Comparison of Subjective and Wavefront-Measured Refractions by InnovEyes Platform in Myopic Patients.

Purpose: To compare the subjective refraction and Innov-Eyes (Alcon Laboratories, Inc) wavefront-measured refraction in patients with myopia and astigmatism before refractive surgery.

Methods: Consecutive myopic patients planning to receive refractive surgery with ages between 18 and 50 years old were retrospectively enrolled. The subjective and wavefront-measured refraction (InnovEyes platform) were compared, and the influential factors for the measurement difference were analyzed.

Results: Of the 500 eyes enrolled, the mean age was 29.3 ± 6.8 years. Mean wavefront-measured refraction was 0.58 ± 0.62 diopters (D) more myopic and 0.10 ± 0.27 D more astigmatic than subjective refraction (P < .001). Wavefront-measured refraction exhibited excellent consistency and significant correlation with subjective refraction. Linear regression demonstrated that age (P = .008) and wavefront-measured sphere standard deviation (P < .001) were positively correlated with spherical measurement difference, and total quality score (P < .001) and accommodative response (binocular cross-cylinder) (P = .011) demonstrated a negative correlation with spherical and cylindrical measurement difference. The patients with low wavefront measurement quality had significantly greater spherical differences than those with high-quality measurement (P < .001). The patients with accommodative lead had greater spherical equivalent differences than other participants (P = .047).

Conclusions: Wavefront-measured refraction had excellent consistency with subjective refraction, although it measured more myopia and astigmatism than subjective refraction. The spherical measurement difference was greater in older patients and those with accommodative lead. More stable and higher quality repeated measurements will yield closer results between wavefront-measured and subjective refraction. [J Refract Surg. 2024;40(11):e836-e844.].