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Accuracy of wavefront aberrometer refraction vs manifest refraction in cataract patients: impact of age, ametropia and visual function

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Abstract

Background

To evaluate accuracy of WASCA wavefront aberrometry (WA) refraction in comparison to manifest refraction (MR) in an older population awaiting cataract surgery.

Methods

Prospectively, refractive errors of 130 eyes were determined by WA and MR. Mean age was 65.9 (SD 11.81), corrected distance visual acuity (CDVA) averaged 0.20 logMar (SD 0.57), mean manifest sphere was 0.23 dioptres (D, SD 3.39) and manifest astigmatism amounted to −1.25 D (SD 1.21). For further analysis, refractive values were transformed into power vector components: spherical equivalent (SE), Jackson cross cylinder at 0° and 45° (J0 and J45). The ‘limits of agreement’ approach, regression analysis, correlation analysis, and ANOVA were applied and additionally compared to 28 healthy eyes (mean VA −0.1 logMAR) of a group of young subjects (mean age 33.9).

Results

SE measures in myopia correlated highly between WA and MR (r = 0.917, p < .001). In hyperopia this correlation was moderately high (r = 0.800, p < .001). For all subjects, correlations between WA and MR for J0 and J45 were r = 0.742 (p < .001) and r = 0.760 (p < .001) respectively. WA measurements revealed larger agreement ranges with increasing myopia and astigmatism. Controlled for possible confounding variables of age, VA, and refractive state, no statistically significant effects were found. Across nearly all conditions, WA measured significantly higher myopic and astigmatic values than MR. Most effects were replicated in the reference group.

Conclusions

WA refraction can provide valuable information in previously under-researched conditions such as reduced VA (cataract-related), advanced age, and hyperopia. However, loss of optical media transparency will inherently reduce accuracy of WA. Further studies are needed to define cut-off values for automated wavefront quality grading and intra-operative application of WA in refractive surgery.

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Authors and Affiliations

  1. Klinik und Poliklinik fuer Augenheilkunde, Universitaetsklinikum Hamburg-Eppendorf, Haus W40, Martinistr. 52, 20246, Hamburg, Germany

    Jan O. Huelle, Toam Katz, Jan Draeger, Milena Pahlitzsch, Vasyl Druchkiv, Johannes Steinberg, Gisbert Richard & Stephan J. Linke

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  1. Jan O. Huelle
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  2. Toam Katz
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  3. Jan Draeger
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  4. Milena Pahlitzsch
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  5. Vasyl Druchkiv
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  6. Johannes Steinberg
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  7. Gisbert Richard
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  8. Stephan J. Linke
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Corresponding authors

Correspondence to Jan O. Huelle or Stephan J. Linke.

Additional information

Jan O. Huelle and Toam Katz contributed equally

Notes

The authors have full control of all primary data, and agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review the data upon request. Financial relationships with the organisations that provided the instruments used in this study do not exist. The authors have no proprietary or commercial interests in any material or methods discussed in this paper. The authors do not report any conflict of interest or opinion. No financial support was received for this study. Parts of this study were presented at the 110. DOG Congress, 20–23 September 2012, Berlin.

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Huelle, J.O., Katz, T., Draeger, J. et al. Accuracy of wavefront aberrometer refraction vs manifest refraction in cataract patients: impact of age, ametropia and visual function. Graefes Arch Clin Exp Ophthalmol 251, 1163–1173 (2013). https://doi.org/10.1007/s00417-012-2246-7

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  • DOI: https://doi.org/10.1007/s00417-012-2246-7

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