{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T15:55:16Z","timestamp":1785686116789,"version":"3.56.0"},"reference-count":38,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vision"],"abstract":"<jats:p>The purpose of this study is to evaluate the potential impact of small aperture optics on corneal aberrations in post-RK patients. Preoperative data was evaluated from 32 eyes of 23 post-RK patients. Scheimpflug tomography was used to obtain measurements of corneal HOAs at 6-mm, 4-mm, and 2-mm corneal plane aperture diameters. The data was extrapolated using a non-linear fit to estimate HOAs that would be obtained with the 1.6 mm effective pinhole IOL aperture at the corneal plane for individual patients. The average RMS HOAs estimated for the 1.6 mm aperture was 0.063 \u00b1 0.015 \u03bcm compared to 0.185 \u00b1 0.029 \u03bcm for the natural pupil size. A postoperative RK case with an IC-8\u00ae Apthera\u2122 unilateral implantation demonstrated a 70% reduction in HOAs by objective measurement and prediction, plus a 2-line improvement in CDVA. Prediction modeling revealed that HOAs may be reduced in post-RK patients following pinhole IOL implantation, compared to the natural photopic pupil size. Furthermore, the approach can be used to guide which post-RK patients would benefit from a small aperture IOL during cataract surgery.<\/jats:p>","DOI":"10.3390\/vision9020046","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T04:46:38Z","timestamp":1748493998000},"page":"46","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Predicted Visual Impact of a Small Aperture Intraocular Lens in Reducing Higher Order Aberrations in Post-Radial Keratotomy Patients"],"prefix":"10.3390","volume":"9","author":[{"given":"Roberta M.","family":"van den Berg","sequence":"first","affiliation":[{"name":"Storm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USA"},{"name":"Department of Ophthalmology, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04023-062, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"DeVaro","sequence":"additional","affiliation":[{"name":"Storm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0624-1783","authenticated-orcid":false,"given":"Karolinne Maia","family":"Rocha","sequence":"additional","affiliation":[{"name":"Storm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"Fetrin de Barros","sequence":"additional","affiliation":[{"name":"Storm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USA"},{"name":"Department of Ophthalmology, University of S\u00e3o Paulo (USP), S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9138-4980","authenticated-orcid":false,"given":"Stephen D.","family":"Klyce","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/S0886-3350(13)80074-0","article-title":"Combined myopia and astigmatism surgery. 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