Journal of Refractive Surgery

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Proceedings 

Enhanced Visual Acuity and Image Perception Following Correction of HighlyAberrated Eyes Using an Adaptive Optics Visual Simulator

Karolinne Maia Rocha, MD, PhD; Laurent Vabre, PhD; Nicolas Chateau, PhD; Ronald R. Krueger, MD, MSE

Abstract

PURPOSE

To evaluate the changes in visual acuity and visual perception generated by correcting higher order aberrations in highly aberrated eyes using a large-stroke adaptive optics visual simulator.

METHODS

A crx1 Adaptive Optics Visual Simulator (Imagine Eyes) was used to correct and modify the wavefront aberrations in 12 keratoconic eyes and 8 symptomatic postoperative refractive surgery (LASIK) eyes. After measuring ocular aberrations, the device was programmed to compensate for the eye’s wavefront error from the second order to the fifth order (6-mm pupil). Visual acuity was assessed through the adaptive optics system using computer-generated ETDRS optotypes and the Freiburg Visual Acuity and Contrast Test.

RESULTS

Mean higher order aberration root-mean-square (RMS) errors in the keratoconus and symptomatic LASIK eyes were 1.88±0.99 µm and 1.62±0.79 µm (6-mm pupil), respectively. The visual simulator correction of the higher order aberrations present in the keratoconus eyes improved their visual acuity by a mean of 2 lines when compared to their best sphero-cylinder correction (mean decimal visual acuity with spherocylindrical correction was 0.31±0.18 and improved to 0.44±0.23 with higher order aberration correction). In the symptomatic LASIK eyes, the mean decimal visual acuity with spherocylindrical correction improved from 0.54±0.16 to 0.71±0.13 with higher order aberration correction. The visual perception of ETDRS letters was improved when correcting higher order aberrations.

CONCLUSIONS

The adaptive optics visual simulator can effectively measure and compensate for higher order aberrations (second to fifth order), which are associated with diminished visual acuity and perception in highly aberrated eyes. The adaptive optics technology may be of clinical benefit when counseling patients with highly aberrated eyes regarding their maximum subjective potential for vision correction. [J Refract Surg. 2010;26:52-56.]

doi:10.3928/1081597X-20101215-08

AUTHORS

From Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio (Rocha, Krueger); Imagine Eyes, Orsay, France (Vabre, Chateau); and Federal University of São Paulo, São Paulo, Brazil (Rocha).

Drs Vabre and Chateau are employees of Imagine Eyes, Orsay, France. Drs Rocha and Krueger have no financial interest in the materials presented herein.

This paper was presented at the Lens, Refractive & Wavefront Summit ARI/WFC 2009; March 5-7, 2009; Alicante, Spain.

Correspondence: Karolinne Maia Rocha, MD, PhD, 309 Ferguson St, Atlanta, GA 30307. E-mail: karolinnemaia@hotmail.com

Abstract

PURPOSE

To evaluate the changes in visual acuity and visual perception generated by correcting higher order aberrations in highly aberrated eyes using a large-stroke adaptive optics visual simulator.

METHODS

A crx1 Adaptive Optics Visual Simulator (Imagine Eyes) was used to correct and modify the wavefront aberrations in 12 keratoconic eyes and 8 symptomatic postoperative refractive surgery (LASIK) eyes. After measuring ocular aberrations, the device was programmed to compensate for the eye’s wavefront error from the second order to the fifth order (6-mm pupil). Visual acuity was assessed through the adaptive optics system using computer-generated ETDRS optotypes and the Freiburg Visual Acuity and Contrast Test.

RESULTS

Mean higher order aberration root-mean-square (RMS) errors in the keratoconus and symptomatic LASIK eyes were 1.88±0.99 µm and 1.62±0.79 µm (6-mm pupil), respectively. The visual simulator correction of the higher order aberrations present in the keratoconus eyes improved their visual acuity by a mean of 2 lines when compared to their best sphero-cylinder correction (mean decimal visual acuity with spherocylindrical correction was 0.31±0.18 and improved to 0.44±0.23 with higher order aberration correction). In the symptomatic LASIK eyes, the mean decimal visual acuity with spherocylindrical correction improved from 0.54±0.16 to 0.71±0.13 with higher order aberration correction. The visual perception of ETDRS letters was improved when correcting higher order aberrations.

CONCLUSIONS

The adaptive optics visual simulator can effectively measure and compensate for higher order aberrations (second to fifth order), which are associated with diminished visual acuity and perception in highly aberrated eyes. The adaptive optics technology may be of clinical benefit when counseling patients with highly aberrated eyes regarding their maximum subjective potential for vision correction. [J Refract Surg. 2010;26:52-56.]

doi:10.3928/1081597X-20101215-08

AUTHORS

From Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio (Rocha, Krueger); Imagine Eyes, Orsay, France (Vabre, Chateau); and Federal University of São Paulo, São Paulo, Brazil (Rocha).

Drs Vabre and Chateau are employees of Imagine Eyes, Orsay, France. Drs Rocha and Krueger have no financial interest in the materials presented herein.

This paper was presented at the Lens, Refractive & Wavefront Summit ARI/WFC 2009; March 5-7, 2009; Alicante, Spain.

Correspondence: Karolinne Maia Rocha, MD, PhD, 309 Ferguson St, Atlanta, GA 30307. E-mail: karolinnemaia@hotmail.com

PURPOSE

To evaluate the changes in visual acuity and visual perception generated by correcting higher order aberrations in highly aberrated eyes using a large-stroke adaptive optics visual simulator.

METHODS

A crx1 Adaptive Optics Visual Simulator (Imagine Eyes) was used to correct and modify the wavefront aberrations in 12 keratoconic eyes and 8 symptomatic postoperative refractive surgery (LASIK) eyes. After measuring ocular aberrations, the device was programmed to compensate for the eye’s wavefront error from the second order to the fifth order (6-mm pupil). Visual acuity was assessed through the adaptive optics system using computer-generated ETDRS optotypes and the Freiburg Visual Acuity and Contrast Test.

RESULTS

Mean higher order aberration root-mean-square (RMS) errors in the keratoconus and symptomatic LASIK eyes were 1.88±0.99 µm and 1.62±0.79 µm (6-mm pupil), respectively. The visual simulator correction of the higher order aberrations present in the keratoconus eyes improved their visual acuity by a mean of 2 lines when compared to their best sphero-cylinder correction (mean decimal visual acuity with spherocylindrical correction was 0.31±0.18 and improved to 0.44±0.23 with higher order aberration correction). In the symptomatic LASIK eyes, the mean decimal visual acuity with spherocylindrical correction improved from 0.54±0.16 to 0.71±0.13 with higher order aberration correction. The visual perception of ETDRS letters was improved when correcting higher order aberrations.

CONCLUSIONS

The adaptive optics visual simulator can effectively measure and compensate for higher order aberrations (second to fifth order), which are associated with diminished visual acuity and perception in highly aberrated eyes. The adaptive optics technology may be of clinical benefit when counseling patients with highly aberrated eyes regarding their maximum subjective potential for vision correction. [J Refract Surg. 2010;26:52-56.]

doi:10.3928/1081597X-20101215-08

AUTHORS

From Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio (Rocha, Krueger); Imagine Eyes, Orsay, France (Vabre, Chateau); and Federal University of São Paulo, São Paulo, Brazil (Rocha).

Drs Vabre and Chateau are employees of Imagine Eyes, Orsay, France. Drs Rocha and Krueger have no financial interest in the materials presented herein.

This paper was presented at the Lens, Refractive & Wavefront Summit ARI/WFC 2009; March 5-7, 2009; Alicante, Spain.

Correspondence: Karolinne Maia Rocha, MD, PhD, 309 Ferguson St, Atlanta, GA 30307. E-mail: karolinnemaia@hotmail.com

10.3928/1081597X-20101215-08

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