To compare the corneal first surface higher-order aberrations (HOAs) of normal subjects and patients with dry eye using KR-1W® (Topcon Corp., Tokyo, Japan) and Pentacam® HR (Oculus Inc., Dutenhofen, Germany). We analyzed the relationship between the aberrations and the diagnostic parameters of dry eye.

We evaluated anterior corneal HOAs in 71 normal eyes and 71 dry eyes using KR-1W® and Pentacam®. Dry eye patients were examined for fluorescein staining, tear break-up time (TBUT), and Schirmer I test. Ocular Surface Disease Index (OSDI) was used for assessment of subjective symptoms in dry eye patients.

HOAs measured by both instruments were greater in the dry eye group than in the control group, although HOAs using KR-1W® only achieved statistical significance. The anterior corneal HOAs measured by the 2 instruments were significantly correlated with superficial punctate keratitis. Moreover, TBUT and the Shirmer I test negatively correlated, and OSDI positively correlated, with anterior corneal HOAs.

The HOAs in patients with dry eye were significantly different from controls and tended to increase with disease severity. KR-1W® might be more useful than Pentacam® to detect tear film instabilities.