Objective evaluation of refractive data and astigmatism: quantification and analysis

The aim of this study was to present methods to improve the analysis of refractive data. A comparison of methods is used to analyse refractive powers using individual powers and aggregate data. Equations are also developed for the representation of the average power of a lens or refractive data as a univariate measure, which includes spherical, coma, and/or other aberrations. The equations provide a precise representation of refractive power, which is useful for comparing individual and aggregate data. Average lens power in the principal meridian can be adequately computed as can the average lens power through orthogonal and oblique meridians, providing a good univariate representation of astigmatism and refractive power. Although these formulae are perhaps not as easy to use as, for example, the spherical equivalent, they are more precise and superior in principle involving fewer approximations and are not subject to systematic bias. These effects are of significance when dealing with high-powered lenses such as intraocular lenses or the cornea. They need to be taken into account particularly for calculations of intraocular lens power, toric intraocular lenses, and cornea refractive surgery, especially if outcomes are to be improved. Such issues are of particular importance when dealing with aggregate data and determining statistical significance of treatment effects.