Are optical aberrations during accommodation a significant problem for refractive surgery?
OBJECTIVE
To study the limits to a perfect ideal customized wavefront correction due to the change of aberrations during accommodation. METHODS. We measured the dynamic changes of ocular aberrations during accommodation in normal eyes with a real-time Hartmann-Shack wavefront sensor. Those results were used in computer simulations to predict the benefit of a perfect customized correction.


RESULTS
Due to the continuous changes of the aberrations over time, an ideal perfect static correction will not provide stable aberration-free optics. For example, when the eye accommodates to near objects, due to the changing aberrations, the eye will become aberrated again. An alternative correction using the aberration pattern for a slightly accommodated condition could provide a better-correction in a larger accommodative range, although at the cost of non-perfect correction for far vision.


CONCLUSIONS
Due to the dynamic nature of ocular optics, a static perfect correction, for instance performed in customized refractive surgery, would not remain perfect for every condition occurring during normal accommodation.
D000065:Accommodation, Ocular / Q000502:physiology*; D019781:Corneal Topography; D003941:Diagnostic Techniques, Ophthalmological / Q000295:instrumentation*; D006801:Humans; D012029:Refraction, Ocular / Q000502:physiology*; D012030:Refractive Errors / Q000503:physiopathology; D054140:Refractive Surgical Procedures; D014785:Vision, Ocular / Q000502:physiology*; D014792:Visual Acuity