Role of clearance and treatment zones in contrast sensitivity : Significance in refractive surgery

• Published in: Journal of cataract and refractive surgery Vol. 25; no. 1; pp. 16 - 23
• Main Authors: WACHLER, B. S. B, DURRIE, D. S, ASSIL, K. K, KRUEGER, R. R
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Science 1999
• Subjects: Adult; Biological and medical sciences; Contrast Sensitivity - physiology; Cross-Sectional Studies; Female; Humans; Keratotomy, Radial; Lasers, Excimer; Male; Medical sciences; Middle Aged; Photorefractive Keratectomy; Pupil - physiology; Refractive Errors - physiopathology; Refractive Surgical Procedures; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Visual Acuity - physiology; Human; Postoperative; Iatrogenic; Vision disorder; Zone; Clearance; Ablation; Contrast; Radial keratotomy; Photorefractive keratectomy; Eye disease; Sensitivity; Treatment; Surgery; Refractive error; Complication; Halo
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/S0886-3350(99)80006-6

To evaluate the relationship between contrast sensitivity, surgical treatment zone, and clearance (ablation or clear zone-pupil diameter) in photorefractive keratectomy (PRK) and radial keratotomy (RK). Saint Louis University Eye Institute, St. Louis, Missouri, and Hunkeler Eye Center, Kansas City, Missouri, USA. Thirteen patients had PRK and 20, RK. Contrast sensitivity was measured with the Stereo Optical F.A.C.T. (F.A.C.T.) and VectorVision CSV-1000 (VV) charts. Pupils were measured with the Rosenbaum card. In the PRK group, VV contrast sensitivity at 6 and 12 cycles per degree (cpd) correlated with the ablation zone (r2 = 0.18 and 0.22, respectively), while visual acuity and F.A.C.T. contrast sensitivity did not correlate. In the RK group, both VV and F.A.C.T. contrast sensitivity at 6 cpd correlated with clearance (r2 = 0.29 and 0.12, respectively). Pupils were larger with the VV test than with the F.A.C.T. chart because ambient chart luminance was less in the former. Contrast sensitivity is likely a more sensitive indicator of visual function than acuity in refractive surgery. The VV system unmasks aberrations from the transition zone of ablated and unablated cornea in PRK. Larger samples are needed to determine the critical ablation clearance of the pupil to avoid loss of visual function.