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Changes in Ocular Monochromatic Higher-Order Aberrations in the Aging Eye

Lyall, Douglas A.M.*; Srinivasan, Sathish; Gray, Lyle S.

doi: 10.1097/OPX.0b013e31829cac79
Original Articles

Purpose To characterize corneal, internal, and total ocular monochromatic higher-order aberration (MHOA) changes that occur in the aging eye.

Methods Prospective observational case series including 300 eyes of 167 patients (mean age = 63.8 years) attending the ophthalmology service at University Hospital Ayr, Scotland. Corneal, internal, and total ocular aberrations were measured over a 6-mm dilated pupil. Zernike coefficients were obtained to the sixth order. Changes in MHOA between age groups and inter-eye correlations between right and left eyes were analyzed.

Results A significant inter-eye correlation was found for refractive mean spherical equivalent and cylinder. A significant inter-eye correlation for the whole eye, corneal, and internal MHOA was found (p < 0.001). Right eye analysis found a significant positive correlation between age and the root mean square of whole eye MHOA (p = 0.012), with an increase from 0.517 μm in the fifth decade to 0.824 μm in the ninth. Total internal MHOA increased from 0.411 to 0.704 μm. A significant positive correlation was found between age and internal fourth- (p = 0.007), fifth- (p = 0.029), and sixth-order (p = 0.025) root mean square aberrations. There were no significant age-related changes in corneal MHOA or corneal spherical aberration. Overall mean (SD) corneal SA was 0.203 (0.082) μm.

Conclusions A strong correlation between the right and left eyes exists for MHOA. Whole eye MHOA increases with age. Such changes can be attributed to age-related changes in the internal optical quality of the eye. Such normative data are useful to the cataract surgeon when considering the use of an aspherical IOL to counteract corneal-induced SA during cataract surgery.



MCOptom, PhD

Department of Ophthalmology (DAML, SS), University Hospital Ayr, NHS Ayrshire and Arran; Department of Life Sciences (DAML, LSG), Glasgow Caledonian University, Glasgow; and Faculty of Medicine (SS), University of Glasgow, Glasgow, Scotland, United Kingdom.

Douglas Lyall Department of Ophthalmology 3rd Floor, University Hospital Ayr Dalmellington Rd Ayr, KA6 6DX Scotland, United Kingdom e-mail:

© 2013 American Academy of Optometry