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  • Title: Effect of pupil size on corneal aberrations before and after standard laser in situ keratomileusis, custom laser in situ keratomileusis, and corneal refractive therapy.
    Author: Queirós A, Villa-Collar C, González-Méijome JM, Jorge J, Gutiérrez AR.
    Journal: Am J Ophthalmol; 2010 Jul; 150(1):97-109.e1. PubMed ID: 20488432.
    Abstract:
    PURPOSE: To evaluate the effect of changing the pupil size on the corneal first-surface higher-order aberrations induced by different refractive treatments: standard laser in situ keratomileusis (LASIK), custom LASIK, and corneal refractive therapy. DESIGN: Observational study. METHODS: Eighty-one right eyes from patients with a mean age of 29.94 +/- 7.5 years, of which 50 were female (61.7%), were analyzed retrospectively at the Clínica Oftalmológica NovoVision, Madrid, Spain. Corneal videokeratographic data were used to obtain corneal first-surface higher-order aberrations for aperture diameters from 3 to 8 mm using the Vol-CT software (Sarver & Associates, Inc). Total root mean square (RMS) and RMS for third- to sixth-order Zernike polynomials as well as spherical-like, coma-like, secondary astigmatism, and spherical plus coma-like variables were calculated. RESULTS: We verified an increase in the higher-order aberration total RMS after treatments of 0.014 +/- 0.025 microm, 0.019 +/- 0.027 microm, and 0.018 +/- 0.031 microm for standard LASIK, custom LASIK, and corneal refractive therapy, respectively, for 3-mm pupil diameter. For the 8-mm aperture diameter, changes in total RMS increased by a factor of 50 compared with the variation for the 3-mm diameter up to 0.744 +/- 0.731 microm, 0.493 +/- 0.794 microm, and 0.973 +/- 1.055 microm for standard LASIK, custom LASIK, and corneal refractive therapy, respectively. CONCLUSIONS: The 3 techniques increase the wavefront aberrations of the cornea and change the relative contribution of coma-like and spherical-like aberrations. For a large aperture (> 5 mm), corneal refractive therapy induces more spherical-like aberrations than standard and custom LASIK. However, no clinically or statistically significant differences existed for narrower apertures. Standard and custom LASIK did not display statistically significant differences regarding higher-order aberrations.
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