title: Higher-order aberrations due to the posterior corneal surface in patients with keratoconus.
abstract: OBJECTIVE
  This study was designed to investigate higher-order aberrations (HOAs) due to the posterior corneal surface in keratoconic eyes compared with normal eyes.
  
  
  METHODS
  We studied 24 normal and 28 keratoconic eyes. The anterior/posterior corneal heights and pachymetric data were obtained with a rotating Scheimpflug camera. HOAs for 6 mm pupils were calculated from the differences between the height data and the best-fit sphere, using an original program for each corneal surface. The reference axes of the measurements were aligned with the primary line of sight. The HOAs were expanded with normalized Zernike polynomials. For each pair of standard Zernike terms for trefoil, coma, tetrafoil, and secondary astigmatism, one value for the magnitude and axis was calculated by Zernike vector analysis.
  
  
  RESULTS
  The mean total corneal HOAs (root mean square [microm]) from the anterior/posterior surfaces were significantly (P < 0.001) higher in keratoconic (4.34/1.09, respectively) than in control eyes (0.46/0.15). The mean magnitude of each Zernike vector terms for trefoil, coma, and spherical aberration from the anterior/posterior surfaces was significantly (P < 0.001) higher in keratoconic (0.77/0.19, 3.57/0.87, -0.44/0.17) than control eyes (0.09/0.04, 0.33/0.07, 0.25/-0.07), respectively. The mean axes by vector calculation for coma due to the anterior (63.6 degrees ) and posterior surfaces (241.9 degrees ) were in opposite directions.
  
  
  CONCLUSIONS
  Corneal HOAs on both corneal surfaces in keratoconic eyes were higher than in control eyes. Coma from the posterior surface compensated partly for that from the anterior surface. Residual irregular astigmatism in patients with keratoconus wearing rigid gas permeable contact lenses can be estimated by measuring the HOA from the posterior corneal surface.
authors.affiliation: Department of Ophthalmology, Osaka University Medical School, Osaka, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Maeda
authors.forename: Ryo
authors.initials: R
authors.lastname: Kosaki
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hori
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Inoue
authors.forename: Makoto
authors.initials: M
authors.lastname: Saika
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 / Q000503:physiopathology*; D019781:Corneal Topography; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D010781:Photography; D012029:Refraction, Ocular / Q000502:physiology