Influence of trifocal intraocular lenses on standard autorefraction and aberrometer-based autorefraction.

Abstract

PURPOSE\nTo study the agreement between manifest refraction and objective refraction measured with two autorefractor models and an aberrometer in eyes implanted with a trifocal diffractive intraocular lens (IOL).\n\n\nSETTING\nIOA Madrid Innova Ocular, Madrid, Spain.\n\n\nDESIGN\nProspective comparative cohort study.\n\n\nMETHODS\nAn autorefractor keratometer (KR-8800), based on a Scheiner double pinhole, and a 3-dimension wavefront topography aberrometer system (OPD-Scan III), based on the scanning-slit retinoscopy principle, were used to obtain objective refraction readings. In addition, lower-order Zernike coefficients (Z) were used to calculate objective refraction. A set of 7 different results was obtained in power vector notation (spherical equivalent [SE], Jackson cross-cylinder, axes at 180 degrees and 90 degrees [J0] and Jackson cross-cylinder, axes at 45 degrees and 135 degrees [J45]) for 7 different methods: manifest refraction, autorefraction obtained with the autorefractor keratometer, WF-P (Z-based objective refraction for the photopic pupil), WF-M (Z-based objective refraction for the mesopic pupil), WF-4 (Z-based objective refraction for a 4.0\xa0mm pupil), OPD-C (autorefraction measured with the 3-dimension wavefront topography aberrometer system under photopic conditions), and OPD-M (autorefraction measured with the 3-dimension wavefront topography aberrometer system under mesopic conditions).\n\n\nRESULTS\nThe study comprised 102 eyes from 51 cataract patients who underwent binocular implantation of a diffractive trifocal IOL (FineVision POD F). All 6 objective methods yielded more negative SE values than manifest refraction (P\xa0<\xa0.001). As for the astigmatism components (J0 and J45), only autorefraction (P\xa0=\xa0.003) and OPD-M (P\xa0<\xa0.001) differed significantly from manifest refraction. The best and worst correlation for the SE component were intraclass correlation coefficient (ICC)\xa0=\xa00.70 (for WF-M) and ICC\xa0=\xa00.48 (for WF-4).\n\n\nCONCLUSION\nObjective methods tend to yield more negative sphere values than manifest refraction.