Refractive Outcomes, Contrast Sensitivity, HOAs, and Patient Satisfaction in Moderate Myopia: Wavefront-Optimized Versus Tissue-Saving PRK.

PURPOSE: To compare refractive outcomes, contrast sensitivity, higher-order aberrations (HOAs), and patient satisfaction after photorefractive keratectomy for correction of moderate myopia with two methods: tissue saving versus wavefront optimized. METHODS: In this prospective, comparative study, 152 eyes (80 patients) with moderate myopia with and without astigmatism were randomly divided into two groups: the tissue-saving group (Technolas 217z Zyoptix laser; Bausch & Lomb, Rochester, NY) (76 eyes of 39 patients) or the wavefront-optimized group (WaveLight Allegretto Wave Eye-Q laser; Alcon Laboratories, Inc., Fort Worth, TX) (76 eyes of 41 patients). Preoperative and 3-month postoperative refractive outcomes, contrast sensitivity, HOAs, and patient satisfaction were compared between the two groups. RESULTS: The mean spherical equivalent was -4.50 ± 1.02 diopters. No statistically significant differences were detected between the groups in terms of uncorrected and corrected distance visual acuity and spherical equivalent preoperatively and 3 months postoperatively. No statistically significant differences were seen in the amount of preoperative to postoperative contrast sensitivity changes between the two groups in photopic and mesopic conditions. HOAs and Q factor increased in both groups postoperatively (P = .001), with the tissue-saving method causing more increases in HOAs (P = .007) and Q factor (P = .039). Patient satisfaction was comparable between both groups. CONCLUSIONS: Both platforms were effective in correcting moderate myopia with or without astigmatism. No difference in refractive outcome, contrast sensitivity changes, and patient satisfaction between the groups was observed. Postoperatively, the tissue-saving method caused a higher increase in HOAs and Q factor compared to the wavefront-optimized method, which could be due to larger optical zone sizes in the tissue-saving group.

Effect of cataract type and severity on visual acuity and contrast sensitivity.

PURPOSE: To determine the effect of cataract type and severity in eyes with pure types of age-related lens opacities on visual acuity (VA) and contrast sensitivity in the presence and absence of glare conditions. METHODS: Sixty patients with senile cataracts aged 40 years or older with no other ocular pathologies were evaluated for VA and contrast sensitivity with and without glare. Lens opacities were classified according to the Lens Opacities Classification System (LOCS) III. VA was measured using the Snellen chart. Contrast sensitivity was measured with the Vector Vision CSV-1000E chart in the presence and absence of glare by calculating the area under log contrast sensitivity (log CS) function (AULCSF). RESULTS: Cataracts were posterior subcapsular in 26 eyes, cortical in 19 eyes and nuclear in 15 eyes. VA significantly decreased with increasing cataract severity and there was significant loss of contrast sensitivity at all spatial frequencies with increasing cataract severity. AULCSF significantly decreased with increasing cataract severity in the presence and absence of glare conditions. Contrast sensitivity was significantly reduced at high spatial frequency (18 cpd) in cortical cataracts in the presence of glare in day light and at low spatial frequency (3 cpd) in night light. CONCLUSION: Increased cataract severity is strongly associated with a decrease in both VA and AULCSF. Contrast sensitivity scores may offer additional information over standard VA tests in patients with early age-related cataracts.

Contrast Sensitivity versus Visual Evoked Potentials in Multiple Sclerosis.

PURPOSE: To compare the Cambridge contrast sensitivity (CS) test and visual evoked potentials (VEP) in detecting visual impairment in a population of visually symptomatic and asymptomatic patients affected by clinically definite multiple sclerosis (MS). METHODS: Fifty patients (100 eyes) presenting with MS and 25 healthy subjects (50 eyes) with normal corrected visual acuity were included in this study. CS was determined using the Cambridge Low Contrast Grating test and VEP was obtained in all eyes. Findings were evaluated in two age strata of 10-29 and 30-49 years. RESULTS: Of the 42 eyes in the 10-29 year age group, CS was abnormal in 22 (52%), VEP was also abnormal in 22 (52%), but only 12 eyes (28%) had visual symptoms. Of the 58 eyes in the 30-49 year group, CS was abnormal in 7 (12%), VEP was abnormal in 34 (58%), while only 11 eyes were symptomatic. No single test could detect all of the abnormal eyes. CONCLUSION: The Cambridge Low Contrast Grating test is useful for detection of clinical and subclinical visual dysfunction especially in young patients with multiple sclerosis. Nevertheless, only a combination of CS and VEP tests can detect most cases of visual dysfunction associated with MS.