Abstract:AIM: To study the relation between higher-order aberrations (HOAs) and contrast sensitivity (CS) in normal eyes among a population of laser in situ keratomileusis (LASIK) candidates. METHODS: In 6629 eyes of 3315 LASIK candidates, CS were measured under dark environment at the spatial frequencies of 1.5, 3, 6, 12 and 18 cycles per degree (c/d), respectively, using an Optec 6500 visual function tester. Meanwhile, ocular HOAs were measured for a 6.0 mm pupil with a Hartmann-Shack wavefront analyzer. RESULTS: In the study, the subjects with an average spherical equivalent of -4.86±2.07 D were included. HOAs decreased from the third to the sixth order aberrations with predominant aberrations of third-order coma, trefoil and fourth-order spherical aberration. At low and moderate spatial frequencies, CS was negatively correlated with the third-order coma and trefoil aberrations, and decreased with increasing Z31, but increased with increasing Z3-3 and Z5-1. At high spatial frequencies, CS decreased with increasing Z3-3 and increased with increasing Z5-1. CONCLUSION: At a large pupil size of 6.0 mm, the third-order aberrations, but not the total aberrations, are the main factors affecting CS. Vertical coma is negatively correlated with CS.