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Disparity between manifest, wavefront refraction studied

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DENVER – Differences between wavefront and manifest refractions may be caused by higher-order aberrations (HOAs) in the eye and could have implications on the success of refractive surgery outcomes, according to a study presented here at the American Academy of Optometry meeting.

The study, presented by Manoj Venkiteshwar, BSOptom, PhD, FAAO, was aimed at investigating the effect of aberration interactions on the disparities between manifest and wavefront refraction.

The retrospective data analysis looked at 330 eyes that had been treated with custom LASIK using the Zywave platform (Bausch & Lomb, Rochester, N.Y.). Dr. Venkiteshwar had access to preoperative and 6-month postoperative manifest refraction, wavefront refraction and HOAs at 6-mm aperture diameter data. The preoperative and 6-month postoperative refraction values were converted to vector format: spherical equivalent (SE), J0 and J45 terms. Discrepancy between manifest and wavefront refraction vectors was assessed as a function of HOA. Potential optical interaction effect of HOA on second-order defocus and cylinder were evaluated using image convolutions.

According to the study results, significant correlations were found between disparity in SE and spherical aberration, and between discrepancy in J0, J45 and spherical aberration, and coma (<0.001). The correlation was greater postoperatively than it was preoperatively. Significant effect of spherical aberration and coma on defocus and astigmatism was revealed through optical convolution. This supported the clinical data.

"The effect of such aberration interactions and potential implications to refining custom corneal treatment will be discussed," Dr. Venkiteshwar said. "We need to understand this discrepancy."