Custom photorefractive keratectomy ablations for the correction of spherical and cylindrical refractive error and higher-order aberration.

Photorefractive keratectomy is an evolving refractive procedure for correcting myopia, hyperopia, and astigmatism. Earlier descriptions of the patterns required for this surgery are based on paraxial optics. In this investigation the required pattern is generalized to account for spherical refractive error (defocus), axial astigmatism of arbitrary orientation, and fourth-order aberrations of the eye. The patterns described in this study can be used to customize photorefractive keratectomy and to provide corrections that account for aberration content as well as paraxial values. Furthermore, a description of the pattern along the boundary of the optical zone is given, which may prove useful in designing blending zones. An example of the use of these techniques is given for a schematic eye model.