Improvement of visual function with glare testing after photorefractive keratectomy and radial keratotomy.
OBJECTIVE
To evaluate the effect of a glare source on visual function in patients after photorefractive keratectomy and radial keratotomy.


METHODS
Thirteen patients (22 eyes) who underwent photorefractive keratectomy and 20 patients (40 eyes) who underwent radial keratotomy were evaluated in this cross-sectional study. LogMAR visual acuity and contrast sensitivity were measured. Pupils were measured with the Rosenbaum card. A halogen/tungsten glare source approximated the luminance of headlights of an oncoming car at 100 feet.


RESULTS
In the photorefractive keratectomy and radial keratotomy groups, pupils were significantly smaller (P<.01) and the pupillary clearance of the ablation zone in photorefractive keratectomy and the clear zone in radial keratotomy were significantly larger under the glare condition (P<.01). In the photorefractive keratectomy group, visual acuity and contrast sensitivity under the glare condition were significantly higher than in the no-glare condition (P = .02). In the radial keratotomy group, contrast sensitivity under the glare condition was significantly higher than under the no-glare condition (P = .001 to .003).


CONCLUSIONS
After photorefractive keratectomy or radial keratotomy, the traditional glare source constricted the pupil and partially masked the optical aberrations, which resulted in an improvement in visual function. A "pupil-sparing" aberration test is needed for evaluation of visual function after refractive surgery.
Boxer Wachler
B S
BS
Jules Stein Eye Institute, Department of Ophthalmology, University of California, Los Angeles 90095, USA. bbw@jsei.ucla.edu
Durrie
D S
DS
Assil
K K
KK
Krueger
R R
RR
D000328:Adult; D015350:Contrast Sensitivity; D003430:Cross-Sectional Studies; D005260:Female; D019466:Glare; D006801:Humans; D007646:Keratotomy, Radial; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D018903:Photorefractive Keratectomy; D011184:Postoperative Period; D011680:Pupil; D016896:Treatment Outcome; D014787:Vision Tests; D014785:Vision, Ocular; D014792:Visual Acuity