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[Comparison between binocular, open-field auto ref/keratometer and conventional autorefractor].

Xiu-hua Wan1, Zhong Lin, Xiao-gu Cai

  • 1Beijing Ophthalmol & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, China.

[Zhonghua Yan Ke Za Zhi] Chinese Journal of Ophthalmology
|September 5, 2012
PubMed
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A binocular, open-field auto ref/keratometer offers more hyperopic refractive results than conventional autorefractors. This device is valuable for clinical screening and research due to reduced instrument myopia.

Area of Science:

  • Ophthalmology
  • Optometry
  • Vision Science

Background:

  • Accurate refractive error assessment is crucial for diagnosing and managing visual impairments in children.
  • Conventional autorefractors are widely used but can be influenced by accommodation, leading to instrument myopia.
  • Open-field autorefractors offer a potentially more naturalistic method for refractive assessment.

Purpose of the Study:

  • To compare refractive outcomes between a binocular, open-field auto ref/keratometer (WAM) and a conventional autorefractor (K9001).
  • To evaluate the impact of cycloplegic refraction on the differences observed between the two devices.
  • To assess the clinical utility of the open-field auto ref/keratometer in pediatric populations.

Main Methods:

  • A cohort of 304 primary and secondary school students underwent non-cycloplegic and cycloplegic objective refractions.

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  • Measurements were taken using a conventional autorefractor (K9001) and a binocular, open-field auto ref/keratometer (WAM).
  • Coincidence rates for sphere, spherical equivalent (SE), and axis were calculated, alongside Bland-Altman and distribution analyses of SE differences.

    • Main Results:

    • The WAM showed significantly higher coincidence rates for sphere (94.4%) and SE (95.1%) after cycloplegia compared to pre-cycloplegia (77.3%, 78.6%).
    • Post-cycloplegia, the mean SE difference between WAM and K9001 was minimal (-0.08 D), indicating good agreement.
    • The K9001 exhibited a larger refractive shift between non-cycloplegic and cycloplegic states compared to the WAM, suggesting less instrument myopia with the WAM.

    Conclusions:

    • The binocular, open-field auto ref/keratometer yields more hyperopic readings compared to conventional autorefractors.
    • The WAM demonstrates reduced instrument myopia, making it a potentially superior tool for pediatric eye screening and research.
    • Cycloplegic refraction significantly improves agreement between the two autorefractor types, particularly for the WAM.