Normative Data of Higher-Order Aberrations in Healthy Caucasian Eyes and Their Correlation with Age, Gender, and Spherical Equivalent

Purpose: To investigate the distribution of normative data for higher-order aberrations (HOA) among younger and older populations and identify their correlations with age, gender, and refractive errors. Methods: This study analyzed healthy, phakic, treatment-naïve eyes from Caucasian participants examined at three European centers between July 2019 and July 2022. Total eye and corneal HOA were analyzed using a novel corneal tomographer with an integrated Hartmann-Shack aberrometer. Simple correlation analysis was conducted using the Pearson correlation coefficient, assuming a linear model. Results: A total of 1075 eyes were analyzed. Mean age and spherical equivalent (SE) were 52.9 ± 19.5 years (range: 10-91 years) and -1.81 ± 3.76D (range: -17.11-+8.72D). A strong correlation was found between age and ocular RMS HOA (r = 0.55, p < 0.001) and the age-related effect on spherical aberration (SA) was moderate (r = 0.30, p < 0.001). There was a moderate positive correlation between age and corneal RMS HOA (r = 0.46, p < 0.001), horizontal coma (r = 0.28, p < 0.001), and SA at 4-mm (r = 0.39, p < 0.001) and 6-mm (r = 0.55, p < 0.001) zones, indicating that these aberrations increase with age. Weak correlations were observed between SE and ocular SA at 4-mm (r = 0.27, p < 0.001) and 6-mm (r = 0.26, p < 0.001) zones, with SE explaining only a limited proportion of the observed variability. Gender-dependent differences were small but identified between ocular vertical trefoil (p < 0.01), corneal RMS HOA (p < 0.03), horizontal coma (p < 0.001), and oblique secondary astigmatism (p < 0.03). Conclusion: This large Caucasian cohort demonstrates the distribution of normative HOA data. Significant age, gender, and SE-dependent differences were identified that may be taken into consideration when mitigating HOA in clinical practice. Translational Relevance: Our data demonstrates the distribution and normative values of HOA among healthy phakic eyes and may serve as a reference for mitigation of wavefront errors in clinical practice.