Agreement of wavefront-based refraction, dry and cycloplegic autorefraction with subjective refraction

To evaluate the agreement of dry, and cycloplegic autorefraction and wavefront-based refraction with subjective refraction.

83 subjects aged 19-57 years were included in this cross-sectional study. Refractive status was determined using four methods including subjective refraction, wavefront-based refraction, dry and cycloplegic autorefraction. Refractive data were recorded as sphere, cylinder and spherical equivalent (SE). Power vector components were used to compare the astigmatism obtained using the different methods of refraction.

The more negative spherical, cylindrical and SE components were obtained using dry autorefraction, wavefront-based refraction and dry autorefraction, respectively. The less negative spherical, cylindrical and SE components were obtained using cycloplegic autorefraction, subjective refraction and cycloplegic autorefraction, respectively. Considering the spherical component, there was a statistically significant hyperopic shift (0.12 ± 0.29 D, p = 0.001) with cycloplegic autorefraction and a significant myopic shift (-0.17 ± 0.32 D, p < 0.001) with dry autorefraction compared to subjective refraction, while the difference between wavefront-based and subjective refraction was not significant statistically (p = 0.145). The calculated cylindrical component using subjective refraction showed statistically significant difference with dry auto-refraction (p < 0.001), cycloplegic auto-refraction (p = 0.041) and wavefront refraction (p < 0.001). The highest correlation with subjective refraction in sphere, cylinder and SE was observed for cycloplegic auto-refraction (r_s = 0.967), dry auto-refraction (r_s = 0.983) and cycloplegic auto-refraction (r_s = 0.982), respectively.

As subjective refraction is gold standard in our study, sphere in cycloplegic auto-refraction and astigmatism in dry auto-refraction showed better agreement and correlation.