Koray Gumus1, Anisa Gire, Stephen C Pflugfelder. 1. Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas 77030, USA.
Abstract
PURPOSE: To evaluate the effect of the Boston Ocular Surface Prosthesis (Boston Foundation for Sight) on higher-order wavefront aberrations in eyes with keratoconus, eyes that have undergone penetrating keratoplasty, eyes that have undergone refractive surgery, and eyes with ocular surface diseases. DESIGN: Prospective, clinical study. METHODS: The study evaluated 56 eyes of 39 patients with irregular astigmatism who were treated with the Boston Ocular Surface Prosthesis when conventional treatments failed. Patients were sorted into 4 clinical groups based on the underlying cause of irregular astigmatism, including keratoconus (group 1), post-penetrating keratoplasty (group 2), post-refractive surgery (group 3), and ocular surface diseases (group 4). Another 6 eyes of 5 patients who were treated with rigid gas permeable lenses also were evaluated. Best-corrected visual acuity; topographic refractive indices, including spherical, cylindrical, spherical equivalent values; and higher-order and total wavefront aberration errors were noted at baseline and after fitting the lens. RESULTS: In all groups, higher-order wavefront aberration error was noted to decrease significantly in eyes wearing the Boston Ocular Surface Prosthesis (P<.001, P=.001, P=.002, and P=.001, respectively). By post hoc analysis, significant differences in the level of higher-order aberrations were observed only between groups 1 and 4 (P=.012) and groups 1 and 2 (P=.033). In the overall group, mean correction rate of higher-order aberration error with the Boston Ocular Surface Prosthesis was 72.3%. However, in eyes with rigid gas permeable lenses, 2 eyes demonstrated increased higher-order aberration error, whereas the mean correction rate in other 4 eyes was only 42.5%. CONCLUSIONS: With its unique structure, the Boston Ocular Surface Prosthesis was found to be very effective in reducing higher-order wavefront aberrations in patients with irregular astigmatism resulting from a number of corneal and ocular surface conditions who had not responded satisfactorily to conventional methods of optical correction.
PURPOSE: To evaluate the effect of the Boston Ocular Surface Prosthesis (Boston Foundation for Sight) on higher-order wavefront aberrations in eyes with keratoconus, eyes that have undergone penetrating keratoplasty, eyes that have undergone refractive surgery, and eyes with ocular surface diseases. DESIGN: Prospective, clinical study. METHODS: The study evaluated 56 eyes of 39 patients with irregular astigmatism who were treated with the Boston Ocular Surface Prosthesis when conventional treatments failed. Patients were sorted into 4 clinical groups based on the underlying cause of irregular astigmatism, including keratoconus (group 1), post-penetrating keratoplasty (group 2), post-refractive surgery (group 3), and ocular surface diseases (group 4). Another 6 eyes of 5 patients who were treated with rigid gas permeable lenses also were evaluated. Best-corrected visual acuity; topographic refractive indices, including spherical, cylindrical, spherical equivalent values; and higher-order and total wavefront aberration errors were noted at baseline and after fitting the lens. RESULTS: In all groups, higher-order wavefront aberration error was noted to decrease significantly in eyes wearing the Boston Ocular Surface Prosthesis (P<.001, P=.001, P=.002, and P=.001, respectively). By post hoc analysis, significant differences in the level of higher-order aberrations were observed only between groups 1 and 4 (P=.012) and groups 1 and 2 (P=.033). In the overall group, mean correction rate of higher-order aberration error with the Boston Ocular Surface Prosthesis was 72.3%. However, in eyes with rigid gas permeable lenses, 2 eyes demonstrated increased higher-order aberration error, whereas the mean correction rate in other 4 eyes was only 42.5%. CONCLUSIONS: With its unique structure, the Boston Ocular Surface Prosthesis was found to be very effective in reducing higher-order wavefront aberrations in patients with irregular astigmatism resulting from a number of corneal and ocular surface conditions who had not responded satisfactorily to conventional methods of optical correction.
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