Image Quality Analysis of Eyes Undergoing LASER Refractive Surgery.

Laser refractive surgery for myopia increases the eye's higher-order wavefront aberrations (HOA's). However, little is known about the impact of such optical degradation on post-operative image quality (IQ) of these eyes. This study determined the relation between HOA's and IQ parameters (peak IQ, dioptric focus that maximized IQ and depth of focus) derived from psychophysical (logMAR acuity) and computational (logVSOTF) through-focus curves in 45 subjects (18 to 31 yrs) before and 1-month after refractive surgery and in 40 age-matched emmetropic controls. Computationally derived peak IQ and its best focus were negatively correlated with the RMS deviation of all HOA's (HORMS) (r≥-0.5; p<0.001 for all). Computational depth of focus was positively correlated with HORMS (r≥0.55; p<0.001 for all) and negatively correlated with peak IQ (r≥-0.8; p<0.001 for all). All IQ parameters related to logMAR acuity were poorly correlated with HORMS (r≤|0.16|; p>0.16 for all). Increase in HOA's after refractive surgery is therefore associated with a decline in peak IQ and a persistence of this sub-standard IQ over a larger dioptric range, vis-à-vis, before surgery and in age-matched controls. This optical deterioration however does not appear to significantly alter psychophysical IQ, suggesting minimal impact of refractive surgery on the subject's ability to resolve spatial details and their tolerance to blur.