Corneal regular and irregular astigmatism assessed by Fourier analysis of videokeratography data in normal and pathologic eyes

Purpose: To assess corneal regular and irregular astigmatism using Fourier series harmonic analysis of videokeratography data in normal subjects, as well as in subjects with pathologic and postsurgical conditions. Study Design: Retrospective, case-control study. Participants: Two hundred normal eyes, 58 eyes with keratoconus, 24 eyes with suspect keratoconus, 100 eyes that underwent LASIK, 101 eyes that underwent photorefractive keratectomy (PRK), and 79 eyes that underwent penetrating keratoplasty (PK). Methods: Videokeratography data were decomposed, using Fourier analysis, into spherical power, regular astigmatism, asymmetry, and higher order irregularity. Results: The normal range of the Fourier indices was defined as the mean +/-2xstandard deviation in the normal eyes, which were 40.81-47.13 diopters (D) for spherical power, 0-1.04 D for regular astigmatism, 0.02-0.68 D for asymmetry, and 0.05-0.17 for higher order irregularity. The keratoconus and suspect keratoconus groups showed significantly greater values in all indices than did the normal group (P<0.001 or 0.0001, Mann-Whitney test with Bonferroni correction). Eyes that had undergone LASIK and PRK had significantly smaller spherical power and regular astigmatism (P<0.0001) and significantly larger asymmetry (P<0.0001) than the normal eyes. All indices were significantly greater in the PK group than in the normal group (P<0.0001). Among the eyes tested in this study, eyes with keratoconus had the largest asymmetry, whereas eyes that had undergone PK had the most irregular corneas. Conclusions: The normal range was defined for the corneal irregular astigmatism index (asymmetry and higher order irregularity) to support future studies in this field. Eyes with ocular pathologic and postsurgical conditions were evaluated using the normal range. (C) 2004 by the American Academy of Ophthalmology.