title: Comparison of spherical aberration and small-pupil profiles in improving depth of focus for presbyopic corrections.
abstract: OBJECTIVE
  To compare the validity and effectiveness of 2 methods for expanding depth of focus to correct for presbyopia; that is, induction of spherical aberration and small-pupil apertures.
  
  
  METHODS
  University of California, Berkeley, California, USA.
  
  
  METHODS
  Comparative case series.
  
  
  METHODS
  A random 4-alternative forced-choice acuity task was performed on 13 subjects. Visual performance and depth of focus were compared using adaptive optics-corrected distance visual acuity (CDVA) values and mean visual acuity over a 3.0 diopter (D) range of defocus using the following 3 adaptive optics-corrected profiles: 2.0 mm pupil, 5.0 mm pupil, and 5.0 mm pupil with -0.274 μm of spherical aberration.
  
  
  RESULTS
  The 5.0 mm pupil profile had a CDVA of -0.218 logMAR and a mean visual acuity through focus of 0.156 logMAR. The 2.0 mm pupil profile had a worse CDVA (0.012 logMAR) but an improved mean visual acuity (0.061 logMAR). The 5.0 mm pupil profile with -0.274 μm of spherical aberration measured a CDVA of -0.082 logMAR and a mean visual acuity of 0.103 logMAR.
  
  
  CONCLUSIONS
  The spherical aberration and small-pupil profiles improved the mean visual acuity across a 3.0 D range of defocus but resulted in decreased CDVA at the plane of best focus in comparison to an adaptive optics-corrected 5.0 mm pupil. Small-pupil profiles are a better choice than spherical aberration profiles for presbyopic corrections due to expected accuracy, predictability, and patient satisfaction.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: University of California, Berkeley, California, USA. dradamh@gmail.com
authors.forename: Adam
authors.initials: A
authors.lastname: Hickenbotham
authors.forename: Pavan
authors.initials: P
authors.lastname: Tiruveedhula
authors.forename: Austin
authors.initials: A
authors.lastname: Roorda
mesh_terms: D057128:Aberrometry; D000328:Adult; D003315:Cornea / Q000503:physiopathology*; D057108:Corneal Wavefront Aberration / Q000503:physiopathology*; D003867:Depth Perception / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage; D011305:Presbyopia / Q000503:physiopathology*; D011680:Pupil / Q000187:drug effects / Q000502:physiology*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D009184:Mydriatics