AIM: To evaluate the accuracy of the Plusoptix A09 photorefraction with and without cycloplegia compared to an autorefractometer in pediatric patients.

METHODS: We assessed the refractive status of 180 eyes in 90 pediatric patients. Refractions were measured with the Plusoptix A09 photorefractor(Plusoptix GmbH, Nürnberg, Germany)with and without cycloplegia and compared with those obtained by autorefractometer(Topcon KR-8900, Tokyo, Japan)after cycloplegia. Spherical equivalent, spherical power cylindrical power and cylindrical axis J0, J45 values measurements were analyzed with Bland-Altman analysis.

RESULTS: The mean age of the patients was 7.48±3.01(range 3 to 13y). Between the non-cycloplegic Plusoptix A09 photorefractometer and the cycloplegic autorefractometer measurements, there was significant difference between spherical power and spherical equivalent values(P<0.001)but there was no significant difference between cylindrical power, J0 and J45 values(P>0.05). Between the cycloplegic Plusoptix A09 photorefractometer and the cycloplegic autorefractometer measurements, there was significant difference between spherical power and spherical equivalent values(P<0.001)but there was no significant difference between the cylindric power, J0 and J45 values(P>0.05). Bland-Altman correlation analysis revealed an excellent correlation for the spherical power, cylindrical power and spherical equivalent measurements, but poor correlation for J0 and J45 values between the non-cycloplegic, cycloplegic Plusoptix A09 and the cycloplegic autorefractometer measurements.

CONCLUSION: To determine refractive errors in children, the Plusoptix A09 measurements with and without cycloplegia can give reliable results. But it is inadequate when measuring the cylindrical axis and high refractive values. This device can be an effective option to detect and screen refractive errors in uncooperative children.