Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter

The aim is to evaluate the agreement and accuracy of refraction using a binocular wavefront optometer with the autorefractor and phoropter. To do this, 1 month after corneal refractive surgery, the right eyes of 125 subjects were enrolled in this cross-sectional study. Objective and subjective refractions were measured using a binocular wavefront optometer, an autorefractor, and a phoropter in a noncycloplegic condition. The differences and agreement of refractive data were analyzed using the Wilcoxon signed-rank test and Bland-Altman plots. The differences between sphere (Z=-0.872, p=0.38), J0 (Z=-0.065, p=0.95), J45 (Z=-1.199, p=0.23), and SE (Z=-1.316, p=0.19), objectively detected by binocular wavefront optometer and autorefractor, were not statistically significant. The differences between J0 (Z=-0.533, p=0.59), J45 (Z=-0.724, p=0.47), and SE (Z=-0.933, p=0.35), subjectively detected by binocular wavefront optometer and phoropter, were not statistically significant, whereas sphere (Z=-3.699, p<0.0001) had statistically significant differences. The Bland-Altman plots showed agreement between binocular wavefront optometer objective refraction and autorefractor in sphere (95% LoA: -1.00 D to 0.89 D), J0 (95% LoA: -0.47 D to 0.47 D), J45 (95% LoA: -0.55 D to 0.58 D), and SE (95% LoA: -0.89 D to 0.96 D). The Bland-Altman plots also showed agreement between binocular wavefront optometer subjective refraction and phoropter in sphere (95% LoA: -0.59 D to 0.82 D), J0 (95% LoA: -0.47 D to 0.43 D), J45 (95% LoA: -0.47 D to 0.43 D), and SE (95% LoA: -0.66 D to 0.74 D). Conclusively, the binocular wavefront optometer is an effective instrument, demonstrating good agreement between its objective and subjective refraction results and those obtained from autorefractor and phoropter, its smaller refractive intervals presenting a high accuracy in refractive error detection.