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Wavefront aberrometry advances in refractive surgery
Author(s) -
COCHENER B
Publication year - 2009
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2009.2432.x
Subject(s) - aberrations of the eye , refractive surgery , wavefront , astigmatism , optics , optometry , computer science , pupil , photorefractive keratectomy , keratometer , human eye , visual acuity , medicine , cornea , computer vision , physics
Wavefront aberrometry has been adapted from optical astronomy in order to analyze complex image distortions caused by the human optical system, called higher order aberrations. The aberrations increase with larger pupil size or during nocturnal vision when the pupil dilates. They may have a significant impact on vision, even in a patient with 20/20 visual acuity. Most Shack Hartman aberrometers can be used as a super auto refracto‐keratometer during refractive surgery pre‐operative evaluations. They can capture the full amount of astigmatism and so will minimize the need for retreatment due to undercorrection. Modern Shack Hartman aberrometers give also the refractive surgeons the possibility to measure aberrations induced by flap creations. In addition they will be useful for performing customized excimer laser ablation (data coming from the aberrometer mapping out a path for the laser in reshaping the cornea). This technique has been shown to improve the correction of lower order aberrations (90% of the aberrations of the human eye), but is there a real benefit for treating higher order aberrations? Is a Shack Hartman aberrometer needed for every day refractive surgery practice? Thru an evidence based review of the literature confronted to personal experience we will try to answer these questions.