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K. S. Kunert, M. Nennstiel, M. Dick, H. Vogelsang, M. Blum; Measurement of Wavefront Dynamics During Accommodation With Dynamic Stimulation Aberrometry. Invest. Ophthalmol. Vis. Sci. 2007;48(13):968.
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The Dynamic Stimulation Aberrometry System (DSA) was used to measure and analyze the individual dynamic behavior of the ocular wavefront during accommodation. DSA functions as an add-on to the approved Wave Front Technology such as the "Wavefront Analyzer" (WASCA) or the "Complete Ophthalmic Analysis System" (COAS).
DSA is an optomechanical attachment to the aberrometer head including additional driving electronics and an application software (Optana Medizintechnik, Grossostheim, Germany) [Image 1]. After the alignment of the patient in front of the aberrometer a target can be inspected with both eyes via a mirror arrangement. The target distance can be changed abruptly between two distances (near and far). In reality, the near target can be switched in and out of the optical pathway. This allows for very fast changes in the target distance. The far target may be applied from about 0,5 meters up to any possible distance and near target can be set in 0,25 Diopter steps between 3 to 9 Diopters.
Approximately 40 patients in different states of refraction (myopia, hyperopia or ametropia) were investigated using this method. At first, the wavefront refraction and aberration was evaluated during accommodation as a function of time (dynamic). Secondly, targets were offered stepwise (static). Reproducible data were obtained using both methods, dynamic and static. Changes in higher order aberrations and pupillary diameters during accommodation were comparable in both. However, a significant difference was seen in the maximum individually reached accommodation stroke. The deviation in accommodative power was less in the dynamic evaluation.
DSA is the first method with binocular stimulation and keeping the natural stereopsis. It allows studies of the ability for dynamic as well as static accommodation, i.e. the maximum individually reached accommodation stroke. DSA might therefore be a useful tool in basic research or application within the area of presbyopia, accommodative IOL's or refractive surgery.
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