{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T18:55:48Z","timestamp":1776365748281,"version":"3.51.2"},"reference-count":46,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,9]],"date-time":"2022-01-09T00:00:00Z","timestamp":1641686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Red Tem\u00e1tica de Investigaci\u00f3n Cooperativa en Salud","award":["OFTARED RD12\/0034 and RD16\/0008"],"award-info":[{"award-number":["OFTARED RD12\/0034 and RD16\/0008"]}]},{"name":"Multiopticas Grant","award":["Multiopticas Grant"],"award-info":[{"award-number":["Multiopticas Grant"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The main aim of this study was to compare refraction measurements with and without cycloplegia from two refractors devices, (TRK-2P autorefractometer (TRK-2P) and wavefront-based refraction Visionix 130 (VX130)) in children and adolescents. This descriptive observational study included 20 myopic eyes and 40 hyperopic eyes measured in two different Spanish hospitals. Cycloplegia was carried out by three drops of cyclopentolate hydrochloride 1% (Colircus\u00ed cycloplegic, Alcon Healthcare S.A., Barcelona). The mean age of the myopia group was 12.40 \u00b1 3.48 years; for the hyperopia group, the mean age was 7.37 \u00b1 2.47 years. In the myopia group, autorefraction and wavefront-based refraction did not show clinically significant differences in any components between with and without cycloplegia. The hyperopia group showed statistical and clinically significant differences in sphere and SE components between relaxed and non-relaxed states of accommodation, although the cylindrical components were not clinically different. In this study, we considered a value of \u22650.50D as a clinically significant difference in refraction. Therefore, both devices were capable of obtaining accurate refractions without cyclopegia in myopia children, although they did not avoid instrument myopia and accommodation involved in hyperopia children. Moreover, both refractometers could be useful for astigmatism monitoring in children without the need for cycloplegic drops.<\/jats:p>","DOI":"10.3390\/children9010088","type":"journal-article","created":{"date-parts":[[2022,1,9]],"date-time":"2022-01-09T20:29:26Z","timestamp":1641760166000},"page":"88","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Comparative Study of Refraction between Wave Front-Based Refraction and Autorefraction without and with Cycloplegia in Children and Adolescents"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9021-6336","authenticated-orcid":false,"given":"Ana M","family":"Calvo-Maroto","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Cl\u00ednica Universidad de Navarra, 28027 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8815-4757","authenticated-orcid":false,"given":"Sara","family":"Llorente-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Cl\u00ednica Universidad de Navarra, 28027 Madrid, Spain"},{"name":"Experimental Ophthalmology Laboratory, Department of Ophthalmology, Cl\u00ednica Universidad de Navarra, IdiSNA, 31008 Pamplona, Spain"},{"name":"Red Tem\u00e1tica de Investigaci\u00f3n Cooperativa Sanitaria en Enfermedades Oculares, Oftared, ISCIII, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaione","family":"Bezunartea-Bezunartea","sequence":"additional","affiliation":[{"name":"Experimental Ophthalmology Laboratory, Department of Ophthalmology, Cl\u00ednica Universidad de Navarra, IdiSNA, 31008 Pamplona, Spain"},{"name":"Red Tem\u00e1tica de Investigaci\u00f3n Cooperativa Sanitaria en Enfermedades Oculares, Oftared, ISCIII, 28040 Madrid, Spain"},{"name":"Department of Ophthalmology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Javier","family":"Hurtado-Ce\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Pediatric Ophthalmology, Cl\u00ednica Rementer\u00eda, 28010 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Berrozpe-Villabona","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Public Health and Health Management, Miguel Servet University Hospital, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Bilbao-Malav\u00e9","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Bellvitge University Hospital, 08907 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1546-4807","authenticated-orcid":false,"given":"David P","family":"Pi\u00f1ero","sequence":"additional","affiliation":[{"name":"Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0654-0249","authenticated-orcid":false,"given":"Jes\u00fas","family":"Barrio-Barrio","sequence":"additional","affiliation":[{"name":"Red Tem\u00e1tica de Investigaci\u00f3n Cooperativa Sanitaria en Enfermedades Oculares, Oftared, ISCIII, 28040 Madrid, Spain"},{"name":"Department of Ophthalmology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9328-9725","authenticated-orcid":false,"given":"Sergio","family":"Recalde-Maestre","sequence":"additional","affiliation":[{"name":"Experimental Ophthalmology Laboratory, Department of Ophthalmology, Cl\u00ednica Universidad de Navarra, IdiSNA, 31008 Pamplona, Spain"},{"name":"Department of Ophthalmology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050","volume":"123","author":"Holden","year":"2016","journal-title":"Ophthalmology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s10654-015-0010-0","article-title":"Prevalence of refractive error in Europe: The European Eye Epidemiology (E3) Consortium","volume":"30","author":"Williams","year":"2015","journal-title":"Eur. J. Epidemiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/j.ophtha.2015.03.018","article-title":"Increasing prevalence of myopia in Europe and the impact of education","volume":"122","author":"Williams","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S1091-8531(99)70089-3","article-title":"The psychosocial effects of amblyopia study","volume":"3","author":"Packwood","year":"1999","journal-title":"J. AAPOS"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1136\/adc.2003.046755","article-title":"Hyperopia and educational attainment in a primary school cohort","volume":"90","author":"Williams","year":"2005","journal-title":"Arch. Dis. Child."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ajo.2013.08.010","article-title":"Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: An evidence based systematic review","volume":"157","author":"Wong","year":"2014","journal-title":"Am. J. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.preteyeres.2012.06.004","article-title":"The complex interactions of retinal, optical and environmental factors in myopia aetiology","volume":"31","author":"Flitcroft","year":"2012","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.ophtha.2003.05.010","article-title":"Prevalence and causes of visual impairment and blindness among 9980 Scandinavian adults","volume":"111","author":"Buch","year":"2004","journal-title":"Ophthalmology"},{"key":"ref_9","unstructured":"Franklin, A. (2007). Subjective refraction: Principles and techniques for the correction of spherical ametropia. Clinical Optics and Refraction: A Guide for Optometrist, Contact Lens Opticians and Dispensing Opticians, Elsevier."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.4103\/ijo.IJO_266_18","article-title":"Repeatability of ARK-30 in a pediatric population","volume":"66","author":"Martin","year":"2018","journal-title":"Indian J. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1136\/bjo.81.11.941","article-title":"Reproducibility and accuracy of measurements with a hand held autorefractor in children","volume":"81","author":"Harvey","year":"1997","journal-title":"Br. J. Ophthalmol."},{"key":"ref_12","first-page":"491","article-title":"Comparison of the Retinomax hand-held autorefractor versus table-top autorefractor and retinoscopy","volume":"7","author":"Tuncer","year":"2014","journal-title":"Int. J. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ajo.2006.01.084","article-title":"A comparison of autorefraction and subjective refraction with and without cycloplegia in primary school children","volume":"142","author":"Choong","year":"2006","journal-title":"Am. J. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"311","DOI":"10.3928\/01913913-20170329-01","article-title":"Inability of Open-Field Autorefraction to Eliminate Accommodation in Preschoolers","volume":"54","author":"Kara","year":"2017","journal-title":"J. Pediatr. Ophthalmol. Strabismus"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"429","DOI":"10.2147\/OPTH.S5145","article-title":"A comparison of manifest refractions, cycloplegic refractions and retinoscopy on the RMA-3000 autorefractometer in children aged 3 to 15 years","volume":"3","author":"Rotsos","year":"2009","journal-title":"Clin. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.optom.2014.07.001","article-title":"Study on accommodation by autorefraction and dynamic refraction in children","volume":"7","author":"Krishnacharya","year":"2014","journal-title":"J. Optom."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1007\/s00417-015-3246-1","article-title":"Cycloplegic autorefraction in young adults: Is it mandatory?","volume":"254","author":"Mimouni","year":"2016","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Saxena, R., Vashist, P., Tandon, R., Pandey, R.M., Bhardawaj, A., Menon, V., and Mani, K. (2015). Prevalence of myopia and its risk factors in urban school children in Delhi: The North India Myopia Study (NIM Study). PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0117349"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.ajo.2007.03.041","article-title":"Necessity of cycloplegia for assessing refractive error in 12-year-old children: A population-based study","volume":"144","author":"Fotedar","year":"2007","journal-title":"Am. J. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1097\/00006324-199706000-00019","article-title":"Power vectors: An application of Fourier analysis to the description and statistical analysis of refractive error","volume":"474","author":"Thibos","year":"1997","journal-title":"Optom. Vis. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S0140-6736(86)90837-8","article-title":"Statistical methods for assessing agreement between two methods of clinical measurement","volume":"1","author":"Bland","year":"1986","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1111\/j.1475-1313.2011.00851.x","article-title":"Statistical methods for conducting agreement (comparison of clinical tests) and precision (repeteability or repfroducibility) studies in optometry and ophthalmology","volume":"31","author":"McAlinden","year":"2011","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1111\/opo.12243","article-title":"Dizziness, but not falls rate, improves after routine cataract surgery: The role of refractive and spectacle changes","volume":"36","author":"Supuk","year":"2016","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"624","DOI":"10.3928\/1081597X-20190916-02","article-title":"Status of residual refractive error, ocular aberrations, and accommodation after myopic LASIK, SMILE, and TransPRK","volume":"35","author":"Shetty","year":"2019","journal-title":"J. Refract. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2456","DOI":"10.1167\/iovs.10-5441","article-title":"Cycloplegic and noncycloplegic refractions of Chinese neonatal infants","volume":"52","author":"Chen","year":"2011","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"431","DOI":"10.2471\/BLT.08.055673","article-title":"Potential lost productivity resulting from the global burden of uncorrected refractive error","volume":"87","author":"Smith","year":"2009","journal-title":"Bull. World Health Organ."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"63","DOI":"10.2471\/BLT.07.041210","article-title":"Global magnitude of visual impairment caused by uncorrected refractive errors in 2004","volume":"86","author":"Resnikoff","year":"2008","journal-title":"Bull. World Health Organ."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1097\/00006324-200308000-00012","article-title":"The manifestation of noncycloplegic refractive state in pre-school children is dependent on autorefractor design","volume":"80","author":"Suryakumar","year":"2007","journal-title":"Optom. Vis. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/S0886-3350(99)00325-9","article-title":"Accuracy and accommodation capability of a handheld autorefractor","volume":"26","author":"Wesemann","year":"2000","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1016\/S0140-6736(12)60272-4","article-title":"Myopia","volume":"379","author":"Morgan","year":"2012","journal-title":"Lancet"},{"key":"ref_31","first-page":"3633","article-title":"Parental myopia, near work, school achievement, and children\u2019s refractive error","volume":"43","author":"Mutti","year":"2001","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.survophthal.2005.11.003","article-title":"Depth-of-focus of the human eye: Theory and clinical implications","volume":"51","author":"Wang","year":"2006","journal-title":"Surv. Opththalmol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/opo.12241","article-title":"The effect of refractive error on the accommodative response gradient: A summary and update","volume":"35","author":"Millodot","year":"2015","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1111\/j.1444-0938.2011.00644.x","article-title":"Clinical evaluation of the L80 autorefractometer","volume":"95","author":"Shneor","year":"2012","journal-title":"Clin. Exp. Optom."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/00006324-200301000-00003","article-title":"Measurement of refractive errors in young myopes using the COAS Shack-Hartmann aberrometer","volume":"80","author":"Salmon","year":"2003","journal-title":"Optom. Vis. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e633","DOI":"10.1111\/aos.13569","article-title":"Comparison of noncycloplegic and cycloplegic autorefraction in categorizing refractive error data in children","volume":"95","author":"Sankaridurg","year":"2017","journal-title":"Acta Ophthalmol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1136\/bjophthalmol-2017-311594","article-title":"Overestimation of hyperopia with autorefraction compared with retinoscopy under cycloplegia in school-age children","volume":"102","author":"Hashemi","year":"2018","journal-title":"Br. J. Ophthalmol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"221","DOI":"10.4103\/2008-322X.170360","article-title":"Accuracy and repeatability of refractive error measurements by photorefractometry","volume":"10","author":"Rajavy","year":"2015","journal-title":"J. Ophthalmic Vis. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1487013","DOI":"10.1155\/2019\/1487013","article-title":"Comparison of autorefraction and photorefraction with and without cycloplegia using 1% tropicamide in preschool children","volume":"2019","author":"Yassa","year":"2019","journal-title":"J. Ophthalmol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.4103\/ijo.IJO_1465_18","article-title":"Comparison of Plusoptix S12R photoscreener with cycloplegic retinoscopy and autorefraction in pediatric age group","volume":"67","author":"Saini","year":"2019","journal-title":"Indian J. Ophthalmol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Payerols, A., Eliaou, C., Trezeguet, V., Villain, M., and Daien, V. (2016). Accuracy of Plusoptix a09 distance refraction in pediatric myopia and hyperopia. BMC Ophthalmol., 16.","DOI":"10.1186\/s12886-016-0247-8"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1111\/j.1475-1313.2008.00616.x","article-title":"Cycloplegic refraction in preschool children: Comparisons between the hand-held autorefractor, table-mounted autorefractor and retinoscopy","volume":"29","author":"Prabakaran","year":"2009","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"370","DOI":"10.3928\/01913913-20120821-04","article-title":"A comparison of different autorefractors with retinoscopy in children","volume":"49","author":"Oral","year":"2012","journal-title":"J. Pediatr. Ophthalmol. Strabismus"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1111\/cxo.12375","article-title":"A comparison of cycloplegia autorefraction and retinoscopy in Indian children","volume":"100","author":"Guha","year":"2017","journal-title":"Clin. Exp. Optom."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1016\/j.ophtha.2020.03.004","article-title":"Accuracy of autorefraction in children: A report by the American Academy of Ophthalmology","volume":"127","author":"Wilson","year":"2020","journal-title":"Ophthalmology"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1097\/OPX.0000000000000379","article-title":"Comparison of refractive error measures by the IRX3 aberrometer and autorefraction","volume":"91","author":"McCullough","year":"2014","journal-title":"Optom. Vis. Sci."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/1\/88\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:14:42Z","timestamp":1760364882000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/1\/88"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,9]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["children9010088"],"URL":"https:\/\/doi.org\/10.3390\/children9010088","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,9]]}}}