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Updated: May 15, 2026

Correction of Presbyopia by Monocular Bi-Aspheric Ablation Profile
Published on: September 20, 2024
Corneal higher order aberrations after myopic wavefront-optimized ablation
David Smadja1, Marcony R Santhiago, Glauco R Mello
1Cole Eye Institute, Cleveland Clinic Foundation, Refractive Surgery Department, Cleveland, OH, USA. davidsmadj@hotmail.fr
Purpose:
To analyze the induced corneal higher order aberrations (HOAs) after wavefront-optimized ablation.
Methods:
Sixty-four myopic eyes that underwent wavefront-optimized myopic LASIK were divided into three groups based on spherical equivalent (SE): low myopia group (23 eyes with SE <-3.00 diopters [D]); moderate myopia group (27 eyes with SE between -3.00 and -6.00 D); and high myopia group (14 eyes with SE >-6.00 D). Total corneal HOA, corneal spherical aberrations, corneal coma through a 6-mm pupil size, and corneal eccentricity were measured with a dual Scheimpflug imaging device preoperatively and 3 months after surgery.
Results:
An overall increase in total corneal HOA was observed with a mean of 0.18±0.18 μm (P<.01), although this induction was not statistically significant in the low myopic group with a mean of 0.006±0.15 μm (P=.85). Root-mean-square spherical aberration varied the most after myopic ablation, with an overall induction of positive spherical aberration of 0.27±0.25 μm (P<.001).
Conclusions:
Although the wavefront-optimized profile was designed to preserve the preoperative HOAs of the total eye, a significant induction of the corneal HOAs after myopic treatment was observed. The magnitude of the induced corneal HOA was related to the amount of intended correction. Corneal wavefront profiles do not reflect the visual performance; however, they provide relevant information, which may help in optimizing new laser treatment algorithms.
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