title: Magnitude and orientation of Zernike terms in patients with keratoconus.
abstract: OBJECTIVE
  To measure the magnitude and orientation of the Zernike terms in keratoconic eyes, with and without rigid gas-permeable (RGP) contact lenses.
  
  
  METHODS
  A total of 76 eyes with keratoconus, 58 eyes with keratoconus suspect, and 105 normal eyes were studied. To determine the effect of RGP lenses, 19 eyes with keratoconus, 9 eyes with keratoconus suspect, and 17 normal eyes, with and without an RGP lenses, were compared. Ocular higher-order aberrations (HOAs) were measured with a wavefront sensor for a 4-mm-diameter pupil, and the magnitudes, axes of trefoil, and coma were calculated by vector analysis.
  
  
  RESULTS
  Zernike vector analysis showed prominent vertical coma with an inferior slow pattern, with mean axes of 82.5 degrees or 91.0 degrees in the patients with keratoconus or keratoconus suspect, respectively. The mean axes of trefoil in patients with keratoconus (93.8 degrees ) and keratoconus suspect (100.6 degrees ) differed from that in normal subjects (35.4 degrees ), indicating that keratoconus has a reverse trefoil pattern from that of normal eyes. Although the total HOAs were significantly (keratoconus and keratoconus suspect, P < 0.001 and P = 0.012, respectively) reduced with an RGP lens, the patterns of the axes of coma and trefoil were reversed with the lens.
  
  
  CONCLUSIONS
  In addition to the larger amount of trefoil, coma, tetrafoil, and secondary astigmatism, keratoconic eyes tend to have a reverse coma pattern and reverse trefoil aberrations compared with normal eyes. Although RGP lenses correct the irregular astigmatism, smaller comet-like retinal images in the opposite direction remain due to residual vertical coma.
authors.affiliation: Departments of Ophthalmology, Osaka University Medical School, Suita, Osaka, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Kosaki
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Maeda
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Bessho
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hori
authors.forename: Kohji
authors.initials: K
authors.lastname: Nishida
authors.forename: Asaki
authors.initials: A
authors.lastname: Suzaki
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
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Tano
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000175:diagnosis*; D003261:Contact Lenses; D006801:Humans; D007640:Keratoconus / Q000175:diagnosis*; D012029:Refraction, Ocular