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Comparison of corneal higher-order aberrations induced by myopic and hyperopic LASIK.

Kohnen T, Mahmoud K, Bühren J

Department of Ophthalmology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany. kohnen@em.uni-frankfurt.de

OBJECTIVE: To compare the change in anterior corneal higher-order (third- to fifth-order) aberrations (HOAs) induced by myopic and hyperopic LASIK. DESIGN: Retrospective comparative case series. PARTICIPANTS: One hundred eyes (50 myopes and 50 hyperopes) of 59 patients were included. The mean preoperative spherical equivalent (SE) was -4.22+/-1.78 diopters (D; range, -1.25 to -8.00 D) in the myopic group (group A) and +2.72+/-1.25 D (range, +0.25 to +5.00 D) in the hyperopic group (group B). INTERVENTION: LASIK was performed using a conventional spherocylindrical laser algorithm (Planoscan V2.9992, Bausch & Lomb/Technolas, Munich, Germany). Optical zone diameter was 6.70+/-0.32 mm (range, 6-7 mm) in group A and 6.59+/-0.19 mm (range, 6.5 to 7 mm) in group B. Third to fifth corneal HOA were computed for a pupil diameter of 6 mm from corneal topographic examinations before and 1 month after surgery. MAIN OUTCOME MEASURES: Change in corneal HOAs, derived from corneal topography. RESULTS: Total HOA root mean square (RMS) changed in group A by 0.167+/-0.180 microm (factor 1.53) and in group B by 0.341+/-0.341 microm (factor 1.89). The mean induction of coma RMS was significantly different in both groups (myopes, 0.092+/-0.195 microm; hyperopes, 0.252+/-0.305 microm; P<0.05). For spherical aberration (Z 4,0), the myopic group showed a significant increase (0.130+/-0.120 microm; factor 1.6; P<0.001), whereas the hyperopic group showed a significant decrease (-0.317+/-0.158 microm; factor 0.76; P<0.001). Fifth-order aberrations showed an increase in both groups, which was higher in group B (0.069+/-0.120 microm; factor 2.46) than in group A (0.005+/-0.065 microm; factor 1.49). CONCLUSIONS: Myopic and hyperopic LASIK had different patterns of HOA induction. Myopic LASIK induced positive spherical aberrations and positive secondary astigmatism, whereas hyperopic LASIK induced negative spherical aberrations and negative secondary astigmatism. Hyperopic LASIK induced more third- and fifth-order comalike aberrations than myopic LASIK.

Published 3 October 2005 in Ophthalmology, 112(10): 1692.
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