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Predicting visual performance from optical quality metrics in keratoconus.

Paul Schoneveld1, Konrad Pesudovs, Douglas J Coster

  • 1NH&MRC Centre for Clinical Eye Research, Department of Ophthalmology, Department of Ophthalmology, Flinders Medical Centre and Flinders University of South Australia, Bedford Park, South Australia, Australia.

Clinical & Experimental Optometry
|January 20, 2010
PubMed
Summary
This summary is machine-generated.

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Optical quality metrics predict visual performance in keratoconus and post-keratoplasty (PK) eyes. Pupil fraction metrics are best for highly aberrated eyes, correlating strongly with visual acuity.

Area of Science:

  • Ophthalmology
  • Optical Engineering
  • Corneal Disease Research

Background:

  • Keratoconus significantly impacts visual function due to corneal irregularities.
  • Penetrating keratoplasty (PK) is a surgical option for advanced keratoconus, aiming to restore visual clarity.
  • Predicting visual outcomes in these conditions remains a challenge.

Purpose of the Study:

  • To identify optical quality metrics that accurately predict visual performance in eyes with keratoconus.
  • To evaluate the effectiveness of these metrics in eyes that have undergone PK for keratoconus.
  • To compare predictive metrics between normal eyes and those with corneal abnormalities.

Main Methods:

  • A prospective, cross-sectional study included 54 participants (26 keratoconus, 10 PK, 18 normal eyes).

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  • Visual performance was assessed using various visual acuity (VA) and contrast sensitivity tests under different luminance and glare conditions.
  • Corneal wavefront aberrations were analyzed using Orbscan topography, and 31 optical quality metrics were derived.

    • Main Results:

    • Visual performance showed a strong correlation (average r ≈ 0.5) with optical quality metrics.
    • Pupil fraction metrics demonstrated the highest correlations with high- and low-contrast visual acuity at larger pupil sizes.
    • Image plane metrics, such as the volume under the optical transfer function (VOTF), were highly correlated with visual acuity at smaller pupil sizes.

    Conclusions:

    • Visual performance in keratoconus and post-PK eyes is predictable from optical quality metrics, though different metrics are optimal compared to normal eyes.
    • Standard metrics like visual Strehl lack the dynamic range for highly aberrated keratoconic eyes.
    • Pupil fraction metrics, such as PFWc, offer the best predictive power for visual performance in eyes with significant corneal aberrations.