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Comparative Study
. 2015 Apr-Jun;8(2):109-15.
doi: 10.1016/j.optom.2014.11.001. Epub 2014 Dec 11.

Comparison of refractive assessment by wavefront aberrometry, autorefraction, and subjective refraction

Jeffrey R Bennett  1 , Gina M Stalboerger  2 , David O Hodge  3 , Muriel M Schornack  2
Affiliations
Comparative Study

Comparison of refractive assessment by wavefront aberrometry, autorefraction, and subjective refraction

Jeffrey R Bennett et al. J Optom. 2015 Apr-Jun.

Abstract
in English, Spanish

Purpose: To compare refractive assessment results obtained with an aberrometer, an autorefractor, and manual subjective refraction (SR) in a healthy population with optimal visual potential.

Methods: Sixty adults aged 18-59 years with visual acuity of 20/25 or better, no media opacity, and no known corneal or retinal abnormalities were recruited during the course of routine eye examination. Refractive error in both eyes of each patient was assessed by 3 methods: manual SR, a Nidek 530-A autorefractor (AR), and a Nidek OPD-II Scan wavefront aberrometer (OPD). The order of testing was randomized. One technician collected all OPD and AR measurements, and 1 optometrist performed manual SR. Refractive measurements were converted from spherocylindrical prescriptions to power vectors and compared between methods by 2-factor repeated measures and Bland-Altman analysis.

Results: Analysis of the power vectors followed by a log transformation showed no significant difference in refractive results between AR, OPD, and SR (P=.63). Bland-Altman analysis identified mean differences (95% CI of limits of agreement) of -0.06 (-0.67 to 0.55) for OPD vs SR, 0.001 (-0.522 to 0.524) for AR vs SR, and 0.06 (-0.541 to 0.662) for AR vs OPD.

Conclusion: Agreement between all refractive assessments was comparable to previously reported agreement between repeated measures of SR. Agreement between AR and SR was slightly stronger than between OPD and SR. Although both the OPD and AR results, in general, showed a high level of agreement with SR, results beyond ±0.50D (5.8% for AR, 10% for OPD) would discourage prescribing spectacles directly from either instrument.

Objetivo: Comparar los resultados de la evaluación refractiva obtenidos mediante aberrómetro, autorefractómetro y refracción subjetiva manual (RS) en una población sana con un potencial visual óptimo.

Métodos: Se reclutó a sesenta adultos de edades comprendidas entre 18 y 59 años, con agudeza visual de 20/25 o superior, sin opacidad de medios, y sin anomalías retinianas o corneales, en el curso de un examen ocular rutinario. Se evaluó el error refractivo en los dos ojos de cada paciente mediante tres métodos: RS manual, un autorrefractómetro (AR) Nidek 530-A, y un aberrómetro por frente de onda Nidek OPD-II Scan (OPD). El orden de las pruebas fue aleatorio. Un técnico recolectó todas las mediciones de OPD y AR, y un optometrista llevó a cabo la RS manual. Las mediciones refractivas se transformaron de prescripciones esferocilíndricas en vectores de potencia, comparándose entre sí los tres métodos mediante mediciones repetidas de dos factores y análisis de Bland–Altman.

Resultados: El análisis de los vectores de potencia, seguido de una transformación logarítmica, no reflejó ninguna diferencia significativa de los resultados refractivos entre AR, OPD, y RS (P = 0,63). El análisis de Bland–Altman identificó diferencias medias (95% de IC de los límites de acuerdo) de–0,06 (–0,67-0,55) D para OPD frente a RS, 0,001 (–0,522-0.524) D para AR frente a RS, y 0,06 (–0,541-0,662) D para AR frente a OPD.

Conclusión: La concordancia entre todas las evaluaciones refractivas fue comparable a la concordancia previamente reportada entre las mediciones repetidas de RS. La concordancia entre AR y RS fue ligeramente superior que entre OPD y RS. Aunque en general los resultados de OPD y AR reflejaron un elevado nivel de concordancia con RS, los resultados que exceden la diferencia de ±0.50D (5.8% para AR, 10% para OPD) no permiten realizar la prescripción de gafas con cualquiera de ambos instrumentos.

Keywords: Aberrometry; Aberrometría; Autorefracción; Autorefraction; Errores Refractivos; Frente de onda; Refracción; Refraction; Refractive errors; Wavefront.

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Figures

Figure 1
Figure 1
Bland–Altman plot. Comparison of power vector results between the Nidek OPD-II Scan aberrometer (OPD) and subjective refraction (SR). The 95% limits of agreement are indicated by the upper and lower dashed lines, and the mean is indicated by the solid line.
Figure 2
Figure 2
Bland–Altman plot. Comparison of power vector results between the Nidek 530-A autorefractor (AR) and subjective refraction (SR). The 95% limits of agreement are indicated by the upper and lower dashed lines, and the mean is indicated by the solid line.
Figure 3
Figure 3
Bland–Altman plot. Comparison of power vector results between the Nidek OPD-II Scan aberrometer (OPD) and the Nidek 530-A autorefractor (AR). The 95% limits of agreement are indicated by the upper and lower dashed lines, and the mean is indicated by the solid line.
See this image and copyright information in PMC

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