WITHDRAWN_A comparison of refraction data from Hartmann-Shack wavefront and adaptive optics visual simulator to other established methods of refraction

Abstract

Purpose : To compare Hartmann-Shack wavefront refraction and adaptive optics visual simulator to clinical refraction, and to investigate the effect of age, refractive error and presence of ocular conditions

Methods : Non-cycloplegic monocular subjective refraction was obtained in heterogeneous sample of 432 subjects with 4 different refraction methods: 1) subjective clinical refraction by a qualified optometrist (ClinicianRefraction); 2) autorefraction (The Accuref-K 9001 instrumen); 3) Hartmann-Shack wavefront refraction (WavefrontRefraction); and 4) subjective refraction performed on an adaptive optics visual simulator (AORefraction). The Visual Adaptive Optics instrument (VAO, Voptica, S.L., Spain) was used for both the wavefront refraction and the adaptive optics subjective refraction. Subjects were divided into 3 age groups: (1) 18 and 40 years of age; (2) between 41 and 60; (3) older than 60 years of age. Refractive error had 3 levels: myopia; emmetropia; and hyperopia. Emmetropia was defined as the best corrected spherical equivalent between -0.25 to +0.75 D. Ocular conditions was a dichotomic variable with two levels: presence or absence of ocular pathology. Data was analyzed with the 95% Limits of Agreement for each power vector component (M, J₀ and J₄₅)

Results : The median spherical equivalent difference and the limits of agreement with the clinical subjective refraction were (+0.13, ±0.90), (+0.38, ±1.00) and (-0.38, ±1.15) D for AORefraction, WavefrontRefraction and Autorefraction, respectively. When considering only healthy subjects, the results were (+0.00, ±0.90), (+0.38, ±0.95) and (-0.34, ±0.85), respectively. Analogously, when considering only those subjects with any ocular condition, the results were (+0.13, ±1.00), (+0.37, ±1.15) and (-0.50, ±1.95) D

Conclusions : The AORefraction is more accurate than WavefrontRefraction and Autorefraction, regardless of age, refractive error or the presence of ocular conditions. The presence of ocular conditions significantly deteriorates the accuracy of all refraction methods therefore the comparison between refraction methods and the validation of new refraction equipment should be interpreted only within the scope of the typology of the sample measured

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.