Changes in corneal asphericity after laser refractive surgery, including reflection losses and nonnormal incidence upon the anterior cornea.

We tested the effects on laser ablation of reflection losses and nonnormal incidence on the anterior cornea. We measured presurgical and postsurgical corneal asphericity in 94 myopic eyes, comparing it with the corneal asphericity predicted by the Munnerlyn formula, modified or not, with an adjustment factor that takes into account the two effects mentioned above. The predictive power of the experimental results was stronger when we considered the adjustment factor. We propose to modify ablation algorithms by taking this adjustment factor into account, especially in customized corneal ablation, which needs high accuracy for correcting eye aberrations.