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Correction of Presbyopia by Monocular Bi-Aspheric Ablation Profile
Published on: September 20, 2024
Wavefront-guided scleral lens prosthetic device for keratoconus.
Ramkumar Sabesan1, Lynette Johns, Olga Tomashevskaya
1Flaum Eye Institute, Center for Visual Science, Institute for Optics, University of Rochester, Rochester, NY 14624, USA. rsabesan@berkeley.edu
Summary
Custom scleral lenses with wavefront-guided optics effectively correct ocular higher order aberrations in keratoconus patients, significantly improving visual acuity and contrast sensitivity.
Area of Science:
- Ophthalmology
- Optometry
- Biomedical Engineering
Background:
- Keratoconus (KC) is a progressive corneal disease causing irregular astigmatism and higher order aberrations (HOAs).
- Scleral lens prosthetic devices (SLPDs) are used to manage KC, but conventional spherical optics may not fully correct visual distortions.
- Wavefront-guided optics offer a potential method for precise aberration correction.
Purpose of the Study:
- To assess the feasibility of correcting ocular HOAs in advanced keratoconus patients using wavefront-guided optics integrated into scleral lenses.
- To evaluate the impact of customized wavefront-guided SLPDs on visual acuity and contrast sensitivity compared to conventional SLPDs.
Main Methods:
- Six advanced keratoconus patients (11 eyes) were fitted with both conventional spherical and custom wavefront-guided SLPDs.
- A Shack-Hartmann wavefront sensor measured aberrations through the SLPDs.
- Custom SLPDs were designed using measured aberrometry data and manufactured with irregular profiles on the front surface.
- Visual performance was compared between the two types of SLPDs using best-corrected high-contrast visual acuity and contrast sensitivity tests.
Main Results:
- Conventional SLPDs had a mean HOA root mean square (RMS) of 1.17 ± 0.57 μm.
- Wavefront-guided SLPDs reduced HOA RMS by 3.1 times to 0.37 ± 0.19 μm, achieving levels comparable to normal eyes.
- Mean visual acuity improved by 1.9 lines (p < 0.05), and contrast sensitivity significantly increased at multiple spatial frequencies (p < 0.05).
Conclusions:
- Customized scleral lens prosthetic devices with wavefront-guided optics can effectively correct higher order aberrations in advanced keratoconus patients.
- This technology leads to significant improvements in visual acuity and contrast sensitivity for individuals with keratoconus.
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