AIM: To compare the difference between total and anterior corneal high-order aberrations(HOA)calculated based on the pupil diameters of 4.0mm and the actual measurements in different age groups.

METHODS: A cross sectional study. A Total of 100 subjects between March, 31^th and May, 31^th in 2019 were included. Their total corneal high-order aberrations(THOA)and anterior corneal high-order aberrations(AHOA)were detected on the basis of different machine-provided pupil diameters(2.0-7.0mm)and their photopic pupil diameters were recorded as measured pupil diameters in the room with normal illumination. THOA and AHOA based on the machine-measured pupil diameter was calculated through fitting curves, and compared to the THOA and AHOA at a theoretical 4mm pupil diameter.

RESULTS: The measured pupil diameter was negatively correlated with age(r= -0.587, P<0.001). THOA and AHOA based on measured pupil diameter were both negatively correlated with age(r= -0.191, P=0.002; r=-0.181, P=0.004). At 4mm pupil diameter, THOA was positively correlated with age(r=0.282, P<0.001), while there was no obvious correlation between AHOA and age. In 40-49, 60-69 and 70-79 years old groups, their THOA and AHOA at the measured pupil diameters were significantly lower than those at 4mm pupil diameter(P<0.05), while their THOA were significantly higher than AHOA at the measured pupil diameters(P<0.05). At 4mm pupil diameter, THOA were significantly lower than AHOA in 20-29 years old groups(P=0.006), but higher than AHOA in 60-69 years old groups(P=0.039). In the aged group(include 60-69 and 70-79 years old groups), the proportion of observed value of THOA ≥0.3μm at the measured pupil diameters were significantly lower than those at 4mm pupil diameter(χ²=4.300, P=0.038).

CONCLUSION: THOA and AHOA at the measured pupil diameters in the old subjects are significantly lower than those at 4mm pupil diameter, which could be ascribed to their relatively small actual mean pupil sizes. Our study suggested that the THOA rather than AHOA should be used for the selection of multifocal intraocular lens for cataract patients at measured pupil diameter, so that more aged patients will satisfy the inclusion criteria.