Clinical Comparison of High-resolution and Standard Refractions and Prescriptions

SIGNIFICANCE: Recently, novel refraction technology allows subjective refractions to be performed with a higher-resolution. It is unclear, however, if these benefits are noticed and appreciated by the patient during the examination and after dispensing.PURPOSE: This study investigated benefits and drawbacks of high-resolution refraction technology over standard, specifically in terms of the refraction, glasses prescription, and participant's perceptions of the technology.METHODS: Sixty progressive-addition-lens wearers (aged 35 to 70 years) and 60 single-vision wearers (18 years or older) were randomized to a high-resolution refraction (Vision-R 800; Essilor Instruments, Dallas, TX; essilorinstrumentsusa.com) and standard refraction in a 2-week crossover dispensing design. Refractive results were converted to M, J0, and J45 and analyzed using multivariate t tests. Bayesian estimation was used to analyze differences between refraction type and age group for subjective outcomes.RESULTS: Differences in refractive error between the two refractions were small, and none differed statistically (P > .05) or clinically (e.g., <0.25 D) in either subgroup. Visual acuities at distance and near were better than 0.00 logMAR; none of the mean differences between the refractions reached statistical or clinical (e.g., <0.10 D) significance. Participants significantly preferred the high-resolution refraction for its quickness and efficiency, improved comfort, and less stress. Bayesian analysis indicated a 76% probability that participants had higher confidence in the high-resolution refraction, 93% probability that they would seek it out for their care, and 94% probability that they would recommend an optometrist using this technology.CONCLUSIONS: Refractive and acuity endpoints were similar with the high-resolution and standard refraction. Participants, however, perceived several key benefits of the high-resolution refraction and prescription for their care, the care of their friends/family, and the practice itself.