The study was done to compare ray-tracing aberrometry, Hartmann-Shack wavefront analysis, automated refraction, and manifest refraction in patients with echelette diffractive intraocular lenses (IOLs) and patients with monofocal IOLs with negative spherical aberration.

Pseudophakic patients implanted with an echelette diffractive IOL (Tecnis ZXR00; Johnson & Johnson Vision) and a control group consisting of patients implanted with a negative spherical aberration monofocal IOL (Tecnis ZCBOO, Johnson & Johnson Vision) were included in this study.

Thirty-two eyes implanted with a ZXR00 IOL and 30 eyes implanted with a ZCBOO IOL were enrolled in this study. The ZXR00 IOL group yielded more myopic results with automated refactions (−0.62 ± 0.41 diopters [D]), Hartmann-Shack wavefront analysis (−0.85 ± 0.40 D), and ray-tracing aberrometry (−0.45 ± 0.64 D), compared to manifest refraction (−0.12 ± 0.44 D) (P < .001). Hartmann-Shack wavefront analysis showed a statistically significant myopic shift (−0.39 ± 0.47 D) in the ZCBOO group compared to ray-tracing aberrometry, automated refraction, and manifest refraction spherical equivalent (−0.14 ± 0.56, −0.14 ± 0.50, and −0.06 ± 0.44 D, respectively; P < .001).

The study concluded that manifest refraction techniques unique to echelette technology should be used to avoid over-minus end points. Myopic results are expected with echelette achromatic technology.