Predicted Visual Impact of a Small Aperture Intraocular Lens in Reducing Higher Order Aberrations in Post-Radial Keratotomy Patients

The purpose of this study is to evaluate the potential impact of small aperture optics on corneal aberrations in post-RK patients. Preoperative data was evaluated from 32 eyes of 23 post-RK patients. Scheimpflug tomography was used to obtain measurements of corneal HOAs at 6-mm, 4-mm, and 2-mm corne...

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Main Authors: Roberta M. van den Berg, Sarah DeVaro, Karolinne Maia Rocha, Marcela Fetrin de Barros, Stephen D. Klyce
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Vision
Subjects:
Online Access:https://www.mdpi.com/2411-5150/9/2/46
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author Roberta M. van den Berg
Sarah DeVaro
Karolinne Maia Rocha
Marcela Fetrin de Barros
Stephen D. Klyce
author_facet Roberta M. van den Berg
Sarah DeVaro
Karolinne Maia Rocha
Marcela Fetrin de Barros
Stephen D. Klyce
author_sort Roberta M. van den Berg
collection DOAJ
description The purpose of this study is to evaluate the potential impact of small aperture optics on corneal aberrations in post-RK patients. Preoperative data was evaluated from 32 eyes of 23 post-RK patients. Scheimpflug tomography was used to obtain measurements of corneal HOAs at 6-mm, 4-mm, and 2-mm corneal plane aperture diameters. The data was extrapolated using a non-linear fit to estimate HOAs that would be obtained with the 1.6 mm effective pinhole IOL aperture at the corneal plane for individual patients. The average RMS HOAs estimated for the 1.6 mm aperture was 0.063 ± 0.015 μm compared to 0.185 ± 0.029 μm for the natural pupil size. A postoperative RK case with an IC-8<sup>®</sup> Apthera™ unilateral implantation demonstrated a 70% reduction in HOAs by objective measurement and prediction, plus a 2-line improvement in CDVA. Prediction modeling revealed that HOAs may be reduced in post-RK patients following pinhole IOL implantation, compared to the natural photopic pupil size. Furthermore, the approach can be used to guide which post-RK patients would benefit from a small aperture IOL during cataract surgery.
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spelling doaj-art-c0b283ffce3340d4835b3810eb91fd232025-08-20T03:26:52ZengMDPI AGVision2411-51502025-05-01924610.3390/vision9020046Predicted Visual Impact of a Small Aperture Intraocular Lens in Reducing Higher Order Aberrations in Post-Radial Keratotomy PatientsRoberta M. van den Berg0Sarah DeVaro1Karolinne Maia Rocha2Marcela Fetrin de Barros3Stephen D. Klyce4Storm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USAStorm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USAStorm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USAStorm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USADepartment of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USAThe purpose of this study is to evaluate the potential impact of small aperture optics on corneal aberrations in post-RK patients. Preoperative data was evaluated from 32 eyes of 23 post-RK patients. Scheimpflug tomography was used to obtain measurements of corneal HOAs at 6-mm, 4-mm, and 2-mm corneal plane aperture diameters. The data was extrapolated using a non-linear fit to estimate HOAs that would be obtained with the 1.6 mm effective pinhole IOL aperture at the corneal plane for individual patients. The average RMS HOAs estimated for the 1.6 mm aperture was 0.063 ± 0.015 μm compared to 0.185 ± 0.029 μm for the natural pupil size. A postoperative RK case with an IC-8<sup>®</sup> Apthera™ unilateral implantation demonstrated a 70% reduction in HOAs by objective measurement and prediction, plus a 2-line improvement in CDVA. Prediction modeling revealed that HOAs may be reduced in post-RK patients following pinhole IOL implantation, compared to the natural photopic pupil size. Furthermore, the approach can be used to guide which post-RK patients would benefit from a small aperture IOL during cataract surgery.https://www.mdpi.com/2411-5150/9/2/46post-RKhigher-order aberrationspinhole effect
spellingShingle Roberta M. van den Berg
Sarah DeVaro
Karolinne Maia Rocha
Marcela Fetrin de Barros
Stephen D. Klyce
Predicted Visual Impact of a Small Aperture Intraocular Lens in Reducing Higher Order Aberrations in Post-Radial Keratotomy Patients
Vision
post-RK
higher-order aberrations
pinhole effect
title Predicted Visual Impact of a Small Aperture Intraocular Lens in Reducing Higher Order Aberrations in Post-Radial Keratotomy Patients
title_full Predicted Visual Impact of a Small Aperture Intraocular Lens in Reducing Higher Order Aberrations in Post-Radial Keratotomy Patients
title_fullStr Predicted Visual Impact of a Small Aperture Intraocular Lens in Reducing Higher Order Aberrations in Post-Radial Keratotomy Patients
title_full_unstemmed Predicted Visual Impact of a Small Aperture Intraocular Lens in Reducing Higher Order Aberrations in Post-Radial Keratotomy Patients
title_short Predicted Visual Impact of a Small Aperture Intraocular Lens in Reducing Higher Order Aberrations in Post-Radial Keratotomy Patients
title_sort predicted visual impact of a small aperture intraocular lens in reducing higher order aberrations in post radial keratotomy patients
topic post-RK
higher-order aberrations
pinhole effect
url https://www.mdpi.com/2411-5150/9/2/46
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