Analyses on the distribution and influence of higher-order aberrations both clinically and experimentally among varied refractive errors

PURPOSE:

The aim of this work is to determine and compare the distribution and influence of higher-order aberrations (HOAs) both clinically and experimentally between different refractive errors.

METHODS:

Commercially available Shack–Hartmann aberrometer was employed to measure the HOA clinically in human eyes. Experimentally, HOA was measured in a model eye by simulating various refractive errors by constructing an aberrometer based on the same Shack Hartmann principle. One-way analyses of variance and simple regression were employed to analyze the distribution and influence of HOA among various refractive errors.

RESULTS:

A total of 100 eyes were clinically measured for aberrations, of which 35, 50, and 15 eyes were emmetropes, myopes, and hyperopes, respectively. Out of the total root mean square (RMS) value, the HOAs found in the human eyes were 23%, 7%, and 26% and in the model eye, it was 20%, 8%, and 10% between emmetropes, myopes, and hyperopes, respectively. The mean higher-order RMS was almost similar between the groups and among various refractive errors. There was no statistical significance between the individual Zernikes except for the coma in both human and model eyes.

CONCLUSION:

The mean HOA is similar amidst the different refractive errors. The presence of 23% HOA in emmetropes signifies that larger part of the human eye is capable of complying with HOA without compromising the image quality. This work signifies that HOA does not play an important role in image clarity for human eyes with regular refractive surface unlike irregular refractive surfaces.

Correlating Kane formula with existing intraocular lens formulae for corneal curvatures and axial lengths

BACKGROUND:

To evaluate the predictability of the Kane formula in estimating postoperative refractive outcome with various corneal curvatures and axial lengths (ALs) besides comparing with existing intraocular lens (IOL) formulae.

MATERIALS AND METHODS:

A prospective cross-sectional study was carried out among patients having uneventful cataract surgery at an eye hospital. A total of 50 eyes were considered for the study. The corresponding A-constant for the model of IOL implanted into the patient's eye was taken along with the actual power of IOL implanted and corresponding predicted power for the IOL power inserted were taken for all the chosen formulae and was termed as "Adjusted Predicted Refractive Power." This was compared with the actual refractive outcome and the absolute error (AE) was measured. The eyes were separated into groups in terms of corneal curvature as flat (<42D), medium (42D–46D), and steep (>46D) corneas. In terms of AL, it was grouped as short (≤22 mm), medium (>22.0–<24.0 mm), and long (>24.0 mm) eyes.

RESULTS:

The study included 50 eyes and the mean AE for all the selected formulae were calculated for each group. Over the entire corneal curvature range, none of the formulae showed any significance when compared with the Kane formula (P > 0.05). In short AL, SRK-T formula had a statistical significance over the Kane formula (P = 0.043), whereas no other group had any significance over the Kane formula in AL groups.

CONCLUSION:

The study shows, all formulae (SRK-T, Holladay1, Hoffer Q, Hill RBF, Barrett Universal II, Kane) are interchangeable to predict the IOL power for any of the corneal curvature and ALs.

Correlating Kane formula with existing intraocular lens formulae for corneal curvatures and axial lengths

BACKGROUND

To evaluate the predictability of the Kane formula in estimating postoperative refractive outcome with various corneal curvatures and axial lengths (ALs) besides comparing with existing intraocular lens (IOL) formulae.

MATERIALS AND METHODS

A prospective cross-sectional study was carried out among patients having uneventful cataract surgery at an eye hospital. A total of 50 eyes were considered for the study. The corresponding A-constant for the model of IOL implanted into the patient's eye was taken along with the actual power of IOL implanted and corresponding predicted power for the IOL power inserted were taken for all the chosen formulae and was termed as "Adjusted Predicted Refractive Power." This was compared with the actual refractive outcome and the absolute error (AE) was measured. The eyes were separated into groups in terms of corneal curvature as flat (<42D), medium (42D-46D), and steep (>46D) corneas. In terms of AL, it was grouped as short (≤22 mm), medium (>22.0-<24.0 mm), and long (>24.0 mm) eyes.

RESULTS

The study included 50 eyes and the mean AE for all the selected formulae were calculated for each group. Over the entire corneal curvature range, none of the formulae showed any significance when compared with the Kane formula (P > 0.05). In short AL, SRK-T formula had a statistical significance over the Kane formula (P = 0.043), whereas no other group had any significance over the Kane formula in AL groups.

CONCLUSION

The study shows, all formulae (SRK-T, Holladay1, Hoffer Q, Hill RBF, Barrett Universal II, Kane) are interchangeable to predict the IOL power for any of the corneal curvature and ALs.

A novel method in correcting aberropia using pin hole soft contact lenses: A case report

Aberropia leads to decrease in image quality due to higher order aberrations (HOA). Correction of these HOA poses a great challenge to clinicians. A case report is presented here where a 30 year old male visited with complaints of cloudy vision, diplopia in reduced illumination along with inferior vertical elongation of light during night time in the right eye since 6 years. The unaided visual acuity was found to be 0.0 Log MAR units and near acuity was N6. The patient did not accept any correction in subjective refraction. The aberrometry findings revealed vertical trefoil and vertical coma of -0.33 μm and 0.53 μm in the right eye and -0.07 μm and 0.12 μm in the left eye. Orbscan revealed a difference of 30 μm and 25 μm between the anterior and posterior float for the right and left eye respectively. Due to the significant increase in irregular astigmatism, vertical coma and vertical trefoil in the right eye, rigid gas permeable lenses and Rose K lenses were tried, but the symptoms did not reduce. This was due to the increase in posterior corneal astigmatism as the posterior float was more than 25 μm in the right eye which led to a diagnosis of early keratoconus. As the decrease in pupil size reduces HOA, a pin hole (2.5 mm pupil) soft contact lens was tried which reduced the symptoms. Hence a novel method is proposed to eliminate HOA which corrects aberropia by using pin hole soft contact lenses.

A Clinical Study to Validate the Pupil Rescaling Technique by using COAS Shack Hartmann Aberrometer

In any optical system, optical aberrations of the imaging system affect the image quality. The human eye is also like an optical system which has optical aberrations influencing the quality of the retinal image. When pupil size exceeds 3 mm, ocular aberrations increase and play a major role on retinal image degradation. Pupil diameter is made constant in commercially available aberrometers by mathematically rescaling it. The aim of this study is to validate the pupil rescaling technique by using COAS (Complete Ophthalmic Analysis System)Shack Hartmann Aberrometer. Five subjects were recruited for this study. The measurements were taken over a moderately large pupil of 5mm in normal room illumination to allow for natural pupil dilation. The analyses diameter is fixed at 5 mm in COAS which means it rescales the aberration data to 5 mm if the pupil diameter recorded was more than 5 mm at the time of measurement. Ocular aberrations for natural and rescaled pupil sizes were analyzed. Estimation of ocular aberrations showed there was no statistical significance between natural pupil and rescaled pupil diameter.

Visual impairment in school children in southern India

This study was done to determine the prevalence of visual impairment due to refractive errors and ocular diseases in lower middle class school children of Hyderabad, India. A total of 4,029 children, which included 2,348 males and 1,681 females, in the age range of 3 to 18 years from 9 schools were screened with a detailed ocular examination protocol. Among 3,669 children in whom visual acuity could be recorded, on presentation 115 (3.1%) had visual acuity < 6/18 in the better eye (equivalent to visual impairment), while 41 (1.1%) had visual acuity < or = 6/60 [corrected] in the better eye (equivalent to legal blindness) out of which 18 (0.5%) had visual acuity < 6/60 in the better eye (equivalent to economic blindness). Of 115 children who presented with initial visual acuity < 6/18, vision improved to > or = 6/18 with refraction in 109 (94.8%). No child was legally or economically blind after refractive correction. Prevalence of hyperopia was 22.6%, myopia 8.6% and astigmatism 10.3%. The prevalence of myopia was significantly higher among children > or = 10 years of age (P < 0.001). The maximum, mean and median values for myopia were 10.00, 1.35 and 0.75 D in the better eye. For hyperopia these values were 8.50, 0.65 and 0.50 D. The major causes for best corrected visual acuity < 6/9 in the worse eye for 51 (1.4%) children included amblyopia in 40 (1.1%), corneal diseases in 5 (0.1%), cataract in 2 (0.05%) and others in 4 (0.1%). Out of the total, 30 (0.7%) children had strabismus. These data support the assumption that vision screening of school children in developing countries could be useful in detecting correctable causes of decreased vision, especially refractive errors, and in minimising long term permanent visual disability.