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T. Kawamorita, H. Uozato, N. Nakayama, M. Shindo, T. Hannda, M. Ito, K. Shimizu; Relationship Between Visual Acuity, Pupil Size and Refractive Difference in Pseudophakic Monovision. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3966.
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To investigate the relationship between pupil size and estimated visual acuity in pseudophakic monovision with ray tracing.
For the simulation, a modified Liou-Brennan model eye was used. The model eye was designed to include a centered optical system, corneal asphericity, a pupil, a Stiles-Crawford effect, an intraocular lens, and chromatic aberration. Calculation of the modulation transfer function (MTF) was performed with ZEMAX software. Visual acuity was estimated from the MTF and the retinal threshold curve. The sizes of the entrance pupil were 2.0, 2.5, 3.0, and 4.0 mm.
Decreasing pupil diameter and increasing myopia progressively improved near visual acuity. For an entrance pupil size of 2.5-mm and a refractive difference of 1.5 D, the estimated visual acuities were 0.1 logMAR or better from far to a distance of 40 cm, and the estimated logMAR value (Snellen; metric) in the non-dominant eye at 40 cm was 0.06 (20/23; 6/6.9).
Our results would be of use to help predict visual acuity when using the pseudophakic monovision technique and to determine the optimum refractive difference from pupil size. Also, in cases of patients with a pupil size less 2.5 mm, a 1.5 D interocular difference in refractive error is effective for patients who have a near visual acuity of approximately 0.1 logMAR and excellent intermediate visual acuity.
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