Profiles of intraocular higher-order aberrations in healthy phakic eyes: prospective cross-sectional study

Ocular wavefront aberration is a crucial optical factor affecting retinal imaging. Internal aberrations contributed to compensation mechanism of ocular aberration. However, previous studies mainly focused on total and corneal higher order aberrations, and little is known about the profile of internal HOA (IHOA) in healthy subjects.

Participants with healthy crystalline lenses were prospective enrolled. The root mean square (RMS) of IHOAs for a pupil diameter of 4 mm were measured with an iTrace aberrometer. Lenticular parameters were measured with a swept source anterior segment optical coherence tomography (AS-OCT). Regression analyses were used to determine factors associated with logarithmic IHOAs.

Sixty-six Chinese participants (132 eyes) ranging from 5 to 59 years were analyzed. Logarithmic IHOA was positively associated with axial length (AL) (coefficient =0.101, P=0.016), and negatively associated with ocular refraction (coefficient =-0.032, P=0.023). Logarithmic internal coma increased by 0.161/mm (P=0.016) as AL became longer and decreased by 0.081/diopter (P<0.001) as ocular refraction became hyperopic. Lens tilt (coefficient =-0.121, P=0.037), decentration (coefficient= 3.027, P=0.003), and radius of anterior lens surface curvature (RAL) (coefficient= 0.096, P=0.026) were associated with logarithmic internal trefoil. lens tilt was also associated with logarithmic internal spherical aberration (coefficient =-0.195, P=0.018) and second astigmatism (coefficient =-0.132, P=0.030). Binocularly, the extent of coma, trefoil was different, while that of spherical aberration, secondary astigmatism was consistent. The vectors of the same type of IHOAs were nearly paralleled.

IHOAs are mainly affected by ocular refraction, RAL, lens tilt and decentration. Intraocular differences and directions of higher-order aberrations follow certain rules, and their effects on visual function warrant further study.