Impact of Spherical Aberration Terms on Multifocal Contact Lens Performance.

PURPOSE: To investigate the impact of the primary (PSA) and secondary (SSA) spherical aberration terms on visual performance (VP) in presbyopes, as measured using multifocal (MFCL) soft contact lenses on eye. METHODS: Seventeen presbyopes (age: 55.1 ± 6.9 years) wore seven commercial lenses (four center-near (MFCL N), one center-distance (MFCL D), one bifocal, and one single vision control). Unaided and with each lens on eye, the PSA and SSA terms were obtained with an aberrometer, the BHVI-EyeMapper (low illumination, natural and 4 mm pupil diameter). High- and low-contrast distance visual acuity, contrast sensitivity, high-contrast visual acuities at near, and range of clear vision were measured. In addition, subjective VP variables included clarity of vision at distance and near, ghosting, and overall vision satisfaction. Pearson's correlation was used to determine the association between the PSA and SSA terms and the VP variables. RESULTS: PSA (natural pupil) was more negative (P < .05) with the MFCL N (mean PSA = -0.053 ± 0.080 µm) and bifocal (PSA = +0.005 ± 0.067 µm) lenses and more positive with the MFCL D lens (PSA = +0.208 ± 0.160 µm) than the control (+0.067 ± 0.072 µm). SSA (natural pupil) was significantly more positive for the MFCL N lenses (mean SSA = +0.025 ± 0.029 µm) compared to the control (SSA = -0.001 ± 0.017 µm). PSA and SSA terms were significantly (P < .05) correlated with 78% and 56% of VP variables, respectively, but the correlation coefficients were weak, ranging between |0.210| and |0.334|. Although distance variables showed improved VP with more positive PSA or negative SSA, most near variables showed improved VP with more negative PSA. Range of clear focus was greater for more negative PSA terms. CONCLUSIONS: The amount and direction of PSA and SSA terms, as measured with different MFCLs on eye, can affect VP at different distances. Results of this study may provide useful information when designing new or optimize existing MFCLs for improved VP at specific distances.