Effects of higher‐order wavefront aberrations on the eye's depth of focus

Abstract

Abstract Purpose To evaluate the impact of higher order aberrations (HOA), defined by individual Zernike polynomial coefficients, on the eye's depth of focus using an adaptive optics (AO) system. Methods A crx1 AO visual simulator (Imagine Eyes, France) was used to introduce different amounts of individual 3rd and 4th order HOA in 10 healthy eyes. These HOA included coma (Z(3,‐1)) and trefoil (Z(3,‐3)) at magnitudes of +/‐0.3 µm, and spherical aberration (SA) (Z(4,0)) at magnitudes of +/‐0.3,+/‐0.6 and +/‐0.9 µm through a fixed 6‐mm pupil diameter. A through‐focus response (TFR) curve was assessed by recording the percentage of optotype letters of fixed 20/50 size that the subject could identify while these letters were presented at various target distances. Testing was performed under cycloplegia. For each applied HOA, the subject's depth of focus (DoF) and center of focus (CoF) were computed as, respectively, the half‐maximum width and the midpoint of the TFR curve. Results The introduction of SA resulted in linearly shifting the CoF by 1.3 D for each 0.5 µm of wavefront. The shift was hyperopic with positive SA, myopic with negative SA. The simulation of either positive or negative SA also had the effect of enhancing the DoF, up to a maximum increase of 2 D with 0.6 µm of SA. The enhancement became smaller when the SA was further increased. Trefoil and coma appeared to neither shift the CoF nor significantly modify the DoF. Conclusion AO technology allowed us to selectively test the visual impact of several HOA on the DoF. The introduction of SA significantly shifted and expanded the subjects’ overall DoF. This technique could help in designing optimal corrections for presbyopia and allowing patients to preview refractive surgery outcomes. Commercial interest