Forward light scatter and visual acuity before and after intrastromal corneal ring segment implantation at different stages of keratoconus

Abstract

Purpose: to assess forward light scatter (stray light) before and after intrastromal corneal ring segment (ICRS) implantation at different stages of keratoconus and to examine correlation between postoperative stray light and visual acuity (VA). Methods: in 27 eyes of 27 subjects with keratoconus, stray light was determined using the compensation comparison technique before and 6 months after ICRS implantation. Monocular corrected distance VA (CDVA) was measured using a high-contrast logMAR letter chart. Corneal higher-order aberrations (HOAs), contrast sensitivity (CS) and minimum corneal thickness (CT) were also measured. Results: mean CDVA was 0.42 ± 0.28 preoperatively and 0.24 ± 0.15 logMAR postoperatively (p < 0.01). Mean corneal coma-like aberration decreased postoperatively (RMS 0.55 ± 1.18 μm, p < 0.01). Minimum CT increased 25.31 ± 18.59 μm (p < 0.01). Mean preoperative and postoperative stray light were 1.36 ± 0.31 and 1.48 ± 0.32 log units, respectively (p < 0.01). Mean changes produced in stray light (worsening) were 0.03 ± 0.21 (p > 0.05) for stage I, 0.13 ± 0.14 (p = 0.013) for stage II and 0.18 ± 0.21 (p = 0.023) for stage III. Significant positive correlation (r = 0.47, p = 0.01) was detected between postoperative stray light and postoperative CDVA such that as stray light increased, CDVA worsened (higher logMAR values). Postoperative stray light was neither associated with HOAs, CS nor minimum CT. Conclusions: stray light values in these patients with keratoconus were higher than normal preoperatively. In eyes with stage II and III keratoconus, stray light increased 6 months after ICRS placement. Higher postoperative stray light was correlated with a worse visual acuity outcome.