of Vision and Meet Clinical Requests

Corneal higher order aberrations by Sirius topography and their relation to different refractive errors

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