Purpose: Fourier harmonic analysis can decompose videok- eratography data into spherical power, regular astigmatism, and irregular astigmatism (asymmetry and higher- order irregularity). The aim of this study was to evaluate whether determination of cylinder power by Fourier analysis facilitates measurements of visual acuity and refraction in eyes after penetrating keratoplasty. Design: Cross- sectional study. Participants: Sixty- six eyes of 56 subjects who had undergone penetrating keratoplasty. Methods: Spectacle- corrected visual acuity was measured in 2 ways: by the conventional and the Fourier methods. In the conventional method, the refraction was determined subjectively by reference to the measurement results of the autokeratometer and autorefractometer. In the Fourier method, the magnitude and axis of regular astigmatism were calculated by Fourier analysis of the videokeratography data, and spherical lenses were adjusted until best spectacle- corrected visual acuity was attained. Main Outcome Measures: Logarithm of the minimum angle of resolution (logMAR) visual acuity and refraction used for correction. Results: The spectacle- corrected visual acuity obtained with the Fourier method (logMAR, 0.23± 0.32; Snellen equivalent, 20/34) was significantly better than that attained with the conventional method (logMAR, 0.31± 0.29; Snellen equivalent, 20/41; P< 0.001, paired t test). The cylinder power used for spectacle- corrected visual acuity measurements was significantly lower with the Fourier method (- 2.41± 1.26 diopters [D]) than with the conventional method (- 3.53± 1.64 D;P< 0.001). The spherical equivalent at the final refraction was not different between groups (P=0.207). Conclusions: Fourier analysis of videokeratography data significantly facilitates determination of refraction and measurement of best spectacle- corrected visual acuity in eyes with corneal irregular astigmatism, such as eyes that have undergone penetrating keratoplasty.
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