Wavefront analysis of eyes with cataracts in patients with monocular triplopia.
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.
Kim
Aya
A
Department of Ophthalmology, Osaka University Graduate School of Medicine, Japan.
Bessho
Kenichiro
K
Okawa
Yoshitaka
Y
Maeda
Naoyuki
N
Tano
Yasuo
Y
Hirohara
Yoko
Y
Mihashi
Toshifumi
T
Fujikado
Takashi
T
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