Agreement of corneal high-order aberrations measured by three wavefront aberrometers in myopic adults / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the agreement of corneal high-order aberrations from Topcon KR-1W, i.Profiler and OPD-Scan Ⅲ wavefront aberrometers in myopic adults.METHODS:A prospective clinical study. A total of 92 adult patients(92 eyes)with myopia in the department of optometry, the People's Hospital of Guangxi Zhuang Autonomous Region from June to August 2022 were enrolled. The third-order and fourth-order corneal aberrations at the pupil diameter of 4 and 6mm were measured by Topcon KR-1W, i.Profiler, and OPD-Scan Ⅲ, respectively. The difference and agreement of the three aberrometers were evaluated.RESULTS: The measurements at 6mm pupil diameter were all greater than those at 4mm pupil diameter. Although there were no statistical differences in the measurements of Z-44、Z-24 by the three aberrometers at 4 pupil diameter(P>0.05), there were statistical differences in other measurements(P<0.05). The aberration results measured by the three aberrometers were statistically different at the 6mm pupil diameter(P<0.05). The 95% limit of agreement(95%LoA)of the measurements of higher-order aberration, including the third-order aberrations at 4mm pupil diameter and the third-order and fourth-order aberrations at 6mm pupil diameter(except for the Z-24)were greater than 0.1μm. The concordance correlation coefficient(Pc)was lower than 0.90, indicating a poor consistency. The correlation coefficients of corneal higher-order aberrations were significantly different among the three aberrometers at 4 and 6mm pupil diameter(r4mm=0.215～0.805, P4mm<0.05; r6mm=0.561～0.916, P6mm<0.001).CONCLUSION:There were significant differences in the measurements of the third- and fourth-order corneal aberrations at 4 and 6mm pupil diameter among Topcon KR-1W, i.Profiler, and OPD-Scan Ⅲ, and the agreements were poor, so they are not interchangeably in clinical applications.

Feasibility assessment of visual quality analyzer KR - 1 W guiding personalized aspheric lOL implantation / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AlM:To discuss the feasibility of using the visual quality analyzer KR - 1W to guide the relatively personalized aspheric intraocular lens ( lOL ) implants to make the whole eye spherical aberration close to 0. 1μm.?METHODS: ln this prospective case series study, the corneal spherical aberration with 6mm aperture of 73 patients (100 eyes) was measured with KR-1W Visual Function Analyzer 1d before surgery. For the sake of the whole postoperative spherical aberration were close to 0. 1μm, 9 cases ( 16 eyes ) with corneal spherical aberration 0. 35μm were implanted Tecnis ZA9003 lOL, named Tecnis group. Aspherical lOL was implanted after phacoemulsification through a cornea 2. 75mm incision without suture. Uncorrected visual acuity, beat corrected visual acuity, spherical aberration of the whole eye and jnternal optics (mainly lOL) at 6mm pupil diameter were examined at 3mo postoperatively. The relevant data were analyzed using t-test and variance analysis.?RESULTS: The whole ocular spherical aberration at 6mm pupil diameter in all postoperative were 0. 084 ± 0. 032μm;in Tecnis group, the data were 0. 091 ± 0. 021μm;in AO group, the data were 0. 0814-0. 013μm;lQ group were0. 093 ± 0. 042μm. There was no significantly different between the predicted value and actual value of ocular spherical aberration at 6 mm pupil diameter in all postoperative ( t = 1. 932, P = 0. 061 ) and in the three groups. The difference value in the predicted values of the preoperative spherical aberrations of the whole eye and the actual values after surgery was 0. 013±0. 041μm; there was no statistically significant difference ( F=2. 537, P=0. 091 ) . Respectively compared the uncorrected visual acuity and besta corrected visual acuity among three groups of postoperative, no significant difference were found (F=0. 897, P=0. 421;F=1. 423, P=0. 097).?CONCLUSlON: Personality selection of aspheric lOL based on preoperative corneal spherical aberration of patients is feasible and produces satisfactory target postoperative total spherical aberration.

Relationship between Dry Eye Parameters and Anterior Corneal Higher-Order Aberrations Measured by Two Different Instruments

PURPOSE: To compare the corneal first surface higher-order aberrations (HOAs) of normal subjects and patients with dry eye using KR-1W(R) (Topcon Corp., Tokyo, Japan) and Pentacam(R) HR (Oculus Inc., Dutenhofen, Germany). We analyzed the relationship between the aberrations and the diagnostic parameters of dry eye. METHODS: We evaluated anterior corneal HOAs in 71 normal eyes and 71 dry eyes using KR-1W(R) and Pentacam(R). Dry eye patients were examined for fluorescein staining, tear break-up time (TBUT), and Schirmer I test. Ocular Surface Disease Index (OSDI) was used for assessment of subjective symptoms in dry eye patients. RESULTS: HOAs measured by both instruments were greater in the dry eye group than in the control group, although HOAs using KR-1W(R) only achieved statistical significance. The anterior corneal HOAs measured by the 2 instruments were significantly correlated with superficial punctate keratitis. Moreover, TBUT and the Shirmer I test negatively correlated, and OSDI positively correlated, with anterior corneal HOAs. CONCLUSIONS: The HOAs in patients with dry eye were significantly different from controls and tended to increase with disease severity. KR-1W(R) might be more useful than Pentacam(R) to detect tear film instabilities.

The Effects of Pharmacologic Pupil Dilatation on Ocular, Corneal, and Internal Aberrations

PURPOSE: The present study investigates the effects of pharmacologic pupil dilatation on ocular, corneal and internal aberrations. METHODS: Sixty-two right eyes of 62 healthy participants were included in the present study. Ocular, corneal and internal aberrations were measured with a KR-1W wavefront aberrometer (Topcon Corp., Tokyo, Japan) before mydriasis in mesopic conditions. After pupil dilatation with a mydriatic drug (phenylephrine chloride 0.5% + tropicamide 0.5%) (Mydrin-P, Santen, Osaka, Japan), the measurements were repeated. The wavefront data of 4-mm and 6-mm diameter zones were analyzed. The changes of aberrations before and after mydriasis were evaluated by paired t-test. RESULTS: The values of ocular, corneal and internal spherical aberrations before and after mydriasis on the 4-mm diameter pupil zone were not statistically significantly different. On the 6-mm diameter zone, the ocular and internal spherical aberrations were statistically significantly different (p = 0.025, p = 0.002, respectively, paired t-test). However, the corneal aberrations did not show significant changes. The internal aberrations average before mydriasis was -0.043 (+/-0.21) microm and was shifted in a negative direction to -0.093 (+/-0.17) microm after mydriasis. The ocular aberrations average also changed toward negative after mydriasis. The high-order aberrations and astigmatism did not change significantly. CONCLUSIONS: The ocular and internal spherical aberrations changed toward negative with mydriasis in the participants' eyes suggesting the change of the ocular spherical aberration to be attributed to internal changes.

Estimation of Corneal Spherical Aberration from Topography

PURPOSE: To formulate an equation to estimate corneal spherical aberration using Orbscan (Bausch & Lomb Surgical, Rochester, NY, USA) parameters. METHODS: The study was carried out retrospectively. The participants were 76 eyes of 76 senile cataract patients with the mean age of 57.37 +/- 17.63 years. Both Orbscan and KR-1W (Topcon Corp, Tokyo, Japan) were taken as preoperative examinations. Correlation analysis between various parameters from Orbscan and corneal spherical aberrations for a 6 mm pupil by KR-1W was performed. And multivariable linear regression was performed with the significantly correlated Orbscan parameters from the correlation analysis. RESULTS: The mean corneal spherical aberration from KR-1W system was 0.25 +/- 0.08 microm. As a result of the multivariable linear regression, we could generate following equations. If the Q-value was available, estimated corneal spherical aberration = 0.389 x Q-value + (0.022 x Axial power 3 mm) - 0.633 (R2 = 0.436). If the Q-value was not available, estimated corneal spherical aberration = 0.184 x (Mean power 5 mm - Mean power 3 mm) + (0.02 x Axial power 3 mm) - 0.563 (R2 = 0.429). By using the equations, 93.4-94.7% of subjects were in the error range of 0.10 microm. CONCLUSIONS: Even when equipped with Orbscan only, an appropriate aspheric intraocular lens can be selected using the estimated corneal apherical aberration by the equations.

The Efficacy of KR-1W Aberrometer in Assessing the Astigmatism after Toric Intraocular Lens Implantation

PURPOSE: To evaluate the efficacy of the KR-1W aberrometer in assessing the astigmatism and the achieved axis after AcrySof Toric intraocular lens (IOL) implantation. METHODS: Thirty-nine patients (48 eyes) that had undergone phacoemulsification and AcrySof Toric IOL implantation were included in the present study. At postoperative 1 month, ocular aberrations of all the eyes were measured using the KR-1W aberrometer before mydriasis and the achieved axis of AcrySof Toric IOL was measured by slit lamp examination after mydriasis. The achieved axis measured by slit lamp examination and the astigmatism of the implanted AcrySof Toric IOL were compared with the KR-1W. RESULTS: The mean achieved lens axis after mydriasis measured by slit lamp examination and KR-1W was 86.43 +/- 47.49 degrees and 88.93 +/- 41.22 degrees, respectively. The correlation coefficient of the 2 methods was 0.992 (p < 0.001). The measured astigmatism according to the AcrySof Toric IOL model was 1.11 +/- 0.47D in SN60T3, 1.71 +/- 0.51D in SN60T4, and 3.32 +/- 0.78D in SN60T5. CONCLUSIONS: Without the need to directly evaluate the axis of implanted Toric IOL after mydriasis, the achieved lens axis can be measured by the KR-1W without mydriasis. The AcrySof Toric IOL model could be assessed by the KR-1W without information about the AcrySof Toric IOL model.

Changes in Higher Order Aberration According to Tear-Film Instability Analyzed by Continuous Measurement Using Wavefront

PURPOSE: To evaluate the changes of higher order aberration according to tear-film instability measured serially by KR-1W wavefront every second for 10 seconds. The present study also analyzed the relationship between higher order aberration and the tear-film break-up time, Schirmer test, and superficial punctate keratitis. METHODS: The 228 eyes of 114 patients randomly selected from patients who visited hospital were measured once every second for 10 seconds after eye blinking by continuous measurement using wavefront. RESULTS: Higher order aberration increased overtime, and the higher order aberration value measured at the tenth second subtracted from the value of the first second was statistically significant (p = 0.004). In addition, the increment in higher order aberration between 9 seconds and 10 seconds was statistically significant (p = 0.01). The group of patients with a tear-film break-up time less than 6 seconds showed the greatest changes when measuring the higher order aberration difference value between the tenth and first seconds, which was statistically significant (p = 0.002). The group of patients where the Schirmer test results were longer than 10 millimeters and who had superficial punctate keratitis showed the greatest statistically significant changes when measuring the difference in higher order aberration values between the tenth and first seconds (p = 0.008, p = 0.005, respectively). CONCLUSIONS: Analysis of higher order aberration by wavefront could be useful in cases of decreased optical quality, diagnosis and evaluation of treatment in dry eye syndrome.