Comparing Subjective Refraction And Autorefraction After Implantation Of Premium Lenses

To evaluate and compare the subjective manifest refraction (MR) obtained from optician with three diverse objective autorefraction devices (Pentacam®AXL Wave, iTrace and Autorefractor KR-800) aftre implantation of toric lenses (EDOF toric (Vivity), Multifocal toric (Panoptix)) compared to a monofocal control lens (monofocal toric SA6ATx), all lenses with the same material (Alcon, Laboratories). 

Ophthalmological Department, Goethe University of Frankfurt, Germany.

Prospective, comparative study on patients undergoing femtosecondlaser-assisted cataract surgery and implantation of three different toric lenses: monofocal toric, extented depth of focus toric and multifocal toric. A total of 30 subjects (54 eyes) were presented in our clinic for a follow up 3 months after the surgery. Manifest refraction (MR) was always performed under the same lighting conditions for all the patients. For objective refraction the autorefractor TopCon KR800 (TopCon Healthcare), the Pentacam®AXL(Oculus, Wetzlar) and the iTrace ( Tracey Technologies) were used. For each eye included in the study were collected following results: MR, AR-T, AR-P, AR-iT(Autorefraction measured with the above autorefractors respectively).

Statistical analysis showed no significant differences in the comparison between MR and Autorefractor TopCon KR800. There was a significant difference in the sphere and cylinder measures on the iTrace with a p-Value of p=0.001 and p=0.001 respectively. Significant difference in the cylinder on the Pentacam®AXL Wave with a p-Value of 0.001 was recorded and also signifcant change of the sperical equivalent was recorded with Pentacam®AXL Wave and with iTrace with a p-Value of 0.004 respectively. Vector analysis with Alpins methode showed that the Autorefractor KR800 with a difference vector of DV 0,21 @ 71° provided the smallest possible deviation from the comparison with the MR, than the other devices.

We found congruent results of statistical and vector analysis:

In two independent methods, TopConKR800 autorefractor showed the smallest deviation from the MR.

In both statistical and vector analysis, i-Trace measured larger values ​​than MR.

In both statistical and vector analysis, Pentacam®AXL Wave  measured smaller values ​​than MR.

MR remains the gold standard for refraction and visual evaluation after implantation of premium lenses.