Clinical evaluation of refractive techniques.

BACKGROUND

The accuracy of two commercially available auto kerato-refractometers (Shin-Nippon Automatic Ref-Keratometer model RC380 and Topcon Auto Kerato-Refractometer model KR-3100) and one autokeratometer (Alcon Systems Auto-Keratometer) was compared to that of subjective refraction and conventional keratometry.

METHODS

Refractive error and corneal curvature were measured on 20 subjects. Measurements were converted from the standard clinical format of sphere, cylinder and axis to a vector format to assess the contribution of spherical and cylindrical errors simultaneously.

RESULTS

For measurements of refractive error taken in immediate succession, the Shin-Nippon instrument was found to be more repeatable than the Topcon instrument. This trend reversed when subjects were realigned between measurements. The 95 percent confidence limit for precision for subjective refraction was considerably greater: 93 percent of subjective refractions resulted in visual acuities better than or equal to 6/6, compared with 85 percent for the Topcon instrument and 45 percent for the Shin-Nippon instrument. Each of the methods for measuring corneal curvature showed minimal bias and comparable precision.

CONCLUSIONS

Although subjective methods of determining refractive error generally achieved the same or better visual acuity as the automated methods, they displayed considerably poorer precision. Each of the methods of measurement of corneal curvature produced similar results.