Agreement of a Pyramidal Wavefront-Based Autorefraction with Dry, Cycloplegic, and Subjective Refraction in Myopic...

To evaluate the repeatability of a pyramidal wavefront-based refraction (WFR) measurement and its agreement with dry autorefraction (DR), cycloplegic autorefraction (CR), and subjective refraction (SR) in myopic refractive surgery candidates.

One hundred eighty-nine eyes from 189 participants were evaluated. PERAMIS aberrometry (PERAMIS; SCHWIND eye-tech-solutions, Kleinostheim, Germany), DR, and CR, as well as SR, were completed for all candidates. The repeatability of PERAMIS measurements was assessed, and the Bland-Altman plots were used to test the agreement between different methods.

Repeatability of the PERAMIS aberrometer was very high in the measurement of all refractive elements (Sphere, cylinder, spherical equivalent [M], J0, and J45) (interclass correlation coefficient >0.980 for all). A significant myopic shift was found with WFR compared to CR (0.45 diopter [D]) and SR (0.28 D) (P < 0.05). For the M component, there was a significant difference between WFR and CR (P < 0.05). J0 component measured with WFR was significantly different from SR and CR (P < 0.05). For the J45 variable, all three refraction methods were comparable (all, P > 0.05). In M > 5.00 D, a difference of 0.79 D (limit of agreement: -3.50-1.90) was found between WFR and CR.

In lower degrees of myopia, WFR was in good agreement with the manifest autorefraction. WFR, CR, and SR techniques were comparable in measuring astigmatism, especially in oblique astigmatism.