Repeatability and reproducibility of manifest refraction
To evaluate the intraexaminer repeatability and the interobserver reproducibility of manifest refraction. Tertiary referral center. Retrospective study. Patients attending at least 2 preoperative refractions before undergoing subsequent refractive surgery were included. All manifest refractions were...
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Published in | Journal of cataract and refractive surgery Vol. 46; no. 12; pp. 1659 - 1666 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
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United States
01.12.2020
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Abstract | To evaluate the intraexaminer repeatability and the interobserver reproducibility of manifest refraction.
Tertiary referral center.
Retrospective study.
Patients attending at least 2 preoperative refractions before undergoing subsequent refractive surgery were included. All manifest refractions were performed by 1 of 4 experienced optometrists using an automated phoropter according to a standard protocol. The first manifest refraction was performed after obtaining automated refraction and measuring the spectacles of the patient. The second refraction was typically refined from the first also considering wavefront refraction and tomography/topography.
The latest 2 manifest refractions of 1000 eyes obtained at 2 separate visits showed a mean pairwise absolute difference of 0.16 ± 0.19 diopter (D) (range 0 to 1.38 D) in spherical equivalent (SE). This SD was better than 0.25 D (the minimum measurement increment of refraction itself). The 95% limit of agreement (LoA) was within 0.50 D for sphere, cylinder, and SE. The SD of the astigmatism axis was approximately 10 degrees, and the 95% LoA was within 22 degrees (the difference in axis decreasing significantly with the measured cylinder magnitude). The SD for corrected distance visual acuity (CDVA) was half a Snellen line and the 95% LoA was within 1.5 lines (with increasing deviation with worse vision). There were no clinically meaningful differences in reproducibility (2 optometrists) compared with repeatability (same optometrist) in sphere, axis, and CDVA.
Reproducibility was 0.16 D irrespective whether refractions were performed by 1 or 2 different optometrists. Obtaining multiple refractions preoperatively might increase the predictability of surgery and decrease the enhancement rate. |
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AbstractList | PURPOSETo evaluate the intraexaminer repeatability and the interobserver reproducibility of manifest refraction. SETTINGTertiary referral center. DESIGNRetrospective study. METHODSPatients attending at least 2 preoperative refractions before undergoing subsequent refractive surgery were included. All manifest refractions were performed by 1 of 4 experienced optometrists using an automated phoropter according to a standard protocol. The first manifest refraction was performed after obtaining automated refraction and measuring the spectacles of the patient. The second refraction was typically refined from the first also considering wavefront refraction and tomography/topography. RESULTSThe latest 2 manifest refractions of 1000 eyes obtained at 2 separate visits showed a mean pairwise absolute difference of 0.16 ± 0.19 diopter (D) (range 0 to 1.38 D) in spherical equivalent (SE). This SD was better than 0.25 D (the minimum measurement increment of refraction itself). The 95% limit of agreement (LoA) was within 0.50 D for sphere, cylinder, and SE. The SD of the astigmatism axis was approximately 10 degrees, and the 95% LoA was within 22 degrees (the difference in axis decreasing significantly with the measured cylinder magnitude). The SD for corrected distance visual acuity (CDVA) was half a Snellen line and the 95% LoA was within 1.5 lines (with increasing deviation with worse vision). There were no clinically meaningful differences in reproducibility (2 optometrists) compared with repeatability (same optometrist) in sphere, axis, and CDVA. CONCLUSIONSReproducibility was 0.16 D irrespective whether refractions were performed by 1 or 2 different optometrists. Obtaining multiple refractions preoperatively might increase the predictability of surgery and decrease the enhancement rate. Purpose: To evaluate the intraexaminer repeatability and the interobserver reproducibility of manifest refraction. Setting: Tertiary referral center. Design: Retrospective study. Methods: Patients attending at least 2 preoperative refractions before undergoing subsequent refractive surgery were included. All manifest refractions were performed by 1 of 4 experienced optometrists using an automated phoropter according to a standard protocol. The first manifest refraction was performed after obtaining automated refraction and measuring the spectacles of the patient. The second refraction was typically refined from the first also considering wavefront refraction and tomography/topography. Results: The latest 2 manifest refractions of 1000 eyes obtained at 2 separate visits showed a mean pairwise absolute difference of 0.16 ± 0.19 diopter (D) (range 0 to 1.38 D) in spherical equivalent (SE). This SD was better than 0.25 D (the minimum measurement increment of refraction itself). The 95% limit of agreement (LoA) was within 0.50 D for sphere, cylinder, and SE. The SD of the astigmatism axis was approximately 10 degrees, and the 95% LoA was within 22 degrees (the difference in axis decreasing significantly with the measured cylinder magnitude). The SD for corrected distance visual acuity (CDVA) was half a Snellen line and the 95% LoA was within 1.5 lines (with increasing deviation with worse vision). There were no clinically meaningful differences in reproducibility (2 optometrists) compared with repeatability (same optometrist) in sphere, axis, and CDVA. Conclusions: Reproducibility was 0.16 D irrespective whether refractions were performed by 1 or 2 different optometrists. Obtaining multiple refractions preoperatively might increase the predictability of surgery and decrease the enhancement rate. To evaluate the intraexaminer repeatability and the interobserver reproducibility of manifest refraction. Tertiary referral center. Retrospective study. Patients attending at least 2 preoperative refractions before undergoing subsequent refractive surgery were included. All manifest refractions were performed by 1 of 4 experienced optometrists using an automated phoropter according to a standard protocol. The first manifest refraction was performed after obtaining automated refraction and measuring the spectacles of the patient. The second refraction was typically refined from the first also considering wavefront refraction and tomography/topography. The latest 2 manifest refractions of 1000 eyes obtained at 2 separate visits showed a mean pairwise absolute difference of 0.16 ± 0.19 diopter (D) (range 0 to 1.38 D) in spherical equivalent (SE). This SD was better than 0.25 D (the minimum measurement increment of refraction itself). The 95% limit of agreement (LoA) was within 0.50 D for sphere, cylinder, and SE. The SD of the astigmatism axis was approximately 10 degrees, and the 95% LoA was within 22 degrees (the difference in axis decreasing significantly with the measured cylinder magnitude). The SD for corrected distance visual acuity (CDVA) was half a Snellen line and the 95% LoA was within 1.5 lines (with increasing deviation with worse vision). There were no clinically meaningful differences in reproducibility (2 optometrists) compared with repeatability (same optometrist) in sphere, axis, and CDVA. Reproducibility was 0.16 D irrespective whether refractions were performed by 1 or 2 different optometrists. Obtaining multiple refractions preoperatively might increase the predictability of surgery and decrease the enhancement rate. |
Author | Kießler, Saskia Rost, Anika Taneri, Suphi Arba-Mosquera, Samuel Dick, H Burkhard |
Author_xml | – sequence: 1 givenname: Suphi surname: Taneri fullname: Taneri, Suphi organization: From the Center for Refractive Surgery, Eye Department at St. Francis Hospital (Taneri, Rost, Kießler), Muenster, Ruhr-University, University Eye Hospital (Taneri, Dick), Bochum, and SCHWIND eye-tech-solutions (Arba-Mosquera), Kleinostheim, Germany – sequence: 2 givenname: Samuel surname: Arba-Mosquera fullname: Arba-Mosquera, Samuel – sequence: 3 givenname: Anika surname: Rost fullname: Rost, Anika – sequence: 4 givenname: Saskia surname: Kießler fullname: Kießler, Saskia – sequence: 5 givenname: H Burkhard surname: Dick fullname: Dick, H Burkhard |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33259390$$D View this record in MEDLINE/PubMed |
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Cites_doi | 10.1097/OPX.0000000000000923 10.1007/s00347-005-1290-7 10.1016/j.jcrs.2012.02.043 10.3928/1081597X-20110317-01 10.1159/000496865 10.1016/S0886-3350(98)80043-6 10.1016/j.jcrs.2014.08.042 10.1111/j.1444-0938.2006.00022.x 10.1111/j.1475-1313.2008.00549.x 10.1097/OPX.0b013e31819fa590 10.1016/j.jfo.2017.06.032 10.1016/j.jcrs.2013.08.053 10.1046/j.1475-1313.2001.00596.x 10.1007/s00417-019-04405-z 10.1016/j.jcrs.2015.12.053 10.1016/j.jcrs.2015.01.016 10.3928/1081-597X-20040501-08 10.2147/OPTO.S132572 10.1016/j.jcrs.2009.12.044 10.1097/00006324-199508000-00007 |
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Snippet | To evaluate the intraexaminer repeatability and the interobserver reproducibility of manifest refraction.
Tertiary referral center.
Retrospective study.... Purpose: To evaluate the intraexaminer repeatability and the interobserver reproducibility of manifest refraction. Setting: Tertiary referral center. Design:... PURPOSETo evaluate the intraexaminer repeatability and the interobserver reproducibility of manifest refraction. SETTINGTertiary referral center.... |
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