Effect of Monofocal, Wavefront-Shaped, and Diffractive Trifocal Intraocular Lenses on Scanning-Slit Automated...

Area of Science:

• Ophthalmology
• Refractive Surgery
• Optometry

Background:

• Accurate refractive error assessment is crucial for visual outcomes after cataract surgery.
• Intraocular lenses (IOLs) can influence refractive measurements.
• Automated refraction methods are increasingly used but require validation against subjective refraction.

Purpose of the Study:

• To compare scanning-slit retinoscopy automated refraction spherical equivalent (ARSE) with subjective manifest refraction spherical equivalent (MRSE).
• To evaluate the accuracy of ARSE across four different types of intraocular lenses (IOLs) in pseudophakic eyes.

Main Methods:

• A retrospective cross-sectional study included 279 pseudophakic eyes implanted with specific IOLs (Vivity, Panoptix, Tecnis, Envista).
• Automated refraction (NIDEK OPD Scan III) and subjective refraction data were collected 1-2 months postoperatively.
• The primary outcome was the difference between ARSE and MRSE.

Main Results:

• Automated refraction (ARSE) consistently yielded statistically significant myopic results compared to subjective refraction (MRSE) across all four IOL groups.
• Significant myopic shifts were observed for Vivity (-0.95 D), Panoptix (-0.43 D), Tecnis (-0.81 D), and Envista (-0.75 D) IOLs.
• The absolute difference between ARSE and MRSE was statistically significant in the Vivity IOL group.

Conclusions:

• Automated refraction tends to produce myopic results in pseudophakic eyes with both monofocal and presbyopia-correcting IOLs.
• Clinicians should use automated refraction with caution in post-cataract surgery patients.
• Employing the manifest refraction "push-plus" technique is recommended to avoid over-minus prescriptions, particularly in cases of residual refractive error.