AUTOMATED AND SUBJECTIVE REFRACTION WITH MONOFOCAL, MULTIFOCAL AND EXTENDED DEPTH OF FOCUS INTRAOCULAR LENSES - A REVIEW.

Automated refraction (Scheiner principle) is universally used to start a visual exam. While the results are reliable in eyes implanted with monofocal intraocular lenses (IOLs) they may be less precise with multifocal or extended-depth-of-focus (EDOF) IOLs and can even indicate a refractive error that does not clinically exist. Autorefractor results with monofocal, multifocal, and EDOF IOLs were investigated through literature search analysing the papers reporting the difference between automated and clinical refraction. The average difference ranged between -0.50 D and -1.00 D with most multifocal and EDOF IOLs. The differences in astigmatism were generally much lower. Autorefractors using infrared light cannot measure eyes with high technology IOLs precisely because of the influence of the refractive or of the diffractive near add. The systematic error induced with some IOLs should be mentioned in the IOL label to prevent possible inappropriate refractive procedures to treat apparent myopia.