Han Jae Yong, Yoon Sangchul, Brown Nicolas Scott, Han Sueng Han, Han Jinu
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
Department of Global Health, Graduate School of Public Health, Yonsei University, Seoul, Korea.
Korean J Ophthalmol. 2020 Jun;34(3):227-234. doi: 10.3341/kjo.2019.0132.
To compare refractive error measured by hand-held wavefront aberrometers with postcycloplegic autorefraction (AR) and cycloplegic refraction (CR).
The medical records of patients who received refractive measurements using the wavefront aberrometer, postcycloplegic AR, and CR between January 2014 and January 2016 were retrospectively analyzed. The mean differences, 95% confidence intervals, and limits of agreement (LOA) were calculated for the refractive vector components (, , and ).
Fifty-one patients (9.0 ± 5.5 years, male 41.2%) were enrolled in this study, and only the right eye of each was included. Refractive errors ranged from -9.25 to +7.25 diopters (D) for spherical equivalent (median, 0.75 D). The component was not significantly different among the three methods ( = 0.080). However, the vector component was significantly different ( < 0.001). After post hoc analysis, the wavefront aberrometer obtained more positive values for compared to the other methods. The component was not significantly different among the three methods ( = 0.143). The mean difference between the wavefront aberrometer and postcycloplegic AR was -0.115 D (LOA, -1.578 to 1.348 D) for , 0.239 D (LOA, -0.371 to 0.850 D) for , and -0.015 D (LOA, -0.768 to 0.738 D) for . The mean difference between the wavefront aberrometer and CR was -0.220 D (LOA, -1.790 to 1.350 D) for , 0.300 D (LOA, -0.526 to 1.127 D) for , and -0.079 D (-0.662 to 0.504 D) for .
The wavefront aberrometer showed good agreement with postcycloplegic AR and CR in spherical equivalents, but tended to produce slightly myopic results. The wavefront aberrometer also overestimated with-the-rule astigmatism. Therefore, we recommend that the device be used for estimations of refractive error, which may be useful for patients who have postural difficulties, live in undeveloped countries, or are bedridden.
比较手持波前像差仪测量的屈光不正与睫状肌麻痹后自动验光(AR)及睫状肌麻痹验光(CR)结果。
回顾性分析2014年1月至2016年1月期间接受波前像差仪、睫状肌麻痹后AR及CR屈光测量的患者病历。计算屈光矢量分量(、和)的平均差值、95%置信区间及一致性界限(LOA)。
本研究纳入51例患者(9.0±5.5岁,男性占41.2%),仅纳入每例患者的右眼。等效球镜度数的屈光不正范围为-9.25至+7.25屈光度(D)(中位数为0.75 D)。三种方法间分量无显著差异(=0.080)。然而,矢量分量有显著差异(<0.001)。事后分析显示,与其他方法相比,波前像差仪测得的更正值。三种方法间分量无显著差异(=0.143)。波前像差仪与睫状肌麻痹后AR的平均差值,对于为-0.115 D(LOA为-1.578至1.348 D),对于为0.239 D(LOA为-0.371至0.850 D),对于为-0.015 D(LOA为-0.768至0.738 D)。波前像差仪与CR的平均差值,对于为-0.220 D(LOA为-1.790至1.350 D),对于为0.300 D(LOA为-0.526至1.127 D),对于为-0.079 D(-0.662至0.504 D)。
波前像差仪在等效球镜度数方面与睫状肌麻痹后AR及CR显示出良好一致性,但倾向于产生略近视的结果。波前像差仪还高估了顺规散光。因此,我们建议该设备用于屈光不正的估计,这对于有姿势困难、生活在不发达国家或卧床不起的患者可能有用。