Relative contribution of central and peripheral aberrations to overall high order corneal wavefront aberration

To analyze the influence of specific combinations of corneal high order aberrations on the optical image quality of the cornea before and after photorefractive keratectomy (PRK) for low to high myopia and myopic astigmatism.

Corneal topography was obtained for 80 eyes that underwent PRK using a scanning-spot excimer laser. The eyes were subdivided into three groups according to the preoperative refraction. The topographical data were imported into a custom software program that combined the Zernike high order terms having the same sign and angular frequency up to seventh order for 4-mm and 6-mm pupils, ie, coma and spherical aberrations, and midperipheral and peripheral high order aberrations.

Photorefractive keratectomy induced a significant amount of the root-mean-square (RMS) values of the combinations of midperipheral and peripheral high order aberrations over the smaller pupil size for deeper myopic ablations (P<.05). Over the larger pupil, spherical myopic ablations showed a significant increase (P<.05) of the RMS values of coma and spherical aberrations. In the astigmatism group, the combination of terms having higher angular frequency increased significantly (P<.05) after surgery both over 4-mm and 6-mm pupils.

After surface ablation, ablation depth and profile significantly influence the distribution and contribution of determined combinations of high order aberrations to the overall high order corneal wavefront aberration. Terms having high angular frequency were increased following large myopic correction and wide treatment zone. Quality of the whole corneal optics will be enhanced by designing future ablation profiles to compensate for peripheral high order optical aberrations.