Comparisons of wavefront refraction, autorefraction, and subjective manifest refraction

Hong-Zin Lin^{a, b}, Chien-Chung Chen^c, Yuan-Chieh Lee^{a, b, c, d}

^a Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
^b Graduate Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
^c Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
^d Department of Medicine, Tzu Chi University, Hualien, Taiwan

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Abstract
Objectives

To compare cycloplegic wavefront refraction, autorefraction, and subjective manifest refraction.

Materials and Methods

Thirty-one myopic eyes in 17 patients were studied. Subjective manifest refraction was measured and deemed as the true refraction status. After inducing cycloplegia by administering 1% tropicamide, cycloplegic autorefraction was measured using a Topcon autorefractor, and wavefront refraction was measured with an Allegretto wave analyzer. Refraction data were presented as the spherical equivalent and astigmatism. Astigmatism was converted to vector power and analyzed by the Alpins method.

Results

Both cycloplegic wavefront refraction and autorefraction showed good correlations with subjective refraction. The adjusted R2 value was 0.9726 between cycloplegic autorefraction and subjective manifest refraction, and 0.9693 between cycloplegic wavefront refraction and subjective manifest refraction. Compared with subjective manifest refraction, a myopic shift of −0.14 ± 0.06 D was noted in cycloplegic wavefront refraction (p = 0.0182). However, cycloplegic autorefraction was not different from subjective manifest refraction (p = 0.55). Astigmatism in both wavefront refraction and autorefraction differed from subjective astigmatism (p < 0.0001 for both). The difference of astigmatism vector power from subjective refraction was 0.16 D larger in the cycloplegic wavefront refraction group than in the cycloplegic autorefraction group (p = 0.0039).

Conclusion

Autorefraction gives a better estimate of subjective manifest refraction than wavefront refraction in both the spherical equivalent and astigmatism.

Keywords
Autorefraction; Subjective manifest refraction; Wavefront refraction