Comparative accuracy of Plusoptix A16, Vision Screener V100, and Grand Seiko WAM-5500 autorefractors versus subjective refraction.

Clinical relevance: Accurate measurement of refractive errors is essential for vision correction. Understanding the strengths and limitations of different refractive measurement techniques is crucial for clinical practice, particularly in managing patients with complex refractive conditions.

Background: This study compares the accuracy of the Plusoptix A16 and Vision Screener V100 photorefraction devices with the WAM-5500 open-field autorefractor and subjective refraction.

Methods: One hundred and eighty-six subjects with a mean age of 30.3 ± 20.1 years were evaluated using the Plusoptix A16, Vision Screener V100, WAM-5500 autorefractor, and subjective refraction. Measurements were taken in random order in a room with diminished ambient lighting. In subjective refraction, the best visual acuity with the maximum positive sphere hyperopic correction and the minimum negative sphere for myopic correction was used as the endpoint. Mean differences of the M, J0, and J45 parameters were analysed across all techniques, stratified by age groups (<18 years, 18-45 years, >45 years).

Results: There were significant differences in refractive error components (M and J0) across all methods, with subjective refraction yielding the most negative M values. Statistically significant differences were noted for the WAM-5500 (-0.12 ± 0.58D) and Plusoptix A16 (-0.17 ± 0.65D). Subjective refraction showed more positive J0 values, indicating greater with-the-rule astigmatism compared to Plusoptix A16 and Vision Screener V100. No significant trends were found for J45. Age-related differences were observed in M and J0 components when comparing subjective refraction with WAM-5500 and Plusoptix measurements.

Conclusion: Significant differences in refractive error measurements were observed between devices, with the Vision Screener V100 overestimating errors and the Grand Seiko WAM-5500 showing higher J0 values. Subjective refraction detected more with-the-rule astigmatism, highlighting the importance of validating autorefraction results, especially in high astigmatism cases. Age-related differences in M and J0 components highlight the need to confirm objective methods with subjective refraction.