Choice of spatial frequency for contrast sensitivity evaluation after corneal refractive surgery.

PURPOSE To study the utility of measurements of contrast sensitivity at different spatial frequencies as an index of visual recovery following refractive surgery. METHODS Contrast sensitivity at 1.5, 3, 6, 12, and 18 c/deg was measured with the Stereo Optical FACT chart in 20 patients after photorefractive keratectomy (PRK) using the Nidek EC-5000 excimer laser system, and in 18 patients following laser in situ keratomileusis (LASIK). Contrast sensitivity was measured preoperatively and 1, 3, 6, and 12 months after surgery. RESULTS Results showed a statistically significant reduction (P<.01) in contrast sensitivity at all spatial frequencies in PRK patients during the first and third month, but contrast sensitivity recovered to preoperative values by 6 months after surgery (P>.1). In LASIK patients, decreased contrast sensitivity values 1 month after surgery were also obtained at all spatial frequencies. After 3 months, contrast sensitivity at 1.5 and 3 c/deg had recovered and did not differ significantly from preoperative values (P>.1), although contrast sensitivity at other frequencies remained reduced (P<.01). At 6 and 12 months, contrast sensitivity at all spatial frequencies did not differ from that obtained preoperatively (P>.1). CONCLUSIONS Contrast sensitivity measurements at 6 and 12 c/deg appear to be most useful in the assessment of patients who have undergone laser refractive surgery because defocus and optical aberrations primarily affect the higher spatial frequencies.