Background: The image optical quality is affected by changes in corneal shape of patients with keratoconus. The goal of this study was to explore which corneal parameters determine the visual quality in keratoconus subjects, which corneal slope parameter has the strongest correlation with visual quality and contrast sensitivity.
Methods: The study covered eyes of 77 subjects, graded from the first to third keratoconus stages. To characterize the shape of cornea, we obtained measurements in two ways: (a) projected two perpendicular axes onto a cornea – the main axis passed through the central point of the cornea (visual axis projection) and keratoconus apex, while the second axis was perpendicular to the main axis – and read elevation values at points on theses axis; (b) projected circles with different diameters around the central part of the cornea (1, 2 and 3 mm) and read elevation values at points equally displaced on these circles. The measurements were used to calculate various elevation change (slope) parameters.
Results: According to the acquired data, the visual acuity of a corrected eye does not have a strong correlation with the measured keratoconus apex slope. Contrast sensitivity displayed a strong correlation with keratoconus slope in the central part of the cornea (with a radius of 1 mm). Correlations in different spatial frequencies ranging from 0.47 to 0.6.
Conclusion: Contrast sensitivity is more important parameter which describes the visual quality of keratoconus subjects than visual acuity. The most important region which determines the visual quality in keratoconus subjects is the region with a 1 mm radius of the corneal centre in the opposite direction of keratoconus apex.