We studied the effect of radial keratotomy on contrast sensitivity in 69 individuals with one eye operated and one eye unoperated in the Prospective Evaluation of Radial Keratotomy (PERK) Study, with a mean follow-up time of 13.8 months (range 6 months to 31 months). We tested contrast sensitivity under normal daylight conditions using both photographic plates and a computer-video apparatus. On average, we found no clinically meaningful loss of contrast sensitivity in eyes after radial keratotomy. However, eyes with radial keratotomy showed a statistically significant decrease in contrast sensitivity at the higher spatial frequencies of 12 and 18 cycles per degree, although all values were within the previously established normal range. Specifically, 44% of the patients had approximately the same contrast sensitivity in both eyes; 40% of the patients had 50% less contrast sensitivity in the operated eye than in the unoperated eye; 16% of the patients had 50% more contrast sensitivity in the operated eye than in the unoperated eye. Contrast sensitivity improved gradually in operated eyes between 6 months and 2 years after surgery. Eyes with radial keratotomy, in which the diameter of the pupil was the same size as or larger than the central clear zone, had slightly decreased contrast sensitivity compared to eyes in which the pupil was smaller than the clear zone.