Clinical Comparison of High-Resolution and Standard Refractions and Prescriptions

Abstract

Significance Recently, novel refraction and lens manufacturing technology claims to provide more efficient, higher-resolution refractions and resulting lenses. It is unclear, however, if these benefits are realized and appreciated by the patient. Purpose This study investigated benefits and drawbacks of high-resolution refraction technology over standard, specifically in terms of the refraction, glasses prescription, and participant’s perceptions of the technology. Methods Sixty progressive addition lens (PAL) wearers (aged 35-70) and 60 single-vision (SV) wearers (age 18+) were randomized to a high-resolution refraction (Vision-R 800, essilorinstrumentsusa.com) and standard refraction in a 2-week crossover dispensing design. Refractive results were converted to M, J0 and J45 and analyzed using multivariate t-tests. Bayesian estimation was used to analyze differences between refraction type and age group for subjective outcomes. Results Differences in refractive error between the two refractions were small and none differed statistically (P value > .05) or clinically (e.g., <0.25D) in either subgroup. Visual acuities at distance and near were better than 0.00 logMAR; none of the mean differences between the refractions reached statistical or clinical (e.g., <0.25D) significance. Participants significantly preferred the high-resolution refraction for its quickness and efficiency, improved comfort, and less stress. Bayesian analysis indicated a 76% probability that participants had higher confidence in the high-resolution refraction, 93% probability they would seek it out for their care, and 94% probability they would recommend an optometrist using this technology. Conclusions Refractive and acuity endpoints were similar with the high-resolution and standard refraction. Participants, however, perceived several key benefits of the high-resolution refraction and prescription for their care, the care of their friends/family, and the practice itself.