From scattering to wavefronts--what's in between?
OBJECTIVE
Some optical errors are too localized and random to be detected by commercial wavefront devices and Zernike polynomial expression. We looked beyond aberrations defined by Zernike expression to discuss implications of fine irregularities associated with highly aberrated corneal surfaces and complex surface roughness that can lead to light scattering.


METHODS
Most fine irregularities are related to postoperative surface roughness, complexities of corneal ablation, and the laser in situ keratomileusis (LASIK) flap. These can be characterized mathematically by a random function that includes local surface tilts, the correlation radius of irregularities (Ic), surface roughness, and other terms. The Kirchoff method of scatter analysis characterizes fine surface irregularities by replacing each point on the surface with a tangential plane, allowing it to be governed by Snellen and Fresnel laws.


RESULTS
The joint action of the continuum of microbeams defines a complex point spread function that can be expressed by the Strehl ratio. Small, highly irregular steep central islands and flap striae may not be adequately detected by Zernike expression and may have a surface irregularity diameter of 0.1 to 2.0 mm and height of 10 to 20 microm that results in a reduced Strehl ratio below 0.8. Laser ablation inhomogeneities may have dimensions of 1 to 10 microm, resulting in a root mean square tilt value approaching 1.0 and a Strehl ratio below 0.5.


CONCLUSIONS
Corneal surface irregularities after laser vision correction may induce significant optical aberrations and distortions apart from classical wavefront or scattering errors. As these may not be detected by commercial wavefront devices, and yet contribute to the degradation of optical performance, alternate techniques should be evaluated to detect and describe these surface irregularities.
D003315:Cornea / Q000473:pathology* / Q000601:surgery; D019781:Corneal Topography; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D011184:Postoperative Period; D012030:Refractive Errors / Q000175:diagnosis*; D054140:Refractive Surgical Procedures; D014792:Visual Acuity