title: Higher order wavefront aberrations of cornea and magnitude of refractive correction in laser in situ keratomileusis.
abstract: OBJECTIVE
  To assess the relation between magnitude of refractive correction and changes in higher order wavefront aberrations of the cornea after laser in situ keratomileusis.
  
  
  METHODS
  Prospective, consecutive, nonrandomized comparative trial (self-controlled).
  
  
  METHODS
  One hundred eyes of 53 patients with myopia (-2.0 to -13.0 diopters) were included.
  
  
  METHODS
  Laser in situ keratomileusis was performed. Videokeratography measurements were conducted before and 1 month after surgery.
  
  
  METHODS
  The videokeratography data were used to calculate the higher order wavefront aberrations of the cornea for both small (3 mm) and large (6 mm) pupils.
  
  
  RESULTS
  For a 3-mm pupil, the surgery significantly increased coma-like (2.4 +/- 1.3-fold, P < 0.001, paired t test) and spherical-like (1.8 +/- 0.9-fold, P < 0.001) aberrations. For a 6-mm pupil, both coma-like (4.4 +/- 3.3-fold, P < 0.001) and spherical-like (9.4 +/- 5.2-fold, P < 0.001) aberrations were significantly increased by surgery. The amount of achieved correction showed significant correlations with the changes in coma-like (Pearson correlation coefficient r = 0.446, P < 0.001) and spherical-like (r = 0.348, P < 0.001) aberrations for a 3-mm pupil, and coma-like (r = 0.566, P < 0.001) and spherical-like (r = 0.693, P < 0.001) aberrations for a 6-mm pupil. The eyes that lost 2 or more lines of baseline spectacle-corrected visual acuity showed significantly larger induced increases in coma-like (P = 0.003, Mann-Whitney U test) and spherical-like (P = 0.009) aberrations for a 3-mm pupil than those that either improved or remained within 1 line of spectacle-corrected visual acuity
  
  
  CONCLUSIONS
  Laser in situ keratomileusis, performed using the current algorithms, increases higher order wavefront aberrations of the cornea, dependent on the amount of refractive correction.
authors.affiliation: Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Oshika
authors.forename: Kazunori
authors.initials: K
authors.lastname: Miyata
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Tokunaga
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Samejima
authors.forename: Shiro
authors.initials: S
authors.lastname: Amano
authors.forename: Sumiyoshi
authors.initials: S
authors.lastname: Tanaka
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hirohara
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Mihashi
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Maeda
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujikado
mesh_terms: D000328:Adult; D000465:Algorithms; D003315:Cornea / Q000503:physiopathology*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology