Aberrometry Repeatability and Agreement with Autorefraction

SIGNIFICANCE: Commercially available aberrometers are essential to clinical studies evaluating refractive error and image quality. The Discovery System (Innovative Visual Systems, Elmhurst, IL) is a promising clinical instrument that allows investigators to export aberration data for research and analysis purposes. An assessment of the Discovery System's performance is essential to the interpretation of the data obtained. PURPOSE: The aims of this study were to determine the between-visit repeatability of refractive error and higher-order aberration measurements with the Discovery System and to examine between-instrument agreement of refractive error measurements with the Discovery System and Grand Seiko WAM-5500 open-field autorefractor (Grand Seiko Co., Hiroshima, Japan). METHODS: Cycloplegic refractive error values from the Discovery System (over a 3-mm pupil) and the Grand Seiko autorefractor were converted to power vectors (M, J(0), and J(45)), and averaged. Zernike coefficients were also calculated by the Discovery System over a 6-mm pupil through the sixth radial order. Between-visit repeatability and agreement were evaluated using Bland-Altman difference-versus-mean plots. A t-test compared each mean difference (bias) to zero, and the 95% limits of agreement were calculated. RESULTS: Twenty-five young adults with a mean (+/- SD) cycloplegic spherical-equivalent refractive error of -2.91 +/- 1.85 diopters (D) (range, -6.96 to +0.74 D) were enrolled. There were no significant between-visit differences with the Discovery System for M, J(0), J(45), third-through sixth-order root mean square (RMS), higher-order RMS, or spherical aberration (all P > .30), and the repeatability for defocus and higher-order RMS were +/- 0.31 D and +/- 0.095 mu m, respectively, for a 6-mm pupil. At a 3-mm pupil, the Discovery System, on average, measured slightly more positive values than the Grand Seiko for M (0.28 D), J(0) (0.11 D), and J(45) (0.12 D; all P < .005). CONCLUSIONS: The Discovery System was very repeatable and would be an appropriate instrument to measure cycloplegic refractive error and higher-order aberration changes in adults. Small differences in refractive error were found between the Discovery System and Grand Seiko. Copyright (C) 2017 American Academy of Optometry