title: Wavefront analysis of eyes with cataracts in patients with monocular triplopia.
abstract: OBJECTIVE
  To determine whether wavefront analysis using a Hartmann-Shack (H-S) aberrometer can reveal the cause of monocular triplopia in eyes with mild cataracts.
  
  
  METHODS
  Six patients (nine eyes; age range 38-58 years; average 49.8 +/- 6.9 years) who complained of monocular triplopia at the Osaka University Hospital between January and December 2003 were examined. Wavefront analyses of ocular and corneal aberrations of the central 4 mm diameter were performed using a H-S aberrometer equipped with a Placido ring videokeratoscope. The ocular and corneal higher-order wavefronts were fitted with a fourth-order Zernike expansion.
  
  
  RESULTS
  All nine eyes showed mild nuclear cataract and had a mean spherical refractive error of -10.3 +/- 3.5 D. The visual acuity was > or = 20/40 except in one eye with glaucoma. For the Zernike polynomials, the trefoil aberration (C3-3) and the spherical aberration (C40) were significantly higher than those of age-matched normal controls (p < 0.001). The simulated retinal image of a Landolt C showed that the combination of trefoil aberration and the spherical aberration can cause an image with a triple configuration.
  
  
  CONCLUSIONS
  Monocular triplopia was reported by middle-aged patients with mild nuclear cataract and high myopia. Wavefront analyses suggested that the triple configuration was caused by the combined increase of the trefoil and spherical aberration in lenses with mild nuclear cataracts.
authors.affiliation: Department of Ophthalmology, Osaka University Graduate School of Medicine, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Kim
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Bessho
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Okawa
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Maeda
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Tano
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hirohara
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Mihashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujikado
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000503:physiopathology; D002386:Cataract / Q000150:complications / Q000503:physiopathology*; D002387:Cataract Extraction / Q000379:methods; D003315:Cornea / Q000503:physiopathology; D003316:Corneal Diseases / Q000503:physiopathology; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology; D012029:Refraction, Ocular / Q000502:physiology; D012030:Refractive Errors / Q000503:physiopathology; D012160:Retina / Q000503:physiopathology; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology*; D015349:Vision, Monocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology