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A Cervino, MB McDonald, SD Klyce; Shack-Hartmann Pattern as an Aid in the Diagnosis and Evaluation of Dry Eye: A Retrospective Study . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2029.
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Purpose: The potential of Shack-Hartmann (S-H)-based wavefront analysis systems as tools in the diagnosis and evaluation of dry eyes is explored by creating a standard classification of the raw data (grid) patterns and comparing the results to clinical evaluations performed at the same visits. Methods: A total of 71 eyes from 36 patients were examined with the Ladarwave Custom Cornea Wavefront System (v.6.06, Alcon Tech.) after dilation. The S-H grid patterns were classified on a scale from 0 to 4+ (five grades overall). Three masked observers then independently scored the 71 S-H patterns, and their scores were compared to the clinical assessments (also five grades from 0 to 4+, based on the presence of superficial punctate keratitis or SPK) made by one masked observer. Results: For the scoring of the 71 S-H patterns by the three independent masked observers, 100% of the scores were within 1 grade difference for all three observers. When the S-H pattern scoring for each of the three independent masked observers was compared with the clinical scoring by the single masked observer, nearly 50% were identical and nearly 90% were within 1 grade difference. Topography raw data (the ring displays) from a subset of these patients were found to have less correlation with the clinical scores than the S-H pattern scoring, and were often difficult to obtain in extremely dry eyes. Conclusion: S-H grid pattern assessment may be a new aid in the diagnosis (and documentation) of dry eyes and the response to treatment.
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