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Please use this identifier to cite or link to this item: http://hdl.handle.net/2328/996

Title: Contrast and glare testing in keratoconus and after penetratin keratoplasty
Authors: Pesudovs, Konrad
Schoneveld, P
Seto, R J
Coster, Douglas John
Keywords: Contrast Sensitivity
Keratoplasty, Penetrating
Postoperative Period
Research Support, Non-U.S. Gov't
Treatment Outcome
Vision Tests
Visual Acuity
Issue Date: May-2004
Publisher: BMJ Publishing Group - http://bjo.bmjjournals.com/
Citation: K Pesudovs, P Schoneveld, R J Seto and DJ Coster 2004. Contrast and glare testing in keratoconus and after penetrating keratoplasty. 'British Journal of Ophthalmology', May, Vol 88, No 5, 653-7
Abstract: AIM: To compare the performance of keratoconus, penetrating keratoplasty (PK), and control subjects on clinical tests of contrast and glare vision, to determine whether differences in vision were independent of visual acuity (VA), and thereby establish which vision tests are the most useful for outcome studies of PK for keratoconus. METHODS: All PK subjects had keratoconus before grafting and no subjects had any other eye disease. The keratoconus (n = 11, age 35.0 (SD 11.1) years), forme fruste keratoconus (n = 6, 33.0 (13.0)), PK (n = 21, 41.2 (7.9)), and control (n = 24, 33.7 (8.6)) groups were similar in age. Vision testing, conducted with optimal refractive correction in place, included low contrast visual acuity (LCVA) and Pelli-Robson contrast sensitivity (PRCS) both with and without glare, as well as VA. RESULTS: Normal subjects saw better than PK subjects who in turn saw better than keratoconus subjects on all raw measures. However, when adjusted for VA, the normal group only saw significantly better than the keratoconus group on LCVA (low contrast loss 0.05 (0.04) v 0.15 (0.12), F(2,48) = 6.16; p<0.01, post hoc Sheffe p<0.05), and the decrements to glare were no worse than for normals. The forme fruste keratoconus group were indistinguishable from normals on all measures. CONCLUSIONS: PK subjects have superior vision to keratoconus subjects, but not as good as normal subjects. Including mild keratoconus subjects within a keratoconus group could confound these differences in vision. While VA is an excellent test for comparing normal, keratoconus and PK groups, additional information can be provided by LCVA and PRCS, but not by glare testing. Outcomes research into keratoconus management should include a measure in the contrast domain.
URI: http://hdl.handle.net/2328/996
ISSN: 0007 1161
Appears in Collections:Konrad Pesudovs
Doug Coster

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