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RAY TRACING &
WAVEFRONT ANALYSIS USING
THE TRACEY SYSTEM
Donald R. Sanders, M.D., Ph.D.
Center For Clinical Research
20/10 UNCORRECTED PATIENT
20/10 UNCORRECTED PATIENT
Retinal Spot P S F
20/10 UNCORRECTED PATIENT
20/10 UNCORRECTED PATIENTRef +0.04 + 0.16 X 110 Total RMS = 0.068m
Lower
Higher
5th
Order
4th
Order
3rd Order
2nd Order
Astigmatism Defocus
(Refraction)
Higher
Breakdown of Zernike Terms
-0.5 0 0.5 1 1.5 2123456789
1011121314151617181920
Zer
nik
e te
rm
Coefficient value (microns)
astig.defocus
astig.trefoilcomacomatrefoil
spherical aberration
2nd order
3rd order
4th order
5th order
Root Mean Square
2 2 2 22 0 2 12 2 2 3 .......RMS Z Z Z Z
astig
mat
ism
term
defocu
s te
rm
astig
mat
ism
term
trefo
il te
rm……
GROSS APPROXIMATIONTotal RMS Vs. Visual Acuity
1.0m = 20/20 - 20/25
0.5m = 20/15
0.25m = 20/10
COMPONENTS OF TOTAL RMS
Lower Order Aberrations
Defocus (Sphere)
Astigmatism (Cylinder)
Plus
Higher Order Aberrations
20/10 VISIONRef -0.14 + 0.39 X 168 Total RMS = 0.204m
P S F
LARGELY LOWER ORDER ABERRATIONS
Retinal Spot P S F
99% OF RMS VALUE IS LOWER ORDER ABERRATIONS
(Refractive Error)
Lower
Higher
AFTER SUBTRACTING LOWER ORDER ABERRATIONS
Retinal Spot P S F
REFRACTIVE ERROR
“UCVA” “BCVA”
All Aberrations Higher Order Only
P S F
REFRACTIVE ERROR
“UCVA” “BCVA”
All Aberrations Higher Order Only
REFRACTIVE ERROR
“UCVA” “BCVA”
All Aberrations Higher Order Only
Retinal Spot
CORNEAL BIRTH TRAUMA
“UCVA” “BCVA”
All Aberrations Higher Order Only
P S F
CORNEAL BIRTH TRAUMA
“UCVA” “BCVA”
All Aberrations Higher Order Only
Retinal Spot
CORNEAL BIRTH TRAUMA
“UCVA” “BCVA”
All Aberrations Higher Order Only
COMMON SIGNIFICANT HIGHER ORDER ABERRATIONS
Coma
Spherical Aberration
Trefoil
(T.M.) POST LASIK Complains Of Night Glare
6mm Scan (Undilated)
PATIENT T.M. (OD)6 mm Scan – P S F
“UCVA” “BCVA”
All Aberrations Higher Order Only
“UCVA” “BCVA”
All Aberrations Higher Order Only
PATIENT T.M. (OD)6 mm Scan – Retinal Spot
“UCVA” “BCVA”
All Aberrations Higher Order Only
PATIENT T.M. (OD)6 mm Scan
PATIENT T. M. (OD)Decentered Excimer
COMA
PATIENT T. M. (OD) Vertical
Coma
PATIENT T.M. (OD)EFFECT OF SCAN DIAMETER
(PUPIL SIZE) ON PSFHigher Order Aberrations Only
4 mm 6 mm
UCVA(All Aberrations)
BCVA(Higher Order Only)
PATIENT T. M. (OS)6.5mm Scan – P S F
COMASPHERICAL
SPHERICALABERRATION
HORIZONTALCOMA
PATIENT T.M.NIGHT MYOPIA DUE TO
SPHERICAL ABERRATION
0
0.5
1
1.5
2
2.5
3
4 5 6 6.5
Pupil Size(Undilated)
Amount Of Myopia(D)
0.85
2.49
1.991.66
OS
PATIENT T. M. (OS)Night Myopia Due To Spherical Aberration
4 mm 5 mm
6 mm 6.5 mm
PATIENT T. M. (OS) – P S FNight Myopia Due To Spherical Aberration
4 mm 5 mm
6 mm 6.5 mm
SUMMARY PATIENT T.M.Large Pupils In Dim Light
OD Vertical Coma (Decentration) With Mild Spherical Aberration
OS Horizontal Coma(Decentration) +
Spherical Aberration
PATIENT S. P. Complains Of Severe Night Glare
6.5mm Scan Pupil is 7.0 –7.5mm Undilated
PATIENT S. P. (OD)Severe Night Glare
4 mm 4.5 mm
6.0 mm 6.5 mm
PUPIL SIZE
RMS = 0.261 RMS = 0.407
RMS = 1.83RMS = 1.1
PATIENT S. P. (OD)Severe Night Glare
Pupil Size
RMS = 0.166 RMS = 0.346
RMS = 1.83RMS = 0.656
Higher Order Aberration Only
4mm
6.5mm6.0mm
4.5mm
4 mm 6.0 mm
PATIENT S. P. (OD)Severe Night Glare
Lower
Higher
PATIENT S. P. (OS)Complains Of Severe Night Glare
4.5 mm 5.5 mm
6.0 mm 6.5 mm
4.5 mm 6.5 mm
PATIENT S. P. (OS)Complains Of Severe Night Glare
NOTE: Scale Doubles
PATIENT J. C.Most Higher Order Aberrations – Trefoil, Tetrafoil
J. C. D. D.
S/P RK SURGERY