Performance of a new binocular wavefront aberrometer based on a self-imaging diffractive sensor.

PURPOSE: To compare the performance of the Ophthonix Z-View diffractive aberrometer with two different Hartmann-Shack aberrometers. METHODS: The Ophthonix Z-View was compared with the Alcon LADARWave and VISX WaveScan using 4 model eyes and 68 human eyes. Comparisons using three fixed, single-surface model eyes each with a different wavefront pattern were used to determine higher order accuracy. Lower order accuracy, linearity, and higher order repeatability were tested with a fourth model eye with a movable retinal surface. Manifest refraction spherical equivalent and the calculated spherical equivalent refraction of the aberrometers were compared in 68 human eyes. RESULTS: The Z-View was more accurate with lower noise compared to the WaveScan and LADARWave systems for higher order measurements of the fixed model eyes. Total root-mean-square difference from surface topography derived average values for all model eye configurations were 0.48, 0.95, and 0.74 microm for the Z-View, WaveScan, and LADARWave aberrometers, respectively. Average inter-measurement standard deviations for the fixed model eyes were 0.024, 0.025, and 0.034 microm for the Z-View, WaveScan, and LADARWave aberrometers, respectively. Results were similar among the systems for measuring the movable retina surface model eye and comparing manifest refraction spherical equivalent of the patients. CONCLUSIONS: Data gathered using one variable and several fixed-parameter model eyes showed good correlation to predicted values for all of the aberrrometers with one exception. A significant difference was found in the measurement of one individual fixed model eye with one of the three aberrometers. The wavefront refraction provided by the Z-View correlated well with the results of manifest refraction.

Imaging a child's fundus without dilation using a handheld confocal scanning laser ophthalmoscope.

Images of the fundus were acquired in children without pupil dilation using a prototype handheld confocal scanning laser ophthalmoscope (SLO). A 780-nm laser beam imaged a 20 degrees x 20 degrees area of the fundus while a 645-nm beam scanned a fixation target. Scorable images of the optic nerve, macula, and vessels were obtained in 67 (72%) of 93 eyes from pediatric patients with nystagmus, amblyopia, media opacities, or optic nerve or macular abnormalities. Images were obtained in all eyes of pediatric and adult controls. Unsuccessful imaging was associated with media opacities, high refractive error, and poor cooperation. Disadvantages of the SLO were the inability to detect optic nerve pallor or consistently image the periphery. Advantages of the SLO were seen in children with nystagmus, photophobia, eccentric fixation, cone dystrophy, and mild papilledema.