The purpose of this report, made within research in progress, was to discuss the optical effect of irregular surface structures that might be associated with complicated refractive procedures related with the retinal image quality. We concentrated our discussion on the range of surface structures between the known scattering effects and wavefront aberrations of higher orders. The case study demonstrates that the surface irregularities of the cornea might induce, after refractive laser surgery, significant optical aberrations that are much too different from the classical wavevront or scattering errors. Such optical errors, however, cannot be correctly measured by current commercial wavefront sensors. Finally, the influence of the healing process on Strehl ratio is under discussion.
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