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Updated: Feb 22, 2026

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

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

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Subjetiva y objetiva refracción usando autorrefractometría y dos aberrómetros basados en frente de onda en lentes

Petra Davidova¹, Mark Rostom¹, Luca Gabriel Timoceanu¹

¹Department of Ophthalmology, Goethe-University, 60590 Frankfurt, Germany.

American journal of ophthalmology

|February 20, 2026

Abstracto

Purpose:

To evaluate the agreement between subjective (SR) and objective refraction (OR) obtained by an autorefractor (AR), Hartmann-Shack aberrometer and ray-tracing aberrometer after implantation of a wavefront-shaping extended-depth-of-focus (EDOF) or diffractive, simultaneous vision intraocular lens (SVIOL), and to assess potential influences of biometric parameters.

Design:

Prospective, comparative assessment angreement analysis.

Subjects:

Patients with healthy eyes, without previous surgeries, implanted with an EDOF (Group A) or SVIOL (Group B).

Methods:

SR performed by experienced opticians and OR with the three devices were compared for spherical and cylindrical refractive error, spherical equivalent (SE) and vector components. Axial length, pupil size, IOL power and torus were analyzed as influential factors.

Main Outcome Measures:

Agreement of SE, spherical and cylindrical refractive error including vector analysis obtained by SR and OR with different devices.

Results:

Group A comprised 42 eyes and group B 56 eyes. Mean SE was -0.11D (SR), -0.42D (AR), -0.40D (Hartmann-Shack) and -0.29D (Ray-tracing) for group A, and +0.18D, +0.08D, -0.03D, and +0.23D, respectively, for group B. Significant differences between SR and OR were found for most parameters, whereas none were found between vector components. Intraclass correlation coefficients between SR and OR were mostly poor -maximal moderate, and poor for vector analysis. The highest proportion of eyes with an absolute difference ≤0.50 D between SR and OR was achieved with Ray-Tracing aberrometry in group A (79.5%); with AR in group B (96.4%). Pupil size significantly affected SE differences between SR and Hartmann-Shack aberrometry in groups A and B, with the latter also being influenced by IOL toricity.

Conclusion:

OR with modern devices is not interchangeable with SR after implantation of the studied IOLs; agreement was greater for group B. Pupil size and partially IOL toricity had impact on SE difference between SR and OR obtained by Hartmann-Shack aberrometry.

Palabras clave:

aberrometría de Hartmann-Shack aberrometría de trazado de rayos lente intraocular de profundidad de enfoque extendida refracción lente intraocular de visión simultánea aberrometría de frente de onda

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