Impact of Pupil Transmission Apodization on Presbyopic Through-Focus Visual Performance With Spherical Aberration

Abstract

To investigate the impact on through-focus retinal image quality and visual performance of apodizing the pupil's transmission function in combination with extended depth of focus presbyopic corrections, such as spherical aberration (SA). Through-focus retinal image quality was determined theoretically for various magnitudes of pupil transmission apodization and Zernike primary SA (-0.5 to +0.5 μm) for a 4-mm pupil. The impact of pupil transmission apodization was also assessed psychophysically with a vision simulator equipped with a liquid crystal spatial light modulator for controlling pupil transmission. Through-focus visual acuity (VA) was measured with and without apodization in three cyclopleged subjects from distance to near with monochromatic light (550 nm) under two multifocal aberration conditions. Phase plates induced +0.2 and -0.2 μm of SA over a 4-mm artificial pupil. A baseline condition of zero SA was also included for comparison. The theoretical investigation showed that pupil transmission apodization significantly improved distance image quality in the presence of positive and negative SA. Retinal image quality at all target vergences for negative SA conditions was improved by apodization. Pupil transmission apodization improved through-focus VA by 0.1 to 0.2 logMAR at intermediate and near object distances for the zero and negative SA conditions. In the positive SA condition, apodization degraded VA by approximately 0.1 logMAR at intermediate object distances. Pupil transmission apodization had a significant impact on though-focus visual performance. Pupil transmission apodization affects through-focus retinal image quality by diminishing the relative contribution to the retinal image from the peripheral region of the wavefront aberration. Through-focus visual performance in presbyopic eyes with negative SA was improved due to pupil transmission apodization.