Accuracy and reproducibility of Zywave, Tracey, and experimental aberrometers

To compare the accuracy and verify the reliability of different commercial and experimental prototypes of aberrometers using a small group of normal subjects with low myopia.

Three different devices were used to measure the wavefront aberration of five normal myopic eyes: 1) Zywave--commercial aberrometer based on a Hartmann-Shack wavefront sensor; 2) Tracey--commercial system based on the laser ray tracing principle; and 3) an experimental laboratory laser ray tracing instrument working at two different wavelengths (532 and 786 nm). A series of five measurements were taken for each subject. Pupil diameter and alignment were controlled. All wave aberration maps were reduced to a common 6.5-mm pupil diameter, and then the mean and standard deviation were computed for the series, as well as the global average and standard deviation for each subject.

Despite several important differences among devices and sessions, the results obtained with the different devices were equivalent. The main difference found between aberrometers was due to the longitudinal chromatic aberration caused by the use of different wavelengths. The signal-to-noise ratio estimated from the raw data was moderate, 12, but could be improved by a factor of 2 by discarding those measurements with a higher deviation from the mean and averaging the remaining data, which was the approach implemented in the Zywave instrument.

The aberrometers tested were reliable in normal eyes with low myopia. Aberrometry is a robust but noisy technique. Accuracy is limited by noise and other sources of variability, including the size and alignment of the pupil. These conclusions might not apply to eyes with large aberrations.