title: Modified monovision with spherical aberration to improve presbyopic through-focus visual performance.
abstract: OBJECTIVE
  To investigate the impact on visual performance of modifying monovision with monocularly induced spherical aberration (SA) to increase depth of focus (DoF), thereby enhancing binocular through-focus visual performance.
  
  
  METHODS
  A binocular adaptive optics (AO) vision simulator was used to correct both eyes' native aberrations and induce traditional (TMV) and modified (MMV) monovision corrections. TMV was simulated with 1.5 diopters (D) of anisometropia (dominant eye at distance, nondominant eye at near). Zernike primary SA was induced in the nondominant eye in MMV. A total of four MMV conditions were tested with various amounts of SA (± 0.2 and ± 0.4 μm) and fixed anisometropia (1.5 D). Monocular and binocular visual acuity (VA) and contrast sensitivity (CS) at 10 cyc/deg and binocular summation were measured through-focus in three cyclopledged subjects with 4-mm pupils.
  
  
  RESULTS
  MMV with positive SA had a larger benefit for intermediate distances (1.5 lines at 1.0 D) than with negative SA, compared with TMV. Negative SA had a stronger benefit in VA at near. DoF of all MMV conditions was 3.5 ± 0.5 D (mean) as compared with TMV (2.7 ± 0.3 D). Through-focus CS at 10 cyc/deg was significantly reduced with MMV as compared to TMV only at intermediate object distances, however was unaffected at distance. Binocular summation was absent at all object distances except 0.5 D, where it improved in MMV by 19% over TMV.
  
  
  CONCLUSIONS
  Modified monovision with SA improves through-focus VA and DoF as compared with traditional monovision. Binocular summation also increased as interocular similarity of image quality increased due to extended monocular DoF.
authors.affiliation: Institute of Optics, University of Rochester, Rochester, New York 14624, USA. lelenz@optics.rochester.edu
authors.forename: Len
authors.initials: L
authors.lastname: Zheleznyak
authors.forename: Ramkumar
authors.initials: R
authors.lastname: Sabesan
authors.forename: Je-Sun
authors.initials: JS
authors.lastname: Oh
authors.forename: Scott
authors.initials: S
authors.lastname: MacRae
authors.forename: Geunyoung
authors.initials: G
authors.lastname: Yoon
mesh_terms: D000065:Accommodation, Ocular / Q000187:drug effects; D000328:Adult; D015350:Contrast Sensitivity / Q000502:physiology; D057108:Corneal Wavefront Aberration / Q000503:physiopathology*; D003867:Depth Perception / Q000502:physiology*; D006801:Humans; D008962:Models, Theoretical; D009184:Mydriatics / Q000494:pharmacology; D011305:Presbyopia / Q000503:physiopathology*; D015348:Vision, Binocular / Q000502:physiology; D015349:Vision, Monocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D009184:Mydriatics
keywords: aberrations; binocular adaptive optics; monovision; presbyopia
references.citation: J Cataract Refract Surg. 2007 Mar;33(3):522-7
references.pmid: 17321405
references.citation: J Physiol. 1965 Dec;181(3):576-93
references.pmid: 5880378
references.citation: J Cataract Refract Surg. 2009 Apr;35(4):710-4
references.pmid: 19304093
references.citation: J Refract Surg. 2011 May;27(5):332-8
references.pmid: 20839664
references.citation: J Refract Surg. 2009 Jun;25(6):516-23
references.pmid: 19603619
references.citation: Ophthalmology. 2008 Jul;115(7):1196-202
references.pmid: 18061266
references.citation: Ophthalmic Physiol Opt. 1990 Jan;10(1):33-6
references.pmid: 2330211
references.citation: Nature. 1965 Oct 9;208(5006):191-2
references.pmid: 5884255
references.citation: Optom Vis Sci. 1999 Dec;76(12):832-7
references.pmid: 10612404
references.citation: Invest Ophthalmol Vis Sci. 1985 May;26(5):741-50
references.pmid: 3997423
references.citation: Optom Vis Sci. 2008 Mar;85(3):174-9
references.pmid: 18317332
references.citation: J Refract Surg. 2010 Oct;26(10):707-15
references.pmid: 20438021
references.citation: Am J Optom Physiol Opt. 1987 Oct;64(10):723-30
references.pmid: 3688174
references.citation: J Cataract Refract Surg. 2005 Jan;31(1):127-35
references.pmid: 15721705
references.citation: Ophthalmic Physiol Opt. 2009 May;29(3):370-4
references.pmid: 19422571
references.citation: Optom Vis Sci. 1993 Sep;70(9):723-8
references.pmid: 8233366
references.citation: Ophthalmic Physiol Opt. 2007 Sep;27(5):417-39
references.pmid: 17718882
references.citation: Optom Vis Sci. 2001 Sep;78(9):646-51
references.pmid: 11587198
references.citation: J Cataract Refract Surg. 2009 Nov;35(11):1885-92
references.pmid: 19878820
references.citation: Curr Eye Res. 1996 Mar;15(3):315-9
references.pmid: 8654112
references.citation: Int Ophthalmol Clin. 2001 Spring;41(2):33-46
references.pmid: 11290920
references.citation: Biomed Opt Express. 2012 Dec 1;3(12):3176-89
references.pmid: 23243568
references.citation: Curr Opin Ophthalmol. 2005 Feb;16(1):33-7
references.pmid: 15650577
references.citation: J Vis. 2008 Apr 22;8(4):17.1-19
references.pmid: 18484856
references.citation: J Opt Soc Am A Opt Image Sci Vis. 2002 Feb;19(2):266-75
references.pmid: 11822589
references.citation: J Refract Surg. 2011 Nov;27(11):842-5
references.pmid: 22045576
references.citation: Optom Vis Sci. 2010 May;87(5):300-12
references.pmid: 20351600
references.citation: Vision Res. 2011 Jul 15;51(14):1648-58
references.pmid: 21609729
references.citation: J Cataract Refract Surg. 2010 Dec;36(12):2129-38
references.pmid: 21111317
references.citation: J Cataract Refract Surg. 2006 May;32(5):849-58
references.pmid: 16765805
references.citation: J Vis. 2004 Apr 23;4(4):310-21
references.pmid: 15134478
references.citation: J Vis. 2010 Dec 16;10(14):18
references.pmid: 21163955
references.citation: J Refract Surg. 2012 Jun;28(6):413-8
references.pmid: 22692523
references.citation: Invest Ophthalmol Vis Sci. 2011 Jul 15;52(8):5273-7
references.pmid: 21436279
references.citation: J Cataract Refract Surg. 2009 Jun;35(6):998-1002
references.pmid: 19465283
references.citation: Percept Psychophys. 1983 Feb;33(2):113-20
references.pmid: 6844102
references.citation: J Cataract Refract Surg. 2001 Jul;27(7):1093-107
references.pmid: 11489582
references.citation: Vision Res. 1989;29(12):1685-92
references.pmid: 2631389
references.citation: J Cataract Refract Surg. 2005 Jul;31(7):1290-7
references.pmid: 16105597
references.citation: Invest Ophthalmol Vis Sci. 2001 May;42(6):1396-403
references.pmid: 11328757
references.citation: Curr Opin Ophthalmol. 2000 Aug;11(4):296-8
references.pmid: 10977775
references.citation: J Refract Surg. 2006 May;22(5):453-60
references.pmid: 16722483
references.citation: Surv Ophthalmol. 1996 May-Jun;40(6):491-9
references.pmid: 8724641
references.citation: Optom Vis Sci. 1992 Aug;69(8):609-14
references.pmid: 1513556
references.citation: J Opt Soc Am A. 1993 Jul;10(7):1611-23
references.pmid: 8350150
references.citation: J Opt Soc Am A Opt Image Sci Vis. 1997 Jan;14(1):1-12
references.pmid: 8988615
references.citation: J Cataract Refract Surg. 2007 Oct;33(10):1721-6
references.pmid: 17889766
references.citation: Optom Vis Sci. 2003 Dec;80(12):812-9
references.pmid: 14688544
references.citation: Am J Ophthalmol. 2007 Aug;144(2):209-216
references.pmid: 17533108
references.citation: J Cataract Refract Surg. 2011 Jul;37(7):1305-12
references.pmid: 21700107
references.citation: Optom Vis Sci. 2001 Jul;78(7):503-9
references.pmid: 11503939
references.citation: Am J Optom Physiol Opt. 1988 Aug;65(8):619-26
references.pmid: 3177586
references.citation: J Cataract Refract Surg. 2001 Sep;27(9):1449-55
references.pmid: 11566531
references.citation: J Opt Soc Am A. 1985 Jul;2(7):1087-93
references.pmid: 4020506
references.citation: J Refract Surg. 2011 Jan;27(1):23-37
references.pmid: 20205360
references.citation: J Cataract Refract Surg. 2002 Aug;28(8):1439-43
references.pmid: 12160816
references.citation: J Vis. 2011 Oct 10;11(12):
references.pmid: 21985781
references.citation: J Refract Surg. 2009 Jan;25(1):37-58
references.pmid: 19244952
references.citation: Am J Ophthalmol. 2003 Mar;135(3):279-84
references.pmid: 12614742