Original article
Higher-order Aberrations in Children

https://doi.org/10.1016/j.ajo.2005.08.031Get rights and content

Purpose

To quantify and characterize higher order aberrations in children and to investigate the influence of refractive error and cycloplegia.

Design

Observational cross-sectional study.

Methods

setting: Clinical practice. patients: One hundred sixty-two eyes of 82 children were examined. The mean age of the children was 6.7 years (range, 4 to 14 years), and the mean manifest refractive spherical equivalent was 2.39 ± 3.35 diopters (range, −8.98 to +8.45 diopters). Aberrometry was performed with a wavefront analyzer (after cycloplegia and mydriasis with cyclopentolate 1%). Aberrometry was also conducted on a subgroup of 52 eyes of 27 children, both before and 30 minutes after the instillation of cyclopentolate 1% to investigate the effect of paralysis of accommodation.

Results

Mean root mean square values of total-, third-, fourth-, and fifth-order aberrations were 0.37 ± 0.13 μm, 0.23 ± 0.12 μm, 0.16 ± 0.11 μm, and 0.08 ± 0.12 μm, respectively. Mean root mean square values of total coma (Z3−1, Z31, Z5−1, Z51) and total trefoil (Z3−3, Z33, Z5−3, Z53) were 0.27 ± 0.31 μm and 0.21 ± 0.29 μm, respectively. Myopes had statistically significant greater levels of total (P = .005) and fourth order (P = .002) aberrations and Zernicke terms (Z3−3, Z3−1, Z33, Z4−4, and Z42) compared with hyperopes. Cycloplegia had minimal influence on higher-order aberrations.

Conclusion

Significant levels of higher-order aberrations were found in these children. They were influenced by refractive error, because myopes had significantly greater levels compared with hyperopes. Paralysis of accommodation with cyclopentolate appeared to have little effect on higher-order aberrations.

Section snippets

Methods

This study was granted approval by the Institutional Review Board of The Childrens University Hospital, Dublin. Children who attended pediatric ophthalmology clinics at this hospital and the Mater Private Hospital, Dublin, were selected for inclusion in the study. They had a wide range of refractive error, but all eyes had best corrected visual acuity of 20/20 or better. Children with a history of ocular abnormality and with systemic illness were excluded from the study. A Hartmann-Shack

Results

One hundred sixty-two eyes of 82 children (40 male and 42 female) were included in the study. The mean age of the children was 6.7 years (range, 4 to 14 years). The mean manifest refractive spherical equivalent was 2.39 ± 3.35 diopters (range, −8.98 to +8.45). The mean root mean square (RMS) value of total-, third-, fourth-, and fifth-order aberrations were 0.37 ± 0.13, 0.23 ± 0.12, 0.16 ± 0.11, and 0.08 ± 0.12 μm, respectively. The mean RMS of spheric aberration (Z40), total coma (Z3−1, Z31, Z5

Discussion

Recent developments in the field of refractive surgery have been responsible largely for increased interest in higher-order aberrations because technologic advances now allow for both measurement and treatment of these refractive errors. However, the exact clinical significance of higher-order aberrations remains unclear. For many years, it has been accepted widely that these aberrations reduce retinal image quality, thereby acting as an impediment to so-called super vision.1 However, in a

References (10)

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