Height measurement of astigmatic test surfaces by a keratoscope that uses plane geometry surface reconstruction

To assess the accuracy with which the Keratron keratoscope (Optikon 2000, Rome, Italy) measured astigmatic test surfaces by a profile reconstruction algorithm within a plane geometry model and to discriminate between error caused by the model and error caused by other factors.

Height was reported by the Keratron for eight surfaces with central astigmatism ranging from 4 to 16 diopters. A three-dimensional ray tracing simulation produced theoretic reflected ring patterns on which the Keratron's reconstruction algorithm was performed. The Keratron's measurements were compared with the surfaces' formulas and the ray-traced simulations.

With a new mathematical filter for smoothing ring data, now part of the Keratron's software, maximum error was 0.47% of the total height and was usually less than 1% of local power for surfaces with 4 diopters of astigmatism. For surfaces with 16 diopters of astigmatism, maximum error was as high as 2.9% of total height and was usually less than 2.5% of local power. The reconstruction algorithm accounted for 40% and 70% of height error, respectively.

The efficacy of keratoscopes cannot be assumed from their design theories but must be tested. Although plane geometry surface reconstruction contributed greatly to total height error, total error was so small that it is unlikely to affect clinical use.