title: Corneal higher order aberrations: a method to grade keratoconus.
abstract: OBJECTIVE
  To use the anterior corneal surface higher order aberrations as a tool to detect and grade keratoconus using corneal map analysis videokeratoscopy.
  
  
  METHODS
  A prospective observational comparative study of 80 eyes was performed. The eyes were divided into two groups. Group A comprised 40 eyes of 20 asymptomatic individuals with no ocular pathology. Mean sphere was -0.03 diopters (D) (range: +0.75 to -0.75 D), mean cylinder was -0.27 D, mean average K was 43.28 D, and mean uncorrected visual acuity (UCVA) was 1.01. Group B comprised 40 eyes of 25 patients with keratoconus. Mean sphere was -3.70 D (range: +2.00 to -10.00 D), mean cylinder was -3.82 D, mean average K was 49.29, and mean best spectacle-corrected visual acuity (BSCVA) was 0.61.
  
  
  RESULTS
  In group A, mean root-mean-square (RMS) of spherical (Z4 and Z6), coma-like (Z3, Z5, and Z7), and higher order aberrations (Z3-7) were 0.38 microm, 0.35 microm, and 0.52 microm, respectively. In group B, mean RMS of spherical, coma-like, and higher order aberrations were 1.06 microm, 2.90 microm, and 3.14 microm, respectively, for a 6.0-mm simulated pupil diameter. Mean RMS differences between the two groups were 0.68 microm (P < or = .0002), 2.55 microm (P < or = .0001), and 2.61 microm (P < or = .0001) for spherical, coma-like, and total higher order aberrations, respectively. In group B, according to Amsler-Krumeich classification, the mean RMS of coma-like aberration was 1.87 microm in grade I (14 eyes), 2.97 microm in grade II (11 eyes), 3.46 microm in grade III (12 eyes), and 5.20 microm in grade IV (3 eyes).
  
  
  CONCLUSIONS
  Corneal higher order aberrations, especially coma-like aberrations, are significantly higher in eyes with keratoconus than normal eyes. Coma-like aberrations, with the aid of a corneal aberrometry map, are good indicators for early detection and grading of keratoconus.
authors.affiliation: Vissum Instituto Oftalmológico de Alicante, Spain. jlalio@vissum.com
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Alió
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Shabayek
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000209:etiology / Q000473:pathology*; D003315:Cornea / Q000473:pathology*; D019781:Corneal Topography / Q000379:methods*; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000150:complications / Q000473:pathology*; D008297:Male; D012029:Refraction, Ocular; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014792:Visual Acuity