# High-Order Aberrations: A Key Factor in Accommodative Dysfunctions
## 3 Results
SWD: symptomatic without dysfunction; INFA: infacility of accommodation; EA: excess of accommodation; INSA: insufficiency of accommodation. When observing the data collected after disaccommodation, the SWD group presented a RMS HOA value statistically higher than the initial after removing the 1.00 D (0.061 \(\pm\) 0.131 \(\upmu\)m; \(p\) = 0.033) and 4.73D (0.104 \(\pm\) 0.187 \(\upmu\)m; \(p\) = 0.002) stimuli. On the other hand, the subjects with EA displayed a decrease in RMS HOAs when disaccommodated after the 4.73 D stimulus (\(-\)0.01 \(\pm\) 0.09 \(\upmu\)m; \(p\) = 0.043). Other subjects displayed no significant changes. Figure 3 presents the variations in RMS, from the 3 rd to 6 th orders with accommodation, and the differences between the initial relaxed state and the residual accommodation after removing the stimulus are shown in Table 2. Regarding the changes with accommodation, the control group suffered significant changes in 4 th-order RMS at 2.45 D (\(p\) = 0.02) and 5 th-order RMS (\(p\) = 0.049) at 4.73 D, the INFA group in 3 rd-order RMS at 4.73 D (\(p\) = 0.025), the EA group in 4 th- and 6 th-order RMS at both 2.45 D (4 th-order, \(p\) = 0.032; 6 th-order, \(p\) = 0.014) and 4.73 D (4 th-order, \(p\) = 0.047; 6 th-order, \(p\) = 0.048), and SWD in 3 rd-order RMS at 2.45 D (\(p\) = 0.002) and 4.73 D (\(p\) = 0.002), and in 5 th-order RMS at 2.45 D (\(p\) = 0.01) and 4.73D (\(p\) = 0.004). In addition, the increase in 3 rd-order RMS at 2.45 D (\(p\) = 0.003) and 4.73 D (\(p\) = 0.025) in the SWD group was significantly higher than the variation in the control group. Regarding the residual accommodation, subjects from the SWD group had a significantly higher 3 rd-order RMS after the 1.00 D stimuli were removed compared to the initial state (\(p\) = 0.045). For the other stimulus and groups, all orders returned to their initial value after disaccommodation and with no differences compared to the control group (Table 2). Figure 3: Differences between the root mean square (RMS) of high-order aberrations (HOAs) for accommodation (on the (**left**))/residual accommodation (on the (**right**)) and the initial state across different groups (lines represent standard deviation). SWD: symptomatic without dysfunction; INFA: infacility of accommodation; EA: excess of accommodation; INSA: insufficiency of accommodation. Fluctuations in the RMS HOAs were also analyzed and their changes with different stimuli compared to the initial state are shown in Figure 4. The control group suffered a significant increase in microfluctutions at the 2.45 D stimulus (0.053 \(\pm\) 0.201; \(p\) = 0.04) and SWD at 1.00 D (0.134 \(\pm\) 0.125; \(p\) < 0.001) and 2.45 D (0.171 \(\pm\) 0.245; \(p\) < 0.001), whereas the INFA group significantly decreased at the 1.00D stimulus (\(-\)0.010 \(\pm\) 0.172; \(p\) = 0.03). Regarding this parameter for the residual accommodation state, a significant increase in the microfluctuations of RMS HOAs was observed in the control group after disaccommodating 1.00 D (0.104 \(\pm\) 0.115; \(p\) = 0.046) and 2.45 D (0.053 \(\pm\) 0.201; \(p\) = 0.04), as well as in the EA group after the 4.73 D (0.077 \(\pm\) 0.069; \(p\) = 0.03) stimulus was removed and in the SWD after the 2.45 D (0.104 \(\pm\) 0.116; \(p\) < 0.001) and 4.73 D (0.183 \(\pm\) 0.145; \(p\) < 0.001) stimuli were removed.