Higher-order Aberrations and their Visual Impact in Paediatric Blepharokeratoconjunctivitis.

Abstract

Background/Objectives: To analyse the higher-order aberrations (HOAs) and their visual impact on a paediatric blepharokeratoconjunctivitis (PBKC) cohort compared with healthy controls. Subjects/Methods: A prospective observational, case-control study of paediatric patients (≤ 16 years old) was designed. Subjects underwent a visual system wavefront aberrometry analysis to compare HOAs and their impact on visual quality. Results 150 eyes from 76 patients were included for analysis. The PBKC group consisted of 50 eyes, and the control group included 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 ± 1.98 in the PBKC group vs. 0.67 ± 0.76 in the controls (p = 0.01). Mean RMS of HOAs was 1.05 ± 1.7 in the PBKC group and 0.41 ± 0.18 in the controls (p = < 0.001). The mean modulation transfer function (MTF) in the PBKC group was significantly lower (16.37 ± 16.32) than in the controls (30.3 ± 23.57) (p = < 0.001). Corneal leucoma, neovascularization, phlyctenula, and pannus formation were associated with a greater risk of increased HOAs. Conclusions There was a significant increase in the total HOAs of PBKC eyes compared to healthy controls. The PBKC eyes aberrations profile, particularly coma, secondary astigmatism, quadrafoil, and pentafoil, had a significant visual impact. Leukoma, corneal neovascularization, pannus, and phlyctenula were strongly associated with increased HOAs.