Using corneal height maps and polynomial decomposition to determine corneal aberrations

To review the use of corneal videokeratoscopic height date, elaborate on the advantages and disadvantages of such data, describe techniques for overcoming the limitations of height data, and demonstrate its use in quantifying the optical properties and aberrations of the cornea. The steep sag of the cornea hides fine variations in corneal height that arise naturally or due to disease or surgery. The dynamic range, or ratio of the overall sag to the feature height, is the primary limitation of videokeratoscopic height data. Techniques for removing single or multiple reference surfaces are described in detail, and applications of the methodology to wavefront and raytracing analysis of corneal aberrations arising from radial keratotomy (RK), photorefractive keratectomy (PRK), and keratoconus are described. Removing a single reference surface from the raw corneal height data begins to reveal subtle variations in corneal height. However, expansion of surface height data into a complete set of basis functions provides a sophisticated method for extracting high-order corneal variations. Choosing an orthogonal basis set provides a robust least-squares fit and forms unique expansions of the surface. The resulting coefficients are uncorrelated and form a simple measure of the optical quality. Videokeratoscopic height data are useful for analyzing and quantifying corneal deformity arising from disease or refractive surgery and they provide a sophisticated alternative or complement to dioptric power maps.