Comparison of Ocular Wavefront in Seated and Supine Positions Using a Hand-Held Hartmann-Shack Aberrometer

Area of Science:

• Ophthalmology
• Optical Engineering
• Biomedical Optics

Background:

• Intraoperative aberrometry is crucial for cataract and corneal refractive surgery.
• Ocular aberrations are typically measured preoperatively in a seated position, but surgeries are performed supine.
• Discrepancies in measurements due to patient position may impact surgical outcomes.

Purpose of the Study:

• To compare ocular wavefront aberrations between seated and supine positions using a hand-held Hartmann-Shack aberrometer.
• To assess the repeatability and potential measurement errors of a hand-held aberrometer in different positions.
• To evaluate the feasibility of using seated measurements for supine intraoperative aberrometry.

Main Methods:

• Ocular wavefront aberrations were measured in 18 healthy subjects (36 eyes) using a hand-held Hartmann-Shack aberrometer.
• Measurements were taken five times consecutively for a 6 mm pupil under three conditions: seated (holder-fixed and hand-held) and supine (hand-held).
• Repeatability was assessed using standard deviation of repeated measurements (Srm) and intraclass correlation coefficient (ICC).

Main Results:

• No significant differences in spherical or cylindrical aberrations were found across seated and supine conditions.
• Intraclass correlation coefficient (ICC) values exceeded 0.9 for both lower-order aberrations (LOAs) and higher-order aberrations (HOAs), indicating excellent repeatability.
• Mean higher-order aberrations (HOA_RMS) showed no statistically significant difference between seated and supine positions (p=0.913).

Conclusions:

• A hand-held Hartmann-Shack aberrometer provides repeatable measurements for LOAs and HOAs.
• Supine ocular aberration measurements are comparable to seated measurements.
• Preoperative seated aberrometry results can be reliably applied to intraoperative aberrometry, irrespective of patient position.