Predicting through-focus visual acuity with the eye's natural aberrations.

PURPOSE: To develop a predictive optical modeling process that utilizes individual computer eye models along with a novel through-focus image quality metric. METHODS: Individual eye models were implemented in optical design software (Zemax, Bellevue, WA) based on evaluation of ocular aberrations, pupil diameter, visual acuity, and accommodative response of 90 subjects (180 eyes; 24-63 years of age). Monocular high-contrast minimum angle of resolution (logMAR) acuity was assessed at 6 m, 2 m, 1 m, 67 cm, 50 cm, 40 cm, 33 cm, 28 cm, and 25 cm. While the subject fixated on the lowest readable line of acuity, total ocular aberrations and pupil diameter were measured three times each using the Complete Ophthalmic Analysis System (COAS HD VR) at each distance. A subset of 64 mature presbyopic eyes was used to predict the clinical logMAR acuity performance of five novel multifocal contact lens designs. To validate predictability of the design process, designs were manufactured and tested clinically on a population of 24 mature presbyopes (having at least +1.50 D spectacle add at 40 cm). Seven object distances were used in the validation study (6 m, 2 m, 1 m, 67 cm, 50 cm, 40 cm, and 25 cm) to measure monocular high-contrast logMAR acuity. RESULTS: Baseline clinical through-focus logMAR was shown to correlate highly (R² = 0.85) with predicted logMAR from individual eye models. At all object distances, each of the five multifocal lenses showed less than one line difference, on average, between predicted and clinical normalized logMAR acuity. Correlation showed R² between 0.90 and 0.97 for all multifocal designs. CONCLUSIONS: Computer-based models that account for patient's aberrations, pupil diameter changes, and accommodative amplitude can be used to predict the performance of contact lens designs. With this high correlation (R² ≥ 0.90) and high level of predictability, more design options can be explored in the computer to optimize performance before a lens is manufactured and tested clinically.

Population spherical aberration: associations with ametropia, age, corneal curvature, and image quality.

PURPOSE: The aim of this analysis was to determine the total ocular wavefront aberration values of a large phakic population of physiologically normal, ametropic eyes, gathered under the same clinical protocol using the same diagnostic wavefront sensor. MATERIALS AND METHODS: Studies were conducted at multiple sites in Asia, North America, Europe, and Australia. A Bausch + Lomb Zywave II Wavefront Aberrometer (Rochester, NY, USA) was used to measure the lower and higher order aberrations of each eye. Data analysis was conducted using linear regression analysis to determine the relationship between total spherical aberration, ametropia, age, corneal curvature, and image quality. RESULTS: Linear regression analysis showed no correlation (r = 0.0207, P = 0.4874) between degree of ametropia and the amount of spherical aberration. There was also no correlation when the population was stratified into myopic and hyperopic refractive groups (r m = 0.0529, P m = 0.0804 and r h = 0.1572, P h = 0.2754). There was a statistically significant and weak positive correlation (r = 0.1962, P < 0.001) between age and the amount of spherical aberration measured in the eye; spherical aberration became more positive with increasing age. Also, there was a statistically significant and moderately positive correlation (r = 0.3611, P < 0.001) with steepness of corneal curvature; spherical aberration became more positive with increasing power of the anterior corneal surface. Assessment of image quality using optical design software (Zemax™, Bellevue, WA < USA) showed that there was an overall benefit in correcting the average spherical aberration of this population. CONCLUSION: Analysis of this dataset provides insights into the inherent spherical aberration of a typical phakic, pre-presbyopic, population and provides the ability to determine what drives the spherical aberration of the eye, as well as what potential benefit a person could gain by compensating for that average spherical aberration.