Comparison of Optical Quality Metrics to Predict Subjective Quality of Vision after LASIK. Bühren J, Yoon GY, Martin T, Strenger A, Kohnen T
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1 Comparison of Optical Quality Metrics to Predict Subjective Quality of Vision after LASIK Bühren J, Yoon GY, Martin T, Strenger A, Kohnen T
2 Background resolution or stimulus (object) image contrast sensitivity or anatomy optical properties function (subjective) perception Kohnen T et al.: Essentials of Ophthalmogy. Vol. 2: Cataract and Refractive Surgery. Berlin 24: Springer
3 Objective What image quality metric / wavefront error representation is capable best of predicting subjective Quality of Vision?
4 Objective What image quality metric / wavefront error representation is capable best of predicting subjective Quality of Vision? How could predictability be increased?
5 Patients: preop data 56 eyes of 29 patients with LASIK for Myopia 51 eyes (26 patients Zyoptix 5.9 with static iris recognition) 5 symptomatic eyes with LASIK elsewhere age 36.5 years (24 to 55 years) preop Rx median SE D (-1.63 to D) median sphere D (-1.5 to D) median cylinder -.75 D (.74 to -4. D)
6 Patients and Methods Aberrometry 1 month postoperatively Hartmann-Shack sensor (Zywave TM, B & L) Questionnaire 1 month postoperatively rating of optical quality for three illuminance levels: photopic ( bright light ). high-mesopic ( indoors ) low-mesopic ( dusk ) visual analogue scale -1 perfect extremely bad
7 Methods: WFE representation Zernike decomposition (6 mm) of the WFE up to the 5 th order (monochromatic [555 nm]) different WFE representations (wavefront shape) LOA RMS and HOA RMS LOA HOA
8 Methods: WFE representation Zernike decomposition (6 mm) of the WFE up to the 5 th order different WFE representations (wavefront shape) LOA RMS and HOA RMS LOA RMS, coma RMS, Z 4 and residual HOA RMS (LCSR) coma Z 4 rhoa LOA
9 Methods: WFE representation Zernike decomposition (6 mm) of the WFE up to the 5 th order PSF-based single-value metrics Strehl ratio (SR) volume under the cross correlation coefficient function (VXC)
10 Methods: WFE representation Zernike decomposition (6 mm) of the WFE up to the 5 th order PSF-based single-value metrics Strehl ratio (SR) volume under the cross correlation coefficient function OTF-based single-value metrics volume under the MTF (VMTF) Strehl ratio based on the volume under the MTF (SRMTF) visual Strehl ratio based on the OTF (VSOTF)
11 Methods: WFE representation different conditions/simulations: lighting conditions photopic, high- and low-mesopic uncorrected / best-corrected (VSOTF-based or HOA RMS) 6 mm PD / physiological PD (.4 lux) 1. pupil diameter [mm] illuminance [lux]
12 Methods: statistical analysis linear regression analysis SQV: dependent WFE parameters: predictors if more than one predictor: MRA w/ backwards decomposition R 2 (coefficients of determination)
13 Results: SQV photopic highmesopic lowmesopic perfect extremely bad Pearson matrix hi-mes lo-mes phot hi-mes.84
14 Results: R 2 values (6 mm PD) wavefront shape PSF-derived phot hi-mes.4 phot hi-mes R lo-mes.3.2 lo-mes.1.1 total RMS HOA RMS LCSR log UC Strehl log BC Strehl log UCXC log BCXC log UCVXC log BCVXC
15 Results: R 2 values (6 mm PD).5 OTF-derived R phot hi-mes lo-mes log UCVMTF log vbvmtf log UCSMTF log BCSMTF log UCVSOTF log BCVSOTF
16 Results: mean R 2 values (6 mm PD).2 mean R 2.1 wavefront shape PSF OTF
17 Results: R 2 values.4 lux.2 mean R 2.1 wavefront shape PSF OTF
18 Summary / Discussion The influence of the postoperative WFE on SQV was limited (max. 23%) skewed distribution of SQV scores photopic -.5 log VSOTF highmesopic -1. low mesopic -2. perfect mm.4 lux extremely bad UCVSOTF BCVSOTF
19 Summary / Discussion almost universal performance under different lighting conditions (high correlation between SQV for different luminance conditions) no improvement of computation of physiological WFEs low-mesopic SQV lux: R 2 =.8 6 mm: R 2 =.1 Adding 6 additional variance 8 log UCVSOTF More information in a 6 mm WFE
20 Conclusion Take home messages high theoretical OQ = good subjective OQ bad subjective OQ = low theoretical OQ bad theroretical OQ = not necessary bad subjective OQ low-mesopic SQV adj. R 2 = log BCVSOTF -1.5
21 Danke! Thank you!
22 Summary / Discussion higher predictability for best-corrected 6mm low-mesopic SQV BC: R 2 =.23 UC: R 2 =.1 8 Higher tolerance to LOA blur? log VSOTF
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