Corneal Higher Order Aberrations in Granular, Lattice and Macular Corneal Dystrophies

Abstract

PurposeTo evaluate the corneal higher-order aberrations (HOAs) in granular, lattice and macular corneal dystrophies.MethodsThis retrospective study includes consecutive patients who were diagnosed as granular corneal dystrophy type2 (GCD2; 121 eyes), lattice corneal dystrophies type 1, type 3A (LCDI; 20 eyes, LCDIIIA; 32 eyes) and macular corneal dystrophies (MCD; 13 eyes), and 18 healthy control eyes. Corneal HOAs were calculated using anterior segment optical coherence tomography, and the correlations between HOAs and visual acuity were analyzed.ResultsHOAs of the total cornea within 4 mm diameter were significantly larger in GCD2 (0.17 ± 0.35 μm), in LCDI (0.33 ± 0.27), LCDIIIA (0.61 ± 1.56) and in MCD (0.23 ± 0.18), compared with healthy controls (0.09 ± 0.02μm, all P < 0.01). HOAs of the total cornea within 6 mm diameter were significantly larger in GCD2 (0.32 ± 0.48), in LCDI (0.60 ± 0.46), LCDIIIA (0.83 ± 2.29) and in MCD (0.44 ± 0.24), compared with healthy controls (0.19 ± 0.06, all P < 0.001). In GCD2, there was no significant correlation between logMAR and HOAs (r = 0.113, P = 0.227). In MCD, LCDI and LCDIIIA, logMAR was positively significantly correlated with HOAs (r = 0.620 and P = 0.028, r = 0.587 and P = 0.007, r = 0.614 and P < 0.001, respectively).ConclusionsIncreased HOAs occur in eyes with corneal dystrophies, especially in eye with LCD and MCD. Larger amount corneal HOAs are associated with poorer visual acuity in patients with LCD and MCD.

Topographic characteristics after Descemet’s membrane endothelial keratoplasty and Descemet’s stripping automated endothelial keratoplasty

“…HOA was defined as the root mean square (RMS) of the 3rd to 8th order Zernike coefficients as a previous report. [ 15 ] …”

“…Wavefront analyses to quantify lower-order aberrations and HOAs have explained the decreased visual acuity and contrast sensitivity in normal eyes [ 10 ] and in eyes with a number of disorders. [ 11 – 14 ] Our group has recently demonstrated elevated HOAs of the posterior cornea caused by an irregular surface in various diseases of the corneal surface[ 15 – 18 ] and found a significant correlation between corneal HOAs and visual acuity in patients.…”

Contact Lenses in the Management of Corneal Dystrophies

“…The finding of irregular astigmatism is not limited to the superficial corneal dystrophies. Yagi-Yaguchi et al reported the results of corneal higher-order aberration measurements in patients with GCD, LCD, and MCD [34]. The authors found that patients with LCD and MCD in particular had topographies indicative of irregular astigmatism; as we mentioned earlier, this may be related to prior RCEs with subsequent epithelial remodeling and/or advanced anterior stromal deposits with localized topographic changes.…”

Epithelial Basement Membrane Dystrophy and Visual Rehabilitation Using Rigid Gas Permeable Contact Lenses: A Case Report

“…Though we did not confirm the absence of higher order aberrations (HOAs) in this patient, but their effect in patients with corneal dystrophies is known to cause visual distortions. 8 High modulus soft contact lenses may also be tried though their ability to mask surface irregularities is not as good as RGPs. 9 The goal of CL fitting in cases of corneal dystrophies is to reduce the visual symptoms without causing any harm to the cornea, hence an apical clearance RGP fit is preferred (fitting steeper than the flat keratometry reading) which allows for some tear exchange while preventing mechanical insult from the lens to the irregular central cornea.…”