Do patient symptoms and pupil size correlate with specific higher order aberrations from LADAR wave analysis?

Abstract

Abstract: : Purpose: To determine the validity of a preoperative survey of subjective perceived vision with corrective spectacles or contact lens prior to laser vision correction. To correlate the amount of specific higher order wavefront aberrations measured using LadarWave (Alcon Lab.) with pupil size and patient subjective visual complaints. Methods: 39 myopic patients (23 females, 16 males) with mean age 43.5 seeking laser vision correction underwent a survey of subjective visual complaints, including satisfaction, glare, seeing halos, difficulty reading and difficulty driving at night with either spectacle correction (SC) or contact lenses (CL). Patients recorded the severity of visual complaints using a 1 to 10 scale. Objective measurements included pupil size (PS) in millimeters using an infrared pupillometer in dim light, and LadarWave high order aberrations expressed as Root–Mean–Square(RMS) values, including vertical coma (VC), horizontal coma (HC), and spherical aberration (SA). The higher magnitude of right or left eye HC, VC, SA RMS scores, and the pupil size corresponding to the eye chosen, were used for data analysis using regression coefficients (r²). Results: Mean PS was 5.90mm±SD 1.04, mean VC was 0.28±SD 0.37, mean HC was 0.15±SD 0.12, and mean SA was 0.20±SD 0.21. No correlation existed between glare and HC or VC in the SC (r²=0.23, r²=0.04) or CL groups respectively (r²=0.05, r²=0.01). No correlation existed between difficulty reading and HC or VC in the SC (r²=0.12, r²=0.04) or CL groups (r²=0.01, r²=0.00). No correlation existed between seeing halos and SA for CL group (r²=0.23). No correlation existed between difficulty driving at night and SA in the SC (r²=0.05) or CL (r²=0.18) groups. In the SC group, patients with PS greater than 6mm, a weakly positive correlation (r²=0.51) existed between perceiving halos and SA. Conclusions: Theoretically the degree of patient subjective visual complaints in dim light (pupil dilation) should correlate with the presence of higher order aberrations such as HC, VC and SA. However, in this study, no correlation could be determined between subjective visual complaints and objective RMS measurements of VC, HC, and SA. In the SC group with PS greater than 6 mm, only a weak positive correlation between seeing halos and SA was found. Further studies are needed to compare contrast sensitivity to wavefront analysis for the prediction of subjective visual complaints in dim lighting conditions after refractive surgery.

Keywords: cornea: clinical science • refractive surgery: corneal topography