title: Laser in situ keratomileusis disrupts the aberration compensation mechanism of the human eye.
abstract: OBJECTIVE
  To study how changes induced on corneal optics by myopic and hyperopic laser in situ keratomileusis (LASIK) refractive surgery affect the aberration compensation mechanism.
  
  
  METHODS
  Interventional case series and modeling theory.
  
  
  METHODS
  We measured ocular, corneal, and internal aberrations for a 6-mm pupil in 15 myopic and 6 hyperopic eyes with similar age range before and 6 months after standard LASIK. Ocular aberrations were measured using our own developed Hartmann-Shack wavefront sensor, whereas corneal aberrations were calculated by using the elevation data obtained by corneal topography. Ocular, corneal, and internal root mean square (RMS), spherical aberration (SA), coma, and compensation factor were compared for each patient.
  
  
  RESULTS
  After myopic LASIK, we obtained an average 1.6-fold increase in ocular RMS, mainly positive SA, and coma, associated with a similar increase in corneal aberrations. In the hyperopes, we found a higher (2.3-fold) induction of ocular aberrations after surgery, mainly negative SA and coma, but without net increases of corneal aberrations. Aberration compensation clearly decreased or even inverted after hyperopic LASIK, decreasing the ocular optical quality in a higher level than myopic LASIK.
  
  
  CONCLUSIONS
  Although ocular aberrations after myopic LASIK usually were smaller than corneal aberrations because of partial compensation of SA, after hyperopic LASIK, because of induction of negative SA and change in coma, disruption of the compensation mechanism lead to a larger increase of ocular aberrations. Customized procedures should maintain the natural compensation to achieve improved visual outcomes.
authors.affiliation: Departamento de Física, Universidad de Murcia, Spain. abenito@um.es
authors.forename: Antonio
authors.initials: A
authors.lastname: Benito
authors.forename: Manuel
authors.initials: M
authors.lastname: Redondo
authors.forename: Pablo
authors.initials: P
authors.lastname: Artal
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000503:physiopathology*; D003315:Cornea / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer; D009216:Myopia / Q000601:surgery*; D011680:Pupil