Accuracy of WASCA aberrometer refraction compared to manifest refraction and cycloplegic refraction in hyperopia measurement

Abstract

Purpose: To explore the agreement between the wavefront supported custom ablation (WASCA) aberrometer and manifest refraction (MR) and cycloplegic refraction (CR) in hyperopia testing. Methods: Ninety eyes of 90 hyperopic patients (spherical equivalent ≥+0.5 D) were evaluated; MR, CR, and WASCA refraction (WR) were performed consecutively. Analysis pupil size was 6.0 mm in WASCA measurement using the Seidel method. The conven-tional notation was transferred into vector components for analysis, i.e., spherical equivalent (M) and two cross-cylinders at axis 0° (J0) and axis 45° (J45). Bland-Altman plots were used to test the agreement between the two measurements. Results: The mean Ms obtained with MR and CR were 3.23 ± 1.74 D and 4.04 ± 2.04 D, respectively (P < 0.001), and the correlation was high (r = 0.90, P < 0.001). The WR was highly correlated with MR and CR in terms of M (r = 0.89, 0.87), but not significantlycorrelatedinJ0 and J45. The total dioptric power vector error was 0.18 ± 1.00 D between WR and MR and −0.64 ± 1.03 D between WR and CR. The limits of agreement of all vector components were beyond ± 1.0 D. With hyperopia level increase, WR tended to overestimate MR (P = 0.04), whereas WR always underestimated CR. Conclusions: WASCA could act as a reference of subjective refraction in hyperopia measurement, the exchangeability is not fully applicable. Translational Relevance: WASCA can provide an alternative for objective refraction in hyperopia measurement.