A Comparison of a Traditional and Wavefront Autorefraction

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Abstract
Purpose: To evaluate the agreement between the autorefraction function of the Canon RK‐F2, an autorefractor/keratometer based on the ray deflection principle, and the Carl Zeiss Vision i.Profiler Plus , an wavefront aberrometer, compared with each other and with a noncycloplegic subjective refraction. Methods: Objective refraction results obtained using both instruments were compared with noncycloplegic subjective refractions for 174 eyes of 100 participants. Analysis of sphere, cylinder, and axis using spherical equivalent difference and a new measurement, cross‐cylinder difference, was performed. The spherical equivalent refraction and cross‐cylinder difference for the manifest refraction were compared using Bland‐Altman limits of agreement and 95th percentile analysis. Results: The 100 participants represent 52 women and 48 men with a mean (±SD) age of 51.7 (±13.8) years, an average (±SD) spherical power of −0.67 (±2.53) diopters (D), and an average (±SD) cylinder power of −0.94 (±0.87) D. The spherical equivalent difference is 0.03 D (Canon) and −0.11 D (Zeiss). The 95% limits of agreement for the spherical equivalent are −0.69 to 0.75 D (Canon) and −0.75 to 0.75 D (Zeiss). The mean cross‐cylinder power difference is −0.08 D (Canon) and 0.02 D (Zeiss). The 95% limits of agreement for the cross‐cylinder power difference are 0.63 to 0.50 D (Canon) and 0.49 to 0.75 D (Zeiss). The mean axis power difference is −0.04 D (Canon) and 0.05 D (Zeiss). The 95% limits of agreement for axis power difference are −0.71 to 0.63 D (Canon) and −0.78 to 0.78 D (Zeiss). The double‐angle astigmatic plot center of distribution for the RK‐F2 is 0.035 D at 70 degrees, and that for the i.Profiler Plus is 0.053 D at 32 degrees. Conclusions: Both instruments provided clinically useful spherical equivalent refractive data compared with a subjective refraction, whereas the Canon RK‐F2 was slightly more accurate in determining the cylinder power compared with a subjective refraction.

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