Repeatability and reproducibility of manifest refraction

Taneri, Suphi; Arba-Mosquera, Samuel; Rost, Anika; Kießler, Saskia; Dick, H. Burkhard

doi:10.1097/j.jcrs.0000000000000343

Cited by 24 publications

(16 citation statements)

References 20 publications

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“…Considering the agreement for subjective refraction, the difference in absolute value increased significantly with the measured spherical magnitude. Likewise, the difference in absolute value increased significantly with the measured cylinder magnitude, while the difference in axis decreased significantly with the measured cylinder magnitude 24 . We also observed a significant association in the differences for M, J 0 and J 45 power vectors across the three aberrometers as the power vector magnitude changed (Figure 2).…”

Section: Discussionsupporting

confidence: 51%

“…Likewise, the difference in absolute value increased significantly with the measured cylinder magnitude, while the difference in axis decreased significantly with the measured cylinder magnitude. 24 We also observed a significant association in the differences for M, J 0 and J 45 power vectors across the three aberrometers as the power vector magnitude changed (Figure 2). The intrasession repeatability of aberrometers could be influenced by fluctuations in accommodation, tear film instability and micro eye movements.…”

Section: Discussionmentioning

confidence: 62%

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Wavefront aberrometry repeatability and agreement—A comparison between Pentacam AXL Wave, iTrace and OPD‐Scan III

Wan

Liao

et al. 2022

Ophthalmic Physiologic Optic

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Introduction To compare intrasession agreement and repeatability of wavefront aberration measurements from three different aberrometers obtained using Hartmann–Shack, ray tracing and automated retinoscopy methods, as well as their interdevice agreement. Methods Three consecutive measurements were obtained using the Pentacam AXL Wave, the iTrace and the OPD‐Scan III in 47 eyes of 47 patients. Wavefront refractions, root mean square of total aberrations (RMS total), RMS of higher‐order aberrations (HOA) and second‐, third‐ and fourth‐order HOAs were exported for 4‐mm pupils. Wavefront refractions were converted into vector components: M, J0 and J45. Intrasession agreement and repeatability were evaluated using intraclass correlation coefficients (ICCs) and repeatability coefficients (RCs); interdevice agreement was assessed using the Bland–Altman method. Results The intrasession agreement and repeatability of RMS HOA were comparable between the three devices; both the Pentacam AXL Wave and the OPD‐Scan III had better intrasession agreement and repeatability for the RMS total than the iTrace (p ≤ 0.02). Intrasession repeatability for the majority of second‐ and third‐order aberrations was better on the Pentacam AXL Wave than on the iTrace (p ≤ 0.01) and OPD‐Scan III (p ≤ 0.04), although their agreement and repeatability in spherical aberration were comparable (p ≥ 0.24). Significant systematic differences and proportional bias were detected for almost all refraction power vectors and Zernike coefficients among the three devices. Conclusions In this study, all three devices provided good‐to‐excellent agreement for aberration measurements. Most of the individual Zernike's components were not exchangeable between different aberrometers. Their relative intrasession performance in agreement and repeatability varied significantly across different ocular aberration parameters.

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 62%

Wavefront aberrometry repeatability and agreement—A comparison between Pentacam AXL Wave, iTrace and OPD‐Scan III

Wan

Liao

et al. 2022

Ophthalmic Physiologic Optic

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“…This was also the first time anyone has deeply investigated the participants’ attitudes toward tele-controlled subjective refraction. In our cross-sectional study, we found no statistically significant differences between traditional subjective refraction and tele-controlled subjective refraction for any parameters, and the 95% limits of agreement between the 2 methods of refraction in the S (±0.42 D), C (±0.39 D), and SE (±0.36 D) were both similar to a previous study on reproducibility of subjective refraction (±0.44 D 16 for S, ±0.31 D 17 for C, and ±0.37 D to ±0.56 D 18 – 21 for SE). Researchers generally agree that the variation of refractive error should be at least ±0.50 D and consider this to be the minimum significant shift in a refractive state.…”

Section: Discussionsupporting

confidence: 84%

The Reliability and Acceptability of RDx-Based Tele-Controlled Subjective Refraction Compared with Traditional Subjective Refraction

Huang

Yan

et al. 2022

Trans. Vis. Sci. Tech.

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Purpose The purpose of this study was to compare the reliability and acceptability of tele-controlled subjective refraction supported by RDx, a new technique that involves optical software designed for controlling phoropters remotely, to traditional subjective refraction. Methods Sixty-five participants underwent tele-controlled subjective refraction and traditional subjective refraction randomly and nine of them underwent the second tele-controlled subjective refraction measurement on the same day. After their examinations, we distributed a validated satisfaction questionnaire to each participant. The elapsed time taken for refraction, sphere (S), cylinder (C), spherical equivalent (SE), vertical and oblique cylindrical vectors (J 0 and J 45 ), and best corrected visual acuity (BCVA) were compared. Age and refractive error type were included as covariates. Bland-Altman analysis was used to assess the agreement between both methods of refraction. Results The mean age was 20.5 ± 5.9 years for all participants (aged 9 to 40 years); 57% were female participants. The repeatability analysis of tele-controlled method showed no significant differences for all parameters ( P > 0.05). We found no statistical differences ( P > 0.05) between tele-controlled subjective refraction and traditional subjective refraction for all parameters in either group. The mean difference and 95% limits of agreement for SE, J 0 , and J 45 were −0.03 ± 0.36 diopters (D), −0.00 ± 0.57 D, and −0.01 ± 0.79 D, respectively. The tele-controlled method took more time to perform than the traditional one ( P < 0.05). Completed questionnaires were returned by 55 participants (85%), and they showed high satisfaction and acceptance of the tele-controlled method (98%). Conclusions Tele-controlled subjective refraction results agreed with traditional subjective refraction for all refraction components except for cylinder vectors. In addition, the broad acceptability of tele-controlled subjective refraction means practicability in clinical practice. Translation Relevance The RDx-based tele-controlled method can provide an alternative to subjective refraction, especially in areas that lack experienced optometrists.

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“…When considering this data, it is also important to consider that manifest subjective refraction is not perfect either, and it has a measurement noise of about 0.16 D as recently reported by Taneri et al . [ 19 ] The mean difference between manifest subjective refraction and wavefront-based objective refraction in our study falls well between this measurement noise of subjective refraction alone, which suggests even further that data obtained by both methods are very similar.…”

Section: Discussionsupporting

confidence: 77%

The Pentacam® AXL Wave provides a reliable wavefront-based objective refraction when compared to manifest subjective refraction: A prospective study

Balparda¹,

Acevedo-Urrego

Silva-Quintero

et al. 2022

Indian Journal of Ophthalmology

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Purpose: Accurate refraction is arguably the most important parameter for a successful laser vision correction surgery and is based on a combination of manifest and cycloplegic refraction. Wavefront-based objective refraction may be useful in the evaluation of patients. So far, the reliability of objective refraction as measured using the Pentacam ® AXL Wave has not been published in the literature. Methods: This was a prospective study including a total of 168 eyes belonging to 84 young non-presbyopic patients evaluated for refractive surgery. Pentacam ® AXL Wave full sequence was taken for all patients. Then, a clinician who was unaware of the objective refraction results performed a full physical examination, including manifest refraction starting from an autorefractometer value. All refraction values were transferred to astigmatic power vectors as per the Thibos method. Reliability of the different vectors and a unifying blur value were compared using Spearman correlation, Bland–Altman plot, and intraclass correlation coefficient. Results: The mean age was 28.8 ± 5.4 years, with a female preponderance (60.7%). The correlation between both eyes was high. The difference in M vector between subjective and objective refraction was 0.16 D, while the difference was 0.04 and 0.01 D for the J 0 and J 45 vectors, respectively. Paired samples Student t was non-significant for all comparisons. Spearman rho correlations were high (0.666–0.924, all P < 0.001). Intraclass correlation coefficients were also high (0.890–0.966). Bland–Altman plots did not demonstrate any systematic errors. Conclusion: Wavefront-based refractive refraction obtained using the Pentacam ® AXL Wave is highly agreeable and correlated with measurements obtained by manifest subjective refraction.

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Repeatability and reproducibility of manifest refraction

Cited by 24 publications

References 20 publications

Wavefront aberrometry repeatability and agreement—A comparison between Pentacam AXL Wave, iTrace and OPD‐Scan III

Wavefront aberrometry repeatability and agreement—A comparison between Pentacam AXL Wave, iTrace and OPD‐Scan III

The Reliability and Acceptability of RDx-Based Tele-Controlled Subjective Refraction Compared with Traditional Subjective Refraction

The Pentacam® AXL Wave provides a reliable wavefront-based objective refraction when compared to manifest subjective refraction: A prospective study

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