Ablation Design in Relation to Spatial Frequency, Depth-of-focus, and Age

PURPOSE: To consider factors relevant to the design of wavefront-aberration-based customized ablations. METHODS: Review. RESULTS: Ablations that seek to eliminate all wavefront aberrations, both second- and higher-order, may not be optimal for all patients. This is particularly the case for presbyopes. Their main requirement will normally be for extended binocular depth-of-focus to yield adequate distance and near vision with good retinal contrast at lower spatial frequencies, rather than the highest levels of acuity and modulation transfer function at a single distance. For many presbyopes, this can be achieved by aiming for monovision correction or low myopic astigmatism, with reasonable but not necessarily complete correction of higher-order aberrations. This compromise allows a range of everyday tasks to be carried out, including face recognition and reading. CONCLUSION: The targeted correction of wavefront aberration should take into account the visual needs and preferences of the individual patient.