Zusammenfassung
Hintergrund
Das Ziel dieser Studie ist die Untersuchung des Einflusses des Wellenfrontfehlers (WFF) auf die subjektive optische Qualität (SOQ) nach LASIK.
Methoden
Bei 41 myopen Augen (21 Patienten) wurde eine komplikationslose LASIK (Median −4,63 dpt) durchgeführt. Prä- und 1 Monat postoperativ wurden die SOQ für photopische und mesopische Lichtbedingungen mit einem Fragebogen erfragt und der WFF vermessen (6 mm). Es wurden 3 verschiedene WFF-Repräsentationen berechnet: 1. die Maßzahl VSOTF (visual Strehl ratio based on the optical transfer function), 2. RMS-Werte der Zernike-Ordnungen 2–5 und 3. Zernike-Koeffizient der Ordnungen 2–5. Die Beeinflussung der postoperativen SOQ durch den WFF wurde mittels linearer Regressionsanalyse ermittelt.
Ergebnisse
Für photopische Bedingungen war R2 für Modell 1 (VSOTF) 0,24. Für Modell 2 (RMS-Werte) war R2 0,31 und für Modell 3 (Koeffizienten) 0,29, wobei Aberrationen der 2. und der 5. Ordnung die SOQ signifikant beeinflussten. Für mesopische Bedingungen galten ähnliche Ergebnisse.
Schlussfolgerung
Die SOQ nach komplikationsloser LASIK kann partiell durch den postoperativen WFF erklärt werden.
Abstract
Purpose
To investigate the clinical impact of the postoperative ocular wavefront error (WFE) on subjective quality of vision (SQV) after LASIK.
Method
Forty-one myopic eyes of 21 patients underwent uneventful LASIK (median –4.63 D). Preoperatively and 1 month postoperatively, WFE measurements were performed and overall SQV was assessed for two lighting conditions (photopic and mesopic) with a questionnaire. Three different WFE representations were computed for a pupil diameter of 6 mm: (1) the visual quality metric VSOTF (visual Strehl ratio based on the optical transfer function), (2) RMS (root mean square) values of the Zernike orders 2–5, and (3) individual Zernike coefficient for orders 2–5. The impact of the postoperative WFE on SQV was calculated using linear regression analysis.
Results
For photopic conditions R2 was 0.24 for model 1 (VSOTF), 0.31 for model 2 (RMS values), and 0.29 for model 3 (Zernike coefficients). Second-and fifth-order aberrations had significant influence on SQV. For mesopic conditions, results were similar.
Conclusion
Subjective quality of vision after wavefront-guided LASIK could be explained partially by the ocular WFE.
Literatur
Applegate RA, Marsack JD, Ramos R et al. (2003) Interaction between aberrations to improve or reduce visual performance. J Cataract Refract Surg 29: 1487–1495
Applegate RA, Marsack JD,Thibos LN (2006) Metrics of retinal image quality predict visual performance in eyes with 20/17 or better visual acuity. Optom Vis Sci 83: 635–640
Artal P, Chen L, Fernandez EJ et al. (2003) Adaptive optics for vision: the eye’s adaptation to point spread function. J Refract Surg 19: S585–S587
Bailey MD, Mitchell GL, Dhaliwal DK et al. (2003) Patient satisfaction and visual symptoms after laser in situ keratomileusis. Ophthalmology 110: 1371–1378
Bühren J, Kühne C,Kohnen T (2005) Influence of pupil and optical zone diameter on higher-order aberrations after wavefront-guided myopic LASIK. J Cataract Refract Surg 31: 2272–2280
Chalita MR, Chavala S, Xu M et al. (2004) Wavefront analysis in post-LASIK eyes and its correlation with visual symptoms, refraction, and topography. Ophthalmology 111: 447–453
Cheng X, Thibos LN,Bradley A (2003) Estimating visual quality from wavefront aberration measurements. J Refract Surg 19: S579–S584
Kim TI, Yang SJ,Tchah H (2004) Bilateral comparison of wavefront-guided versus conventional laser in situ keratomileusis with Bausch and Lomb Zyoptix. J Refract Surg 20: 432–438
Kohnen T, Bühren J, Kasper T et al. (2004). Cataract and Refractive Surgery. In: Kohnen T, Koch DD (eds) Essentials of Ophthalmology. Berlin, pp 301–314
Kohnen T, Bühren J, Kühne C et al. (2004) Wavefront-guided LASIK with the Zyoptix 3.1 system for the correction of myopia and compound myopic astigmatism with 1-year follow-up: clinical outcome and change in higher order aberrations. Ophthalmology 111: 2175–2185
Kohnen T, Kühne C, Cichocki M et al. (2007) [Cyclorotation of the eye in wavefront-guided LASIK using a static eyetracker with iris recognition.] Zyklorotation des Auges bei wellenfrontgeführter LASIK mit statischem Iriserkennungstracker. Ophthalmologe 104: 60–65
McCormick GJ, Porter J, Cox IG et al. (2005) Higher-order aberrations in eyes with irregular corneas after laser refractive surgery. Ophthalmology 112: 1699–1709
Miller AE, McCulley JP, Bowman RW et al. (2001) Patient satisfaction after LASIK for myopia. CLAO J 27: 84–88
Pesudovs K, Marsack JD, Donnelly WJI et al. (2004) Measureing visual acuity-mesopic or photopic conditions, and high or low contrast letters? J Refract Surg 20: S508–S514
Porter J, Yoon G, Lozano D et al. (2006) Aberrations induced in wavefront-guided laser refractive surgery due to shifts between natural and dilated pupil center locations. J Cataract Refract Surg 32: 21–32
Tahzib NG, Bootsma SJ, Eggink FA et al. (2005) Functional outcomes and patient satisfaction after laser in situ keratomileusis for correction of myopia. J Cataract Refract Surg 31: 1943–1951
Thibos LN (2004) Unresolved issues in the prediction of subjective refraction from wavefront aberration maps. J Refract Surg 20: S533–S536
Thibos LN, Applegate RA, Schwiegerling JT et al. (2002) Standards for reporting the optical aberrations of eyes. J Refract Surg 18: S652–S660
Tran DB,Shah V (2006) Higher order aberrations comparison in fellow eyes following intraLase LASIK with wavelight allegretto and customcornea LADArvision4000 systems. J Refract Surg 22: S961–S964
Tuan KM (2006) Visual experience and patient satisfaction with wavefront-guided laser in situ keratomileusis. J Cataract Refract Surg 32: 577–583
Tuan KM, Chernyak D,Feldman ST (2006) Predicting patients‘ night vision complaints with wavefront technology. Am J Ophthalmol 141: 1–6
Förderung:
Deutsche Forschungsgemeinschaft (DFG Bu 2163/1–1): JB; Bausch & Lomb: AS, TK
Interessenkonflikt
Keine Angaben
Author information
Authors and Affiliations
Corresponding author
Additional information
Der Vortrag wurde auf der 104. Tagung der Deutschen Ophthalmologischen Gesellschaft in Berlin, 2006, gehalten.
Rights and permissions
About this article
Cite this article
Bühren, J., Strenger, A., Martin, T. et al. Wellenfrontaberrationen und subjektive optische Qualität nach wellenfrontgeführter LASIK. Ophthalmologe 104, 688–696 (2007). https://doi.org/10.1007/s00347-007-1545-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00347-007-1545-6