Changes of Higher Order Aberration Analyzed by Continuous Measurement after Phacoemulsification

Hyung Bin Lim; Jong Joo Lee; Si Hwan Choi

doi:10.3341/jkos.2015.56.1.25

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Lim, Lee, and Choi: Changes of Higher Order Aberration Analyzed by Continuous Measurement after Phacoemulsification

Original Article

J Korean Ophthalmol Soc 2015;56(1):25-32.

Published online: 6 September 2015

DOI: https://doi.org/10.3341/jkos.2015.56.1.25

Changes of Higher Order Aberration Analyzed by Continuous Measurement after Phacoemulsification

Hyung Bin Lim, MD¹, Jong Joo Lee, MD¹, Si Hwan Choi, MD, PhD^1,^2,

¹Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea

²Chungnam National University Research Institute for Medical Sciences, Daejeon, Korea

Address reprint requests to Si Hwan Choi, MD, PhD, Department of Ophthalmology, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon 301-721, Korea, Tel: 82-42-280-7609, Fax: 82-42-255-3745 E-mail: shchoi@cnu.ac.kr

Received 13 June 201420 October 2014 Accepted 24 November 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To analyze the changes of higher order aberration (HOA) measured serially by KR-1W^Ⓡ wavefront at every second for 10 seconds between, before, and after phacoemulsification and to evaluate the relationships between HOA and the ocular surface indicators (Schirmer test, tear break-up time, superficial punctate keratitis).

Methods

Corneal HOA was measured in 47 eyes of 30 patients pre- and postoperatively at 2, 4, 6, and 8 weeks by KR-1W^Ⓡ using the continuous measurement mode. The patients were divided into 2 groups according to their Schirmer test (above 10 mm or under 10 mm), tear break-up time (above 5 seconds or less than 5 seconds), and superficial punctate keratitis (any keratitis, none) for analysis of relationships between HOA and ocular surface indicators, and we also analyzed the correlation coefficient.

Results

Short-term follow up after phacoemulsification revealed that corneal HOA rapidly increased at 2 weeks and recovered to the preoperative level 8 weeks after surgery. Corneal HOA values showed increasing tendency depending on time at preop and 8 weeks after phacoemulsification, and the differences were statistically significant (preop: p < 0.001, 8 weeks: p = 0.027). There were no significant differences of HOA between the 2 groups divided according to their ocular surface indicators, and there were no significant correlations between HOA and ocular surface indicators at any time point.

Conclusions

The HOA of the cornea was restored to its preoperative values at 8 weeks after surgery. Preoperative ocular surface indicators are not significantly influenced on postoperative corneal HOA. The surgical factors are more significant in post-operative corneal HOA than preoperative ocular surface indicators.

Keywords: Higher order aberration, Phacoemulsification

References

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Figure 1.

Continuous measurement mode using KR-1W ^Ⓡ wavefront analyzer. HOA = higher order aberration; RMS = root mean square.

Figure 2.

Serial changes in corneal higher order aberration (HOA) over time. Short-term follow up after pha-coemulsification reveals that corneal HOA recovers to the preoperative level at 8 weeks after surgery. RMS = root mean square. ^* p < 0.05; p-value from repeated measure ANOVA.

Figure 3.

Changes of corneal higher order aberration (HOA) between 1 and 10 seconds after blinking. Corneal HOA of the 1 and 10 seconds are both similarly high on the 2 weeks after surgery, however, as time passed to 4th, 6th, and 8th weeks, as like before surgery, values show increasing tendency depending on time. ^* p < 0.05; p-value from paired t-test.

Figure 4.

Serial changes in ocular surface indicators. All factors recovered to preoperative levels at 8 weeks after surgery. SPK = superficial punctate keratitis; BUT = break up time. ^* p < 0.05; p-value from repeated measure ANOVA.

Table 1.

Baseline characteristics of patients

Parameters	Values
No. of patients (eyes)	30 (47)
Sex (M/F)	22/25
Age (years)	65.5 ± 10.2
BCVA (log MAR)	0.3 ± 0.2
Tear break up time (sec)	6.6 ± 2.0
Schirmer test (mm)	10.1 ± 4.9
Presence of SPK (patients)	13

Values are preoperative data and presented as mean ± SD or number. BCVA = best corrected visual acuity; SPK = superficial punctate keratitis.

Table 2.

Mean values and changes in HOA at 1 and 10 seconds in each group classified according to the preoperative Schirmer test

	Group A (>10 mm, n = 13)		Group B (≤10 mm, n = 34)		p-value^‡	p-value^§
	AVG^∗	Δ HOA	AVG^∗	Δ HOA^†	p-value^‡	p-value^§
Preop	0.210	0.051	0.225	0.103	0.035	0.111
POD 2 weeks	0.412	-0.026	0.414	0.017	0.858	0.712
POD 4 weeks	0.287	0.098	0.300	0.006	0.943	0.140
POD 6 weeks	0.192	0.003	0.265	0.100	0.295	0.057
POD 8 weeks	0.236	0.023	0.245	0.057	0.784	0.372

HOA = higher order aberration; POD = postoperative day.

^∗ Average corneal HOA values during 10 seconds

^† HOA at 10 seconds - HOA at 1 second

^‡ From Mann Whitney U-test between average HOA in group A and B

^§ From Mann Whitney U-test between Δ HOA in group A and B.

Table 3.

Mean values and changes in HOA at 1 and 10 seconds in each group classified according to the preoperative BUT

	Group A (>5 seconds, n = 30)		Group B (≤5 seconds, n = 17)		p-value^‡	p-value^§
	AVG^∗	Δ HOA	AVG^∗	Δ HOA^†	p-value^‡	p-value^§
Preop	0.207	0.098	0.218	0.073	0.043	0.412
POD 2 weeks	0.400	-0.003	0.436	0.019	0.765	0.406
POD 4 weeks	0.294	0.010	0.301	0.070	0.595	0.080
POD 6 weeks	0.250	0.057	0.235	0.102	0.425	0.674
POD 8 weeks	0.246	0.033	0.236	0.073	0.782	0.170

HOA = higher order aberration; BUT = break up time; POD = postoperative day.

^∗ Average corneal HOA values during 10 seconds

^† HOA at 10 seconds - HOA at 1 second

^‡ From Mann Whitney U-test between average HOA in group A and B

^§ From Mann Whitney U-test between Δ HOA in group A and B.

Table 4.

Changes in HOA at 1 and 10 seconds in each group classified according to the preoperative SPK

	Group A (SPK (-), n = 34)		Group B (SPK (+), n = 13)		p-value^‡	p-value^§
	AVG^∗	Δ HOA	AVG^∗	Δ HOA^†	p-value^‡	p-value^§
Preop	0.211	0.073	0.221	0.130	0.049	0.379
POD 2 weeks	0.423	-0.001	0.388	0.021	0.432	0.175
POD 4 weeks	0.300	0.014	0.287	0.079	0.794	0.116
POD 6 weeks	0.251	0.045	0.229	0.146	0.335	0.877
POD 8 weeks	0.240	0.037	0.248	0.076	0.195	0.398

HOA = higher order aberration; SPK = superficial punctate keratitis; POD = postoperative day.

^∗ Average corneal HOA values during 10 seconds

^† HOA at 10 seconds - HOA at 1 second

^‡ From Mann Whitney U-test between average HOA in group A and B

^§ From Mann Whitney U-test between Δ HOA in group A and B.

Table 5.

Pearson’s correlation coefficients of preoperative ocular surface indicators values and average HOA during 10 seconds

	Preop Schirmer		Preop BUT		Preop SPK
	r	p-value	r	p-value	r	p-value
Preop	-0.037	0.803	-0.102	0.494	0.073	0.627
POD 2 weeks	0.091	0.541	-0.131	0.379	0.105	0.484
POD 4 weeks	-0.181	0.224	-0.133	0.372	0.074	0.620
POD 6 weeks	-0.185	0.212	-0.118	0.428	-0.043	0.777
POD 8 weeks	-0.293	0.055	0.051	0.736	0.164	0.270

r: correlation coefficient.

HOA = higher order aberration; BUT = break up time; SPK = superficial punctate keratitis; POD = postoperative day.

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