title: Temporal contrast sensitivity using full-field flicker test (Erlangen flicker test) in patients after penetrating keratoplasty.
abstract: BACKGROUND
  The purpose of this study was to evaluate the feasibility of temporal contrast sensitivity testing using full-field flicker stimulation in patients after penetrating keratoplasty (PK) and to assess whether this method is influenced by postoperative corneal topographic changes.
  
  
  METHODS
  Forty-five patients (age 46.5+/-14.2, median 47 years) who had undergone PK and 194 age-matched controls were included in this study. The postoperative interval was 11.8+/-10.2 months (median 9 months). Patients with pre-existing glaucoma or any postoperative intraocular pressure elevation were excluded. The indications for PK were keratoconus in 54% of cases, Fuchs' dystrophy in 38% and stromal dystrophies in 8%. Temporal contrast sensitivity was determined with sinusoidal flickering light (37.1 Hz) of constant mean photopic luminance (10 cd/m(2)) presented in a full-field bowl with an increasing threshold strategy.
  
  
  RESULTS
  Mean temporal contrast sensitivity did not differ between patients after PK (1.49+/-0.13, range 1.26-1.78, confidence interval 1.45-1.53) and controls (1.55+/-0.17, range 1.16-1.98, confidence interval 1.47-1.51). No significant correlation between temporal contrast sensitivity and visual acuity could be found in patients after PK or in normals ( r<0.2, P=0.3). In patients after PK, temporal contrast sensitivity was statistically independent of keratometric astigmatism ( r=0.3, P=0.7), topographic astigmatism ( r=0.3, P=0.4), spherical equivalent ( r=0.07, P=0.7), central corneal thickness ( r=-0.06, P=0.7) and time since operation ( r=-0.07, P=0.6).
  
  
  CONCLUSIONS
  Temporal contrast sensitivity using full-field flicker stimulation seems to be feasible in patients after PK and does not depend on topographic changes of the cornea. The results indicate that the full-field flicker test may be helpful as a supplementary means of detecting early glaucoma caused by ocular hypertension in patients after PK.
authors.affiliation: Department of Ophthalmology and University Eye Hospital, University of Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen, Germany. nhung.nguyen@augen.imed.uni-erlangen.de
authors.forename: Nhung X
authors.initials: NX
authors.lastname: Nguyen
authors.forename: Folkert K
authors.initials: FK
authors.lastname: Horn
authors.forename: Berthold
authors.initials: B
authors.lastname: Seitz
authors.forename: Claus
authors.initials: C
authors.lastname: Cursiefen
authors.forename: Peter
authors.initials: P
authors.lastname: Martus
authors.forename: Achim
authors.initials: A
authors.lastname: Langenbucher
authors.forename: Michael
authors.initials: M
authors.lastname: Küchle
mesh_terms: D000328:Adult; D000368:Aged; D015350:Contrast Sensitivity / Q000502:physiology*; D003315:Cornea / Q000502:physiology*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D014787:Vision Tests