Interocular mismatches of high‐order wavefront aberrations impair stereoacuity following refractive surgeries by reducing the disparity signal quality

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Main Authors: Jingyi Tang, Shrikant R. Bharadwaj, Clifton M. Schor, Samrat Sarkar, Pravin K. Vaddavalli, Sangeetha Metlapally
Format: Artículo Open Access
Published: Wiley 2026
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author Jingyi Tang
Shrikant R. Bharadwaj
Clifton M. Schor
Samrat Sarkar
Pravin K. Vaddavalli
Sangeetha Metlapally
author_facet Jingyi Tang
Shrikant R. Bharadwaj
Clifton M. Schor
Samrat Sarkar
Pravin K. Vaddavalli
Sangeetha Metlapally
Jingyi Tang
Shrikant R. Bharadwaj
Clifton M. Schor
Samrat Sarkar
Pravin K. Vaddavalli
Sangeetha Metlapally
collection Wiley Open Access
contents Interocular mismatches of high‐order wavefront aberrations impair stereoacuity following refractive surgeries by reducing the disparity signal quality Jingyi Tang Shrikant R. Bharadwaj Clifton M. Schor Samrat Sarkar Pravin K. Vaddavalli Sangeetha Metlapally Optometry and Vision Science ABSTRACT Purpose (1) To investigate if binocular cross‐correlation metrics derived from the aberrated monocular retinal images can explain the deterioration of stereoacuity following keratorefractive surgeries. (2) To investigate if the quality of binocular metrics improves with improved monocular retinal image quality and pupil miosis. Methods High‐order aberrations (HOAs) were obtained over 6 mm pupil diameter from 99 young adults undergoing photorefractive keratectomy (PRK) ( n  = 26), laser‐assisted in situ keratomileusis (LASIK) ( n  = 38), and ReLEx small‐incision lenticule extraction (SMILE; n  = 35) for myopia correction. Point spread functions derived from HOAs were convolved with random‐dot stereo pairs and cross‐correlated to obtain four binocular metrics—signal width, signal height, signal‐to‐noise ratio, and height‐to‐width ratio—that signified the quality of the disparity signal. These metrics were derived pre‐operatively and at 1‐week, 1‐month, 3‐month, and 6‐month after surgeries, and correlated with the subject's stereoacuity for 6 mm pupil diameters. Binocular metrics were also derived for 4 mm pupil diameters and compared with the 6 mm data. Results Larger interocular differences in retinal image quality led to reduced disparity signal quality and less optimal values of the binocular metrics. These trends were strongly correlated with the subject's stereoacuity across refractive surgeries ( ρ  ≥ 0.71; p  < 0.001). Relative to pre‐operative values, post‐operative metrics worsened at 1‐week followed by a recovery period ( p  < 0.001). All post‐operative metrics for PRK and LASIK surgeries were similar ( p  ≥ 0.67), but worse than SMILE surgery ( p  < 0.001). The binocular metrics derived for the 4 mm pupil diameters were superior to those of the 6 mm pupil diameters ( p  < 0.001). Conclusions Binocular cross‐correlation metrics derived from the aberrated monocular retinal images signify the strength of the disparity signal, and capture much of the stereoacuity losses following keratorefractive surgeries for myopia. Binocularity may be better preserved after SMILE surgery owing to the smaller interocular mismatches in optical quality, relative to PRK and LASIK surgeries for comparable pupil diameters. 10.1002/ovs2.70021 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1002/ovs2.70021
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institution Wiley Open Access
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publisher Wiley
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spellingShingle Interocular mismatches of high‐order wavefront aberrations impair stereoacuity following refractive surgeries by reducing the disparity signal quality
Jingyi Tang
Shrikant R. Bharadwaj
Clifton M. Schor
Samrat Sarkar
Pravin K. Vaddavalli
Sangeetha Metlapally
Optometry and Vision Science
Interocular mismatches of high‐order wavefront aberrations impair stereoacuity following refractive surgeries by reducing the disparity signal quality Jingyi Tang Shrikant R. Bharadwaj Clifton M. Schor Samrat Sarkar Pravin K. Vaddavalli Sangeetha Metlapally Optometry and Vision Science ABSTRACT Purpose (1) To investigate if binocular cross‐correlation metrics derived from the aberrated monocular retinal images can explain the deterioration of stereoacuity following keratorefractive surgeries. (2) To investigate if the quality of binocular metrics improves with improved monocular retinal image quality and pupil miosis. Methods High‐order aberrations (HOAs) were obtained over 6 mm pupil diameter from 99 young adults undergoing photorefractive keratectomy (PRK) ( n  = 26), laser‐assisted in situ keratomileusis (LASIK) ( n  = 38), and ReLEx small‐incision lenticule extraction (SMILE; n  = 35) for myopia correction. Point spread functions derived from HOAs were convolved with random‐dot stereo pairs and cross‐correlated to obtain four binocular metrics—signal width, signal height, signal‐to‐noise ratio, and height‐to‐width ratio—that signified the quality of the disparity signal. These metrics were derived pre‐operatively and at 1‐week, 1‐month, 3‐month, and 6‐month after surgeries, and correlated with the subject's stereoacuity for 6 mm pupil diameters. Binocular metrics were also derived for 4 mm pupil diameters and compared with the 6 mm data. Results Larger interocular differences in retinal image quality led to reduced disparity signal quality and less optimal values of the binocular metrics. These trends were strongly correlated with the subject's stereoacuity across refractive surgeries ( ρ  ≥ 0.71; p  < 0.001). Relative to pre‐operative values, post‐operative metrics worsened at 1‐week followed by a recovery period ( p  < 0.001). All post‐operative metrics for PRK and LASIK surgeries were similar ( p  ≥ 0.67), but worse than SMILE surgery ( p  < 0.001). The binocular metrics derived for the 4 mm pupil diameters were superior to those of the 6 mm pupil diameters ( p  < 0.001). Conclusions Binocular cross‐correlation metrics derived from the aberrated monocular retinal images signify the strength of the disparity signal, and capture much of the stereoacuity losses following keratorefractive surgeries for myopia. Binocularity may be better preserved after SMILE surgery owing to the smaller interocular mismatches in optical quality, relative to PRK and LASIK surgeries for comparable pupil diameters. 10.1002/ovs2.70021 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Interocular mismatches of high‐order wavefront aberrations impair stereoacuity following refractive surgeries by reducing the disparity signal quality
topic Optometry and Vision Science
url https://onlinelibrary.wiley.com/doi/10.1002/ovs2.70021