Spherical aberration for expanding depth of focus

The increase in the depth of focus (DoF) for the treatment of presbyopia or cataracts is a topic of great interest for anterior segment surgeons who have seen how new surgical possibilities to achieve DoF enlargement have emerged. Nowadays, several technologies to extend the DoF are available, from corneal laser refractive surgery procedures in presbyopia to intraocular lens (IOL) implantation in cataract or refractive lens exchange. Some of these procedures are based on aspheric profiles, either in the cornea or in the IOL, which modulate the spherical aberration (SA) and, therefore, extend the light energy on different focal planes. The aim of this narrative review was to give an overall picture about the reasons why there is not a general solution persistent along time of SA induction to extend DoF, especially considering that SA depends on pupil diameter and this decreases with age.