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Influence of Pupil and Optical Zone Diameter on Higher Order Aberrations after Wavefront-guided LASIK

1Bühren J., 2Kühne C., 2Kohnen T.,
1Johann-Wolfgang-Goethe-Universität, Klinik für Augenheilkunde, Arbeitsgruppe für Refraktive Chirurgie (Frankfurt/Main)
2Johann-Wolfgang-Goethe-Universität, Klinik für Augenheilkunde (Frankfurt/Main)

Background: Discrepancy between scotopic pupil diameter and optical zone (pupil excess, PE) has been made responsible for decreased contrast sensitivity and increased glare disability after LASIK. In the present study we demonstrate the influence of PE on higher order (3rd - 5th order) ocular aberrations after wavefront-guided LASIK.
Methods: 26 eyes of 14 patients were examined pre-operatively and 12 months after wavefront-guided LASIK (Zyoptix, Bausch & Lomb). The mean pre-operative spherical equivalent was -5,88±1,98 D (-3,25 - -9,0 D); the mean optical zone 6,82±0,66 mm (5,7-8,0 mm). Wavefront measurements were performed with a HARTMANN-SHACK sensor (Zywave, Bausch & Lomb) in mydriasis. The root mean square (RMS) wavefront error was computed for all aberrations of 3rd to 5th order for pupil diameters of 3, 4, 5, 6 and 7 mm and for the individual maximum (7,8±0,83 mm). For each measurement a PE value (quotient of simulated pupil diameter and optical zone) was calculated. Average RMS values were calculated for 5 groups (PE £ 0,60; 0,61-0,80; 0,81-1,0; 1,10-1,2 and >1,2).
Results: Higher order aberrations increased on average by factor 1,45. For total aberrations of 3rd to 5th order mean RMS values were as follows: PE £0,60=0,22±0,09µm; PE 0,61-0,80=0,4±0,19µm; PE 0,81-1,0=0,88±0,34µm; PE 1,10-1,2=1,85±0,55µm and for PE>1,2=3,17±0,73µm. For Z 12 (spherical aberration) mean RMS values were as follows: PE £0,60=0,05±0,03µm; PE 0,61-0,80=0,25±0,16µm; PE 0,81-1,0=0,71±0,33µm; PE 1,10-1,2=1,51±0,64µm and for PE>1,2=2,94±1,3µm.
Conclusions: Also for wavefront-guided LASIK maximal optical zone diameters should be chosen to minimise the amount of higher order aberrations postoperatively.

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