ArticleCureus2026
Variation in Preoperative Refraction Results Among Refractive Surgery Patients: A Comparison of Five Measurement Methods.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAccurate preoperative refraction is critical in refractive surgery planning. Manifest refraction (MR) remains the clinical gold standard but is time-consuming and operator-dependent. Alternative objective methods, including wavefront aberrometry and automated refraction, offer speed and objectivity, yet their agreement with MR varies, particularly regarding astigmatic components. Identifying which alternatives most closely approximate MR has direct clinical implications.
objectiveTo compare preoperative spherical equivalent (SE) refraction obtained by five measurement methods and identify which most closely agree with MR as potential clinical alternatives.
methodsRetrospective comparative study of 104 eyes (52 patients) at IIUM Eye Specialist Clinic (January-May 2021). Five methods were compared: MR, Wavefront Supported Custom Ablation (WASCA) aberrometer, Zeiss i.Profiler (ZIP), Righton Retinomax Handheld (RRH) autorefractor, and focimeter (FOCI). Pairwise comparisons used paired t-tests on SE values.
resultsSignificant pairwise differences were found between all five methods (P < 0.05), except ZIP vs. RRH (mean difference (MD) = 0.03 diopters (D); P = 0.753). The two methods with the smallest mean differences from MR were ZIP (MD = 0.20 D) and RRH (MD = 0.22 D), both below the 0.25 D clinical significance threshold. The largest discrepancy was between WASCA and FOCI (MD = 1.44 D).
conclusionBoth the ZIP and RRH autorefractors produced SE values in close agreement with MR. ZIP is preferred due to superior positional control, yielding more reproducible astigmatic readings. Routine autorefraction with ZIP may supplement MR in preoperative refractive surgery assessment.
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