Accuracy and Reproducibility of Zywave, Tracey, and Experimental Aberrometers

Evaluation of the Agreement Between a New Pyramid Wavefront Sensor Aberrometer and Scheiner-Smirnov Aberrometers

PURPOSE

To assess agreement between a new aberrometer (Osiris-T; CSO) employing pyramid wavefront sensor technique and Scheiner-Smirnov aberrometer (OPD-Scan III; Nidek) on measuring ocular, corneal, and internal aberrations in healthy participants.

METHODS

The measurements were conducted three times consecutively by an experienced examiner. The total root mean square (RMS) aberrations, higher order aberration RMS, coma Z3±1, trefoil Z3±3, spherical aberration Z40, and astigmatism II Z4±2 up to 7th order were exported in both 4-and 6-mm pupil zones. The parameters between the two devices were statistically compared using the paired t-test, and the differences assessed with Bland-Altman plots and 95% limits of agreement.

RESULTS

This prospective study included 70 right eyes of 70 healthy participants with an average age of 25.94 ± 6.59 years (range: 18 to 47 years). The mean difference in the two devices ranged from 0.01 µm for astigmatism II Z4±2 to 0.63 µm for total RMS in 4 mm and from 0.01 to 1.41 µm in 6-mm pupil size. The Bland-Altman analysis of ocular, corneal, and internal aberrations indicated high agreement between the two devices and the maximum absolute values for 95% limits of agreement ranged from 0.03 to 1.06 µm for 4-mm pupil diameters and 0.12 to 1.13 µm for 6-mm pupil diameters.

CONCLUSIONS

The newly developed pyramid wavefront sensor technique aberrometer demonstrated a high agreement with a Scheiner-Smirnov aberrometer when measuring ocular, corneal, and internal aberrations in healthy participants. Thus, the two aberrometers may be considered interchangeable for clinical applications. [J Refract Surg. 2024;40(4):e218-e228.].

Wavefront aberrometry repeatability and agreement—A comparison between Pentacam AXL Wave, iTrace and OPD‐Scan III

INTRODUCTION

To compare intrasession agreement and repeatability of wavefront aberration measurements from three different aberrometers obtained using Hartmann-Shack, ray tracing and automated retinoscopy methods, as well as their interdevice agreement.

METHODS

Three consecutive measurements were obtained using the Pentacam AXL Wave, the iTrace and the OPD-Scan III in 47 eyes of 47 patients. Wavefront refractions, root mean square of total aberrations (RMS total), RMS of higher-order aberrations (HOA) and second-, third- and fourth-order HOAs were exported for 4-mm pupils. Wavefront refractions were converted into vector components: M, J₀ and J₄₅ . Intrasession agreement and repeatability were evaluated using intraclass correlation coefficients (ICCs) and repeatability coefficients (RCs); interdevice agreement was assessed using the Bland-Altman method.

RESULTS

The intrasession agreement and repeatability of RMS HOA were comparable between the three devices; both the Pentacam AXL Wave and the OPD-Scan III had better intrasession agreement and repeatability for the RMS total than the iTrace (p ≤ 0.02). Intrasession repeatability for the majority of second- and third-order aberrations was better on the Pentacam AXL Wave than on the iTrace (p ≤ 0.01) and OPD-Scan III (p ≤ 0.04), although their agreement and repeatability in spherical aberration were comparable (p ≥ 0.24). Significant systematic differences and proportional bias were detected for almost all refraction power vectors and Zernike coefficients among the three devices.

CONCLUSIONS

In this study, all three devices provided good-to-excellent agreement for aberration measurements. Most of the individual Zernike's components were not exchangeable between different aberrometers. Their relative intrasession performance in agreement and repeatability varied significantly across different ocular aberration parameters.

Image quality eigenfunctions for the human eye

This work presents a compact statistical model of the retinal image quality in a large population of human eyes following two objectives. The first was to develop a general modal representation of the optical transfer function (OTF) in terms of orthogonal functions and construct a basis composed of cross-correlations between pairs of complex Zernike polynomials. That basis was not orthogonal and highly redundant, requiring the application of singular value decomposition (SVD) to obtain an orthogonal basis with a significantly lower dimensionality. The first mode is the OTF of the perfect system, and hence the modal representation, is highly compact for well-corrected optical systems, and vice-versa. The second objective is to apply this modal representation to the OTFs of a large population of human eyes for a pupil diameter of 5 mm. This permits an initial strong data compression. Next, principal component analysis (PCA) is applied to obtain further data compression, leading to a compact statistical model of the initial population. In this model each OTF is approximated by the sum of the population mean plus a linear combination of orthogonal eigenfunctions (eigen-OTF) accounting for a selected percentage (90%) of the population variance. This type of models can be useful for Monte Carlo simulations among other applications.

Comparison of the Adaptive Optics Vision Analyzer and the KR-1 W for measuring ocular wave aberrations

BACKGROUND

The aim was to assess the agreement in the measurement of ocular aberrations between a new Adaptive Optics Vision Analyzer (AOVA, Voptica, Murcia, Spain) and a commercial aberrometer (KR-1 W, Topcon, Tokyo, Japan), both based on the Hartmann-Shack technique.

METHODS

One experienced examiner measured 29 healthy right eyes nine consecutive times with the two instruments. The individual Zernike coefficients and the root mean square (RMS) of each order from the second to the fifth order, the higher-order RMS (RMS_HOA ), the total RMS (RMS_TOT ) and the values of the spherical equivalent (M) and Jackson cross-cylinder (J₀ and J₄₅ ) were compared. All aberrations were computed for a 4.0 mm pupil diameter.

RESULTS

Bland and Altman analysis showed good agreement between instruments and most of the parameters showed no statistically significant differences. Although the largest mean differences were obtained for the defocus coefficient C(2,0) and the spherical equivalent (M) with a mean difference (and standard deviation) of 0.190 ± 0.099 µm and -0.150 ± 0.188 D, respectively, they were clinically acceptable and significant correlations were found between the AOVA and KR-1 W for the major refractive components such as spherical equivalent (r = 0.995, p < 0.001), J₀ (r = 0.964, p < 0.001), J₄₅ (r = 0.901, p < 0.001) and C(4,0) (r = 0.575, p = 0.001).

CONCLUSION

The results suggest good agreement between instruments. Accommodation and misalignment of the measurements may play a role in some of the statistically significant differences that were obtained, specifically for defocus C(2,0), vertical coma C(3,-1) and spherical aberration C(4,0) coefficients; however, these differences were clinically irrelevant.

Higher order aberrations of the eye: Part two

This article is the second in a series of two articles, which provides a discussion of the factors that may possibly contribute to variable results when wavefront aberrations of the human eye are measured. Some of the factors discussed in this article are the influences that refractive errors (specifically myopia and astigmatism), pupil diameter, accommodation of the crystalline lens, age, mydiatric drops and the integrity of the tear film may have on these wavefront measurements. The first article in the series explained the general principles of higher order aberrations (HOAs), as well as HOAs of importance in the eye and the measuring apparatus used to measure HOAs of the eye.Keywords: wavefront aberrations; aberrometry

Higher order aberrations of the eye: Part one

This article is the first in a series of two articles that provide a comprehensive literature review of higher order aberrations (HOAs) of the eye. The present article mainly explains the general principles of such HOAs as well as HOAs of importance, and the measuring apparatus used to measure HOAs of the eye. The second article in the series discusses factors contributing to variable results in measurements of HOAs of the eye.Keywords: Higher order aberrations; wavefront aberrations; aberrometer

Precision of a commercial hartmann-shack aberrometer: limits of total wavefront laser vision correction

PURPOSE

To assess the intrasession and intersession precision of higher-order aberrations (HOAs) measured using a commercial Hartmann-Shack wavefront sensor (Zywave; Bausch & Lomb) in refractive surgery candidates.

DESIGN

Prospective, experimental study of a device.

METHODS

To analyze intrasession repeatability, 1 experienced examiner measured 30 healthy eyes 5 times successively. To study intersession reproducibility, the same clinician obtained measurements from another 30 eyes in 2 consecutive sessions at the same time of day 1 week apart.

RESULTS

For intrasession repeatability, excellent intraclass correlation coefficients (ICCs) were obtained for total ocular aberrations, total HOAs, and second-order terms (ICC, > 0.94). The ICCs for third-order terms also were high (ICCs, > 0.87); however, fourth-order ICCs varied from 0.71 to 0.90 (Z(4)(0) = 0.90); and fifth-order ICCs were less than 0.85. For intersession reproducibility, only total ocular aberrations, total ocular HOAs, second-order terms, Z(4)(0), Z(3)(1), and Z(3-)(3) had ICCs of 0.90 or more. Bland-Altman analysis showed that the limits of agreement (were clinically too wide for most higher-order Zernike terms, especially for the third-order terms (> 0.21 μm).

CONCLUSIONS

Total ocular aberrations, total HOAs, and second-order terms can be measured reliably by Zywave aberrometry without anatomic recognition. Third-order terms and Z(4)(0) are repeatable, but not as reproducible between visits. Fourth-order terms, except for Z(4)(0), and fifth-order terms are not sufficiently reliable for clinical decision making or treatment. Because the variability of Zywave can be a major limitation of a truly successful wavefront-guided excimer laser procedure, surgeons should consider treating HOA magnitudes that are more than the intrasession repeatability values (2.77 × S(w)) as those presented in this study.

Higher-order aberrations when wearing sphere and toric soft contact lenses

PURPOSE

To determine the on-eye effect of spherical and toric contact lens design on higher-order aberrations (HOA).

METHODS

Thirty eyes (15 subjects) entered a masked, randomized, cross-over study. Each eye was fitted with the spherical and toric lens of the following brands in random order: Acuvue Advance, Biomedics 55, Frequency 55, and SofLens 66. HOAs were measured using the Zywave II Aberrometer over a 6-mm aperture up to fifth order. A linear model accounting for the fixed effect of lens type and random effects of subject and eye was created. Paired t-tests were completed between lens brands within the spherical and toric lenses and between the spherical and toric lens within each brand. Best-corrected visual acuity (VA) was measured and compared.

RESULTS

No clinically meaningful differences in total HOAs were found between brands or between the spherical and toric lens within a brand. Positive spherical aberration (SA) was reduced by all spherical and toric lenses compared to wearing no lens by 0.07 to 0.23 microm (p < 0.0001). Frequency toric induced the greatest change in SA. The thin-zone design lens (Acuvue Advance for Astigmatism) had a statistically different amount of vertical coma (-0.04 microm) than the three prism-balast toric lenses (0.11 to 0.23 microm; p < 0.0001). SofLens toric had the greatest amount of vertical coma, but better VA than Acuvue Advance for Astigmatism and Frequency toric. With the exception of Acuvue Advance for Astigmatism, toric lenses had greater absolute magnitude of vertical coma than their sphere counterparts (all p < 0.002). No other significant HOA differences were observed.

CONCLUSIONS

Toric contact lenses with prism-ballast designs demonstrated more vertical coma, but better VA. Positive SA was reduced by spherical and toric contact lenses. The visual quality effect of lens design and material on induced HOAs warrants further investigation.

[Application of wavefront analysis in clinical and scientific settings. From irregular astigmatism to aberrations of a higher order--Part I: Basic principles]

In recent years, wavefront analysis has emerged from a pure laboratory application to an ophthalmological diagnostic method. This development was promoted mainly by the widespread use of wavefont-guided LASIK. However, aberrometry is still not a common diagnostic technique and the results of measurements are difficult to understand and to interpret for many ophthalmologists. The first part of this 2-part series summarizes the basics of wavefront errors, aberrometry and wavefront analysis to give a comprehensive overview for the interested ophthalmologist and clinical scientist. The second part will review such findings that are relevant for the ophthalmological community and highlight current scientific applications.

Corneal wavefront-guided retreatments for significant night vision symptoms after myopic laser refractive surgery

PURPOSE

To evaluate the results of corneal wavefront (WF)-guided enhancements in patients with night vision symptoms and significantly high positive spherical aberration (SA) after myopic laser refractive surgery.

DESIGN

Noncomparative, interventional case series.

METHODS

Twenty-eight eyes of 20 patients with significant night vision symptoms and positive corneal SA (Z(4)(0)) higher than 0.5 microm after myopic laser refractive surgery were included in the study at Vissum-Instituto Oftalmologico de Alicante, Spain. Enhancement surgery was planned to remove residual refractive error and corneal SA (Z(4)(0)) in all cases. All patients underwent corneal WF-guided excimer laser retreatments using the ESIRIS/SCHWIND excimer laser system (Schwind Eye Tech Solutions, Kleinostham, Germany). The main outcome measures were visual symptoms, change in corneal SA (Z(4)(0)), and corneal asphericity (Q-value).

RESULTS

Subjective reports of night vision symptoms were improved in all patients. Mean corneal SA (Z(4)(0)) decreased from 0.75 +/- 0.19 microm before surgery to 0.43 +/- 0.42 microm after surgery (P < .001). Mean asphericity in the 4.5-mm zone significantly decreased from 1.02 +/- 1.07 before surgery to 0.52 +/- 0.88 after surgery (P = .008), and the mean asphericity in 8 mm did not change significantly (P = .362). The mean spherical equivalent significantly shifted to hyperopia from -0.22 +/- 1.14 diopters (D) before surgery to 0.33 +/- 0.54 D after surgery (P = .025).

CONCLUSIONS

Cornea wavefront-guided retreatment was effective in improving subjective night vision symptoms, reducing corneal SA, and decreasing asphericity in eyes that underwent myopic laser refractive surgery.

Double-pass versus aberrometric modulation transfer function in green light

Intraocular scattering can become an important source of optical degradation in the aging eye. To evaluate its relative contribution to the ocular modulation transfer function (MTF), a compact, dual experimental system comprising a laser ray tracing (LRT) wavefront sensor and a double-pass setup is used. An aberrometric MTF is estimated from aberration measurements, whereas a second MTF is derived from the double-pass point-spread function. While the former only accounts for the effect of aberrations (up to seventh order), the double-pass MTF includes the combined effect of both scattering and aberrations. A 532-nm laser light source is used to minimize choroidal scattering. Measurements are done on 19 normal, healthy eyes from three groups of subjects of different ages. The two MTFs are obtained for a 6-mm pupil diameter and partial refractive compensation. Intraocular scattering is modeled as a random wavefront aberration characterized by its variance and correlation length. These parameters are fitted from the differences between both MTFs. Our results show that double-pass and LRT techniques provide similar MTFs for most normal eyes, although small amounts of scattering, or high-order aberrations, could be measured in some eyes. A gradual increase in intraocular scattering with age is also observed.

Clinical Ocular Wavefront Analyzers

PURPOSE

To provide a summary of the methods used by clinical wavefront analyzers and their historical, current, and future applications.

METHODS

Review of the literature and authors' experience with the various devices.

RESULTS

A wide range of clinical wavefront aberrometers, which use different principles, are available to clinicians and researchers.

CONCLUSIONS

Applications of wavefront analyzers in vision sciences range from assessment of refractive error, refractive surgery planning, evaluation of outcomes, optimization of contact lenses and IOL designs, evaluation of pathology relating to optical performance of the eye, and evaluation of accommodation alterations.

Operator-induced errors in Hartmann-Shack wavefront sensing: Model eye study

PURPOSE

To evaluate the effects of instrument realignment and angular misalignment during the clinical determination of wavefront aberrations by simulation in model eyes.

SETTING

Aston Academy of Life Sciences, Aston University, Birmingham, United Kingdom.

METHODS

Six model eyes were examined with wavefront-aberration-supported cornea ablation (WASCA) (Carl Zeiss Meditec) in 4 sessions of 10 measurements each: sessions 1 and 2, consecutive repeated measures without realignment; session 3, realignment of the instrument between readings; session 4, measurements without realignment but with the model eye shifted 6 degrees angularly. Intersession repeatability and the effects of realignment and misalignment were obtained by comparing the measurements in the various sessions for coma, spherical aberration, and higher-order aberrations (HOAs).

RESULTS

The mean differences between the 2 sessions without realignment of the instrument were 0.020 microm +/- 0.076 (SD) for Z(3)(-1)(P = .551), 0.009 +/- 0.139 microm for Z(3)(1)(P = .877), 0.004 +/- 0.037 microm for Z(4)(0) (P = .820), and 0.005 +/- 0.01 microm for HO root mean square (RMS) (P = .301). Differences between the nonrealigned and realigned instruments were -0.017 +/- 0.026 microm for Z(3)(-1)(P = .159), 0.009 +/- 0.028 microm for Z(3)(1) (P = .475), 0.007 +/- 0.014 microm for Z(4)(0)(P = .296), and 0.002 +/- 0.007 microm for HO RMS (P = 0.529; differences between centered and misaligned instruments were -0.355 +/- 0.149 microm for Z(3)(-1) (P = .002), 0.007 +/- 0.034 microm for Z(3)(1)(P = .620), -0.005 +/- 0.081 microm for Z(4)(0)(P = .885), and 0.012 +/- 0.020 microm for HO RMS (P = .195). Realignment increased the standard deviation by a factor of 3 compared with the first session without realignment.

CONCLUSIONS

Repeatability of the WASCA was excellent in all situations tested. Realignment substantially increased the variance of the measurements. Angular misalignment can result in significant errors, particularly in the determination of coma. These findings are important when assessing highly aberrated eyes during follow-up or before surgery.

Normal-eye Zernike coefficients and root-mean-square wavefront errors

PURPOSE

To compare aberrometry measurements from multiple sites and compute mean Zernike coefficients and root-mean-square (RMS) values for the entire data pool to serve as a reference set for normal, healthy adult eyes.

SETTING

Northeastern State University, Tahlequah, Oklahoma, USA.

METHODS

Data were collected from 10 laboratories that measured higher-order aberrations (HOAs) in normal, healthy adult eyes using Shack-Hartmann aberrometry (2560 eyes of 1433 subjects). Signed Zernike coefficients were scaled to pupil diameters of 6.0 mm, 5.0 mm, 4.0 mm, and 3.0 mm and corrected to a common wavelength of 550 nm. The mean signed and absolute Zernike coefficients across data sets were compared. Then, the following were computed: overall mean values for signed and absolute Zernike coefficients; polar Zernike magnitudes and RMS values for coma-like aberrations (Z(3)(+/-1) and Z(5)(+/-1) combined); spherical-like aberrations (Z(4)(0) and Z(6)(0) combined); and 3rd-, 4th-, 5th-, and 6th-order, and higher-order aberrations (orders 3 to 6).

RESULTS

The different data sets showed good agreement for Zernike coefficients values across most higher-order modes, with greater variability for Z(4)(0) and Z(3)(-1). The most prominent modes and their mean absolute values (6.0-mm pupil) were, respectively, Z(3)(-1) and 0.14 microm, Z(4)(0) and 0.13 microm, and Z(3)(-3) and 0.11 microm. The mean total higher-order RMS was 0.33 microm.

CONCLUSIONS

There was a general consensus for the magnitude of HOAs expected in normal adult human eyes. At least 90% of the sample had aberrations less than double the mean values reported here. These values can serve as a set of reference norms.

Reliability of Corneal and Total Wavefront Aberration Measurements With the SCHWIND Corneal and Ocular Wavefront Analyzers

PURPOSE

To evaluate the reliability of the SCHWIND Corneal and Ocular Wavefront Analyzers.

METHODS

This study comprised 115 eyes of 58 healthy volunteers (26 [44.8%] women and 32 [55.2%] men) with no corneal or lenticular pathologies and normal visual acuity. All eyes underwent three consecutive measurements by one examiner with the Corneal Wavefront Analyzer and the Ocular Wavefront Analyzer (Hartmann-Shack principle). Corneal wavefront errors were calculated using the topography data, a standard eye model, and ray tracing. The reliability was tested for 2nd, 3rd, and 4th order aberrations as mean values of the standard deviations for all measurements.

RESULTS

Mean patient age was 23 +/- 2.1 years. The mean refraction was -0.77 +/- 1.56 diopters (D) (range: +3.33 to -5.28 D). The repeatability test revealed a good reliability for both machines with a slightly better value for the Ocular Wavefront Analyzer for 3rd and 4th order higher order aberrations (P < .05, Wilcoxon test).

CONCLUSIONS

Wavefront measurements of corneal and total optical aberrations performed with the Corneal Wavefront Analyzer and the Ocular Wavefront Analyzer have good reliability. Both measurements are recommended prior to any refractive surgery treatment.

On the prediction of optical aberrations by personalized eye models

PURPOSE

The purpose of this study is to develop and analyze a method to obtain optical schematic models of individual eyes. Each model should be able to reproduce the measured monochromatic wave aberration with high fidelity.

METHODS

First, we choose a generic eye model as the input guess and then apply a two-stage customization procedure. Stage 1 consists of replacing, in the initial generic model, those anatomic and optical parameters with experimental data measured on the eye under analysis. The set of experimental data was that provided by a standard clinical preoperative examination, namely lens topography, ultrasound biometry, and total wave aberration. Then, the second stage is to find the unknown lens structure that would reproduce the measured wave aberration through optical optimization. Two totally different initial eye models have been compared; one considers a simpler constant refractive index for the lens, whereas the second model has a gradient-index (GRIN) lens.

RESULTS

This automatic customization method has been applied to 19 eyes with different degrees of spherical ametropia (from +0.4 D to -8 D). Two models have been obtained for each eye (constant and gradient index lens). The results were highly satisfactory, with 100% convergence, and with average RMS prediction errors approximately lambda/100. This is one order of magnitude lower than typical measurement errors. The models with a constant refractive index lens tended to overestimate surface curvatures, whereas for the GRIN model, lens surfaces were too flat.

CONCLUSIONS

The proposed method is highly efficient and robust giving a high-fidelity reproduction of the wavefront in all cases attempted so far. Limitations found in reproducing the geometry of the lens seem to be associated with the use of inaccurate models of its refractive index.

Objective measurement of intraocular lens movement and dioptric change with a focus shift accommodating intraocular lens

PURPOSE

To objectively measure the shift and refractive change of the 1CU accommodating intraocular lens (IOL) (HumanOptics) and compare them to that of a monofocal AcrySof MA30 IOL (Alcon Laboratories) in the fellow eye.

SETTING

Ophthalmology Department, St. Thomas' Hospital, London, United Kingdom.

METHODS

Thirty patients who had bilateral cataract surgery 18 to 24 months previously with a 1CU IOL prospectively randomly allocated to 1 eye and an AcrySof MA30 monofocal IOL to the other eye were examined. Distance correction, near vision, reading fluency, near point, and defocus to minus spheres were measured. Intraocular lens shift to an accommodative stimulus following instillation of pilocarpine 4% was measured with the ACMaster. Refractive change between distance and near was measured with the Tracey wavefront analyzer.

RESULTS

Of the original 30 patients recruited, complete measurements could only be obtained for 20. There was no significant difference in near visual function with either IOL. A small anterior movement of the 1CU was seen with accommodation 0.010 mm +/- 0.028 (SD). After pilocarpine 4% instillation, a forward movement of 0.220 +/- 0.169 mm was seen with the 1CU compared to a backward movement of 0.028 +/- 0.095 with the MA30. There was no significant correlation between distance corrected near visual acuity and IOL movement. No change in spherical equivalent between distance and near was seen on wavefront analysis of either IOL.

CONCLUSIONS

Small forward movement of the 1CU IOL was seen with accommodation and increased following pilocarpine, compared to the posterior movement of the MA30 IOL. The amount of the IOL shift was not sufficient to provide useful near vision, but the difference suggests that the engineering concept behind the 1CU IOL is valid.

A New Calibration Set of Phase Plates for Ocular Aberrometers

PURPOSE

To manufacture and test a set of phase plates for the calibration of ocular aberrometers and apply it to the calibration of an ocular laser ray tracing aberrometer.

METHODS

The set of phase plates is made by a greyscale single-mask photosculpture in photoresist method. Each plate induces a given amount of a particular aberration (Zernike) mode. The set contains two subsets: 1) pure Zernike modes to test the accuracy among different orders (from 3rd to 7th, approximately 0.3 to 0.4 microm); and 2) plates having different amounts of the same mode, 3rd order coma ranging from 0.11 to 0.47 microm. After manufacturing, the plates were tested twice, as a crosscheck, measuring the aberration pattern of each plate with a Mach-Zehnder interferometer and a single-pass Hartmann-Shack wavefront sensor. The set was then applied to the calibration of an ocular double-pass laser ray tracing aberrometer.

RESULTS

Close agreement was found between the three types of measurement. The maximum difference between Hartmann-Shack and laser ray tracing measurements was 0.032 microm (ie, approximately lambda/20, half of the typical measuring error in human eyes). This permitted detection of a small bias in the ocular laser ray tracing aberrometer.

CONCLUSIONS

The calibration set may be a powerful tool for the assessment of accuracy and reliability in ocular aberrometry. It discovered a small bias, which is almost impossible to detect when working with human eyes or trial lenses. This type of calibration tool is especially important in clinical environments.

Precision of NIDEK OPD-Scan Measurements

PURPOSE

To evaluate the repeatability of wavefront measurements using the NIDEK OPD-Scan.

METHODS

A total of 179 eyes from 90 healthy volunteers (57 women and 33 men) with no corneal or lenticular pathology and normal visual acuity were enrolled in this study. Mean patient age was 39 years (range: 17 to 85 years). All patients underwent four consecutive measurements by one examiner with the NIDEK OPD-Scan. Total, corneal, and internal wavefront errors were measured and calculated with the device, using slit retinoscopy. Repeatability of the measurements was evaluated for spherical aberration, coma, and trefoil.

RESULTS

The repeatability test revealed a good result for all three higher order aberrations evaluated. The best repeatability values were found for total aberrations, followed by internal and corneal aberrations.

CONCLUSIONS

The NIDEK OPD-Scan has good precision in the wavefront measurement of total, corneal, and internal optical aberrations.

Influences of reference plane and direction of measurement on eye aberration measurement

We explored effects of measurement conditions on wave aberration estimates for uncorrected, axially myopic model eyes. Wave aberrations were initially referenced to either the anterior corneal pole or the natural entrance pupil of symmetrical eye models, with rays traced into the eye from infinity (into the eye) to simulate normal vision, into the eye from infinity and then back out of the eye from the retinal intercepts (into/out of the eye), or out of the eye from the retinal fovea (out of the eye). The into-the-eye and out-of-the-eye ray traces gave increases in spherical aberration as myopia increased, but the into/out-of-the-eye ray trace showed little variation in spherical aberration. Reference plane choice also affected spherical aberration. Corresponding residual aberrations were calculated after the models had been optically corrected, either by placing the object or image plane at the paraxial far point or by modifying corneas to simulate laser ablation corrections. Correcting aberrations by ablation was more complete if the original aberrations were referenced to the cornea rather than to the entrance pupil. For eyes corrected by spectacle lenses, failure to allow for effects of pupil magnification on apparent entrance pupil diameter produced larger changes in measured aberrations. The general findings regarding choice of reference plane and direction of measurement were found to be equally applicable to eyes that lacked rotational symmetry.