Effect of capsule treatment on visual acuity and quality after phacoemulsification lens implantation in myopic patients with cataract

BACKGROUND Cataracts pose a significant clinical burden due to their complex pathogenesis.In recent years,an increase in cataracts coexisting with myopia has heightened the incidence of retinopathy and posterior vitreous detachment.Additionally,symptoms of ocular axis elongation,lens nucleus hardening,and vitreous liquefaction have become more prevalent.While conventional extracapsular cataract extraction is commonly employed,it often yields suboptimal visual outcomes.Subsequent advancements in cataract phacoemulsification and lens implantation surgeries have gained widespread acceptance for their ability to improve refraction and significantly improve uncorrected visual acuity.AIM To investigate the effect of capsular treatment after phacoemulsification lens implantation in myopic patients with cataract.METHODS We selected 110 patients(with 134 eyes)with myopia and cataracts treated.These patients were categorized into two groups:an observation group(57 patients with 70 eyes)and a control group(53 patients with 64 eyes).The control group underwent cataract phacoemulsification and lens implantation,while the observation group received a refined capsular treatment based on the control group’s procedure.We assessed the differences in visual acuity and quality between the two groups before and after surgery.RESULTS At six months post-operation,the observation group exhibited significantly improved far vision,intermediate vision,near vision,lower objective scattering index,higher Modulation transfer function cut-off frequency,and overall vision metrics at different contrast levels(100%,20%and 9%)compared to the control group(P<0.05).The total score of the National Eye Institute Visual Function Questionnaire in the observation group at 6 months after operation was significantly higher than that in the control group(P<0.05).No significant difference in the incidence of adverse reactions was observed between the observation group and control group(P>0.05).CONCLUSION Capsular treatment demonstrates efficacy in improving visual acuity and quality after phacoemulsification lens implantation in myopic patients with cataracts,warranting its clinical application.

OCTA characteristics in non-arteritic central retinal artery occlusion and correlation with visual acuity

AIM:To observe the retinal and choroidal circulations in patients with non-arteritic permanent central retinal artery occlusion(NA-CRAO)via optical coherence tomography angiography(OCTA)and analyze their correlation with visual acuity.METHODS:Sixty-two eyes with clinically confirmed acute NA-CRAO were included in the study and divided into:A type(mild n=29),B type(moderate n=27)and C type(severe n=6)based on the degree of visual loss,retinal edema,and arterial blood flow delay in fundus fluorescence angiography(FFA).Contralateral healthy eyes were used as the control group.Best-corrected visual acuity(BCVA),slit lamp microscopy,indirect ophthalmoscopy,fundus color photography,OCTA,and FFA were performed.Spearman’s correlation analysis was used to determine the correlations between retinal and choroidal vessels and visual acuity.RESULTS:There were no statistically significant differences in age,gender,and intraocular pressure among the three types and the control group(P>0.05).Vessel density in deep capillary plexus(VD-DCP)significantly decreased(P<0.05)in all three types of NA-CRAO patients compared to the control group.Vessel density in superficial vascular plexus(VD-SVP)significantly decreased(P<0.05)in type A patients and choriocapillaris flow area significantly decreased(P<0.05)in type B and type C patients compared to the control group;while outer retinal flow areas significantly increased in the type A(P<0.05)and decreased in type C patients(P<0.05).The retinal thickness significantly increased in type C group(P<0.05).The VD-SVP at fovea in the type A was significantly lower than both of type B and C.The VD-SVP at nasal parafovea in type A and B was significantly lower than type C(P<0.05).The logMAR BCVA of type A was significantly better than that of type B and C groups(P<0.05).Spearman’s correlation analysis showed that the logMAR BCVA was positively correlated with VD-SVP at fovea(r=0.679,P=0.031)and nasal parafovea(r=0.826,P=0.013).CONCLUSION:OCTA is valuable for assessing retinal ischemia,and evaluating visual impairment.Deep retinal vasculature is commonly affected in all NA-CRAO types.VDSVPs at fovea and nasal parafovea can serve as reliable markers of visual impairment in NA-CRAO.

Association of age at diagnosis of diabetes with subsequent risk of age-related ocular diseases and vision acuity

BACKGROUND The importance of age on the development of ocular conditions has been reported by numerous studies.Diabetes may have different associations with different stages of ocular conditions,and the duration of diabetes may affect the development of diabetic eye disease.While there is a dose-response relationship between the age at diagnosis of diabetes and the risk of cardiovascular disease and mortality,whether the age at diagnosis of diabetes is associated with incident ocular conditions remains to be explored.It is unclear which types of diabetes are more predictive of ocular conditions.AIM To examine associations between the age of diabetes diagnosis and the incidence of cataract,glaucoma,age-related macular degeneration(AMD),and vision acuity.METHODS Our analysis was using the UK Biobank.The cohort included 8709 diabetic participants and 17418 controls for ocular condition analysis,and 6689 diabetic participants and 13378 controls for vision analysis.Ocular diseases were identified using inpatient records until January 2021.Vision acuity was assessed using a chart.RESULTS During a median follow-up of 11.0 years,3874,665,and 616 new cases of cataract,glaucoma,and AMD,respectively,were identified.A stronger association between diabetes and incident ocular conditions was observed where diabetes was diagnosed at a younger age.Individuals with type 2 diabetes(T2D)diagnosed at<45 years[HR(95%CI):2.71(1.49-4.93)],45-49 years[2.57(1.17-5.65)],50-54 years[1.85(1.13-3.04)],or 50-59 years of age[1.53(1.00-2.34)]had a higher risk of AMD independent of glycated haemoglobin.T2D diagnosed<45 years[HR(95%CI):2.18(1.71-2.79)],45-49 years[1.54(1.19-2.01)],50-54 years[1.60(1.31-1.96)],or 55-59 years of age[1.21(1.02-1.43)]was associated with an increased cataract risk.T2D diagnosed<45 years of age only was associated with an increased risk of glaucoma[HR(95%CI):1.76(1.00-3.12)].HRs(95%CIs)for AMD,cataract,and glaucoma associated with type 1 diabetes(T1D)were 4.12(1.99-8.53),2.95(2.17-4.02),and 2.40(1.09-5.31),respectively.In multivariable-adjusted analysis,individuals with T2D diagnosed<45 years of age[β95%CI:0.025(0.009,0.040)]had a larger increase in LogMAR.Theβ(95%CI)for LogMAR associated with T1D was 0.044(0.014,0.073).CONCLUSION The younger age at the diagnosis of diabetes is associated with a larger relative risk of incident ocular diseases and greater vision loss.

Predicting visual acuity with machine learning in treated ocular trauma patients

AIM:To predict best-corrected visual acuity(BCVA)by machine learning in patients with ocular trauma who were treated for at least 6mo.METHODS:The internal dataset consisted of 850 patients with 1589 eyes and an average age of 44.29y.The initial visual acuity was 0.99 log MAR.The test dataset consisted of 60 patients with 100 eyes collected while the model was optimized.Four different machine-learning algorithms(Extreme Gradient Boosting,support vector regression,Bayesian ridge,and random forest regressor)were used to predict BCVA,and four algorithms(Extreme Gradient Boosting,support vector machine,logistic regression,and random forest classifier)were used to classify BCVA in patients with ocular trauma after treatment for 6mo or longer.Clinical features were obtained from outpatient records,and ocular parameters were extracted from optical coherence tomography images and fundus photographs.These features were put into different machine-learning models,and the obtained predicted values were compared with the actual BCVA values.The best-performing model and the best variable selected were further evaluated in the test dataset.RESULTS:There was a significant correlation between the predicted and actual values[all Pearson correlation coefficient(PCC)>0.6].Considering only the data from the traumatic group(group A)into account,the lowest mean absolute error(MAE)and root mean square error(RMSE)were 0.30 and 0.40 log MAR,respectively.In the traumatic and healthy groups(group B),the lowest MAE and RMSE were 0.20 and 0.33 log MAR,respectively.The sensitivity was always higher than the specificity in group A,in contrast to the results in group B.The classification accuracy and precision were above 0.80 in both groups.The MAE,RMSE,and PCC of the test dataset were 0.20,0.29,and 0.96,respectively.The sensitivity,precision,specificity,and accuracy of the test dataset were 0.83,0.92,0.95,and 0.90,respectively.CONCLUSION:Predicting BCVA using machine-learning models in patients with treated ocular trauma is accurate and helpful in the identification of visual dysfunction.

Forensic Study on Objective Evaluation of Visual Acuity of Ametropia with the Event-related Potential P3

Objective In this study,we aimed to assess the characteristics of the P3 component from an event-related potential(ERP)that was induced by visual acuity(VA)processing.Furthermore,we sought to provide electrophysiological evidence for the objective evaluation of VA.Methods We recruited 32 participants with myopia-related ametropia.They reported no other ocular diseases and had an uncorrected VA of 4.0 in both eyes.We used the block letter“E”at different visual angles and orientations as the graphic stimuli.The oddball paradigm,consisting of 4 modules,was used for ERP analysis.The standard stimuli of each module were identical,with a visual angle of 1°15′.The visual angles of the target stimuli were 1°15′,55′,24′,and 15′.The VA test was performed on each eye separately for all participants,and all characteristics of the P3 component were analyzed.Results There was no significant difference in the P3 peak letencies between the target stimulation angle 1°15′group and the 55′group,or between the target stimulation angle 24′group and the 15′group.There was a significant difference in the P3 peak letencies between the target stimulation angle 1°15′group and the 24′group as well as the 15′group.There was a significant difference in the P3 peak letencies between the target stimulation angle 55′group and the 24′group as well as the 15′group.No significant differences were observed in the P3 amplitude between modules.Conclusion In the oddball paradigm,P3 elicitation indicated a cognitive response to the target stimuli.These data showed that the characteristics of P3 can be used as an objective evaluation of VA.

美国瓦里安Acuity模拟定位机常见故障分析

模拟定位机是肿瘤放射治疗过程中所涉及的重要设备,承担确定照射范围、验证位置精度等工作,在整个放射治疗过程中起到至关重要的作用。因此,模拟定位机一旦发生故障,将导致设备精度下降甚至停机,严重影响临床诊疗工作。

Prognosis value of Chinese Ocular Fundus Diseases Society classification for proliferative diabetic retinopathy on postoperative visual acuity after pars plana vitrectomy in type 2 diabetes

AIM: To compare the postoperative visual acuity among eyes with proliferative diabetic retinopathy(PDR) of different stages after pars plana vitrectomy(PPV) in type 2 diabetic patients. METHODS: A retrospective study was conducted for PDR eyes undergoing PPV in type 2 diabetic patients. All patients were divided into three groups based on Chinese Ocular Fundus Diseases Society(COFDS) classification for PDR: Group A(primary vitreous hemorrhage), Group B(primary fibrovascular proliferation) and Group C(primary vitreous hemorrhage and/or fibrovascular proliferative combined with retinal detachment). The postoperative visual acuity and the change between postoperative and preoperative visual acuity were compared among three groups. The associated risk factors for postoperative visual acuity were analyzed in the univariate and multiple linear aggression. RESULTS: In total, 195 eyes of 195 patients were collected in this study, including 71 eyes of 71 patients in Group A, 75 eyes of 75 patients in Group B and 49 eyes of 49 patients in Group C. The eyes in Group A got better postoperative best-corrected visual acuity(BCVA) compared to the eyes in Group B and C(0.48±0.48 vs 0.89±0.63, P<0.001;0.48±0.48 vs 1.04±0.67, P<0.001;respectively). The eyes in Group A got more improvement of BCVA compared to the eyes in Group B and C(1.07±0.70 vs 0.73±0.68, P=0.004;1.07±0.70 vs 0.77±0.78, P=0.024;respectively). In the multiple linear regression analysis, primary fibro-proliferative type(β=0.194, 95%CI=0.060-0.447, P=0.01), retinal detachment type(β=0.244, 95%CI=0.132-0.579, P=0.02), baseline log MAR BCVA(β=0.192, 95%CI=0.068-0.345, P=0.004), silicone oil tamponade(β=0.272, 95%CI=0.173-0.528, P<0.001) was positively correlated with postoperative log MAR BCVA. Eyes undergoing phacovitrectomy had better postoperative BCVA(β=-0.144, 95%CI=-0.389 to-0.027, P=0.025). CONCLUSION: PDR eyes of primary vitreous hemorrhage type usually have better visual acuity prognosis compared to primary fibrovascular proliferation type and retinal detachment type. COFDS classification for PDR may have a high prognostic value for postoperative visual outcome and surgical management indications.

A comparison of visual acuity measured by ETDRS chart and Standard Logarithmic Visual Acuity chart among outpatients

AIM:To compare the results of visual acuity(VA)measured by Early Treatment Diabetic Retinopathy Study(ETDRS)chart,5 m Standard Logarithm Visual Acuity(5 SL)chart,and 2.5 m Standard Logarithm Visual Acuity(2.5 SL)chart in outpatients of age 12-80 y.METHODS:Each patient(totally 2000 outpatients)had both eyes tested with ETDRS chart at 4 m,5 SL chart at 5 m,and 2.5 SL chart at 2.5 m in random order.The VA values of outpatients were categorized by ages.VA values were expressed by log MAR recording method.RESULTS:The mean VA results of ETDRS charts,5 SL,and 2.5 SL chart were 0.52±0.28,0.50±0.30,and 0.46±0.28 log MAR,respectively.There was a statistically significant difference in the three eye charts in the whole group(P<0.001).For all subjects,the correlation of VA tested with three charts was statistically significant(Spearman correlation coefficient=0.944,0.937,0.946,all P<0.001).Bland–Altman analysis shows the 95%limits of agreement between the 5 SL and 2.5 SL chart were-0.182 to 0.210,-0.139 to 0.251,and-0.151 to 0.235 log MAR,respectively.CONCLUSION:The agreement between the three eye charts is not high.The VA measured by 5 SL chart is slightly better than that by ETDRS chart and 5 SL chart would be a suitable alternative when ETDRS chart are not available in the clinical situation.The VA measured by 2.5 SL chart is about 0.5 line better than VA tested with ETDRS chart,which may overestimate VA.

On Naipaurs novels from reality and acuity

Naipaul＇s novels are real and acute, which reflect many countries and social realities, especially terrible lives and depressed emotions, including human interests, opinions, ideas, consciousnesses, self-acceptance, idea crisis, looking for identity, spiritual trouble, contradiction between religion and life, cultural conflict in colonized countries and post-colonized areas. Such novels are from actual realities, life facts, street matters with miscellaneous, vicissitudinous, and integrative skills and abilities.

Factors influencing stereoacuity levels after surgery to correct unilateral developmental cataracts in children

·AIM: To evaluate factors influencing stereoacuity after surgery to correct unilateral developmental pediatric cataracts. ·METHODS: We retrospectively surveyed 110 patients who had undergone removal of unilateral acquired developmental cataracts and primary posterior chamber intraocular lens implantation between February 1992 and December 2009. In all patients, stereoacuity was assessed using the Titmus test at the last follow -up period of minimum 2 years after surgery. Patients were divided into two groups according to the extent of stereoacuity : group 1 ( = 42 ) had stereoacuity values ≤ 100sec/arc and group 2 ( =68) values 】100sec/arc. The values of ten parameters associated with stereoacuity were measured in each group: Cataract types, preoperative best corrected visual acuity (BCVA) of the affected eyes, preoperative inter -ocular difference of BCVA, age at cataract surgery, operative method, secondary cataract, postoperative strabismus, postoperative BCVA of the affected eyes, postoperative inter-ocular difference of BCVA, and anisometropia. ·RESULTS: The extent of stereoacuity was significantly associated with both operative method and secondary cataract ( =0.000 and =0.016, respectively). All patients in whom the posterior capsule was preserved, had poor stereoacuity 】100sec/arc. Significant correlations with the extent of stereoacuity were found with postoperative strabismus ( =0.048),postoperative BCVA of the affected eyes ( =0.002), anisometropia ( =0.034). ·CONCLUSION: Postoperative stereoacuity was better in patients who underwent either optic capture or anterior vitrectomy after posterior continuous curvilinear capsulorhexis, and who didn’t develop secondary cataracts or strabismus postoperatively. Furthermore, postoperative BCVA of the affected eyes, and anisometropia influenced the stereoacuity of the patients surgically treated for unilateral developmental pediatric cataracts. ·

A new measure of nystagmus acuity

AIM: To construct a new visual acuity measuring function for congenital nystagmus(CN) patients by studying the relationships between acuity,velocities and positions of the eye. ·METHODS: After assessing the relationship between acuity,movement velocities and positions of the eye separately,a new function,which we call the automated nystagmus acuity function(ANAF),was constructed to measure the visual acuity of CN patients. Using a high-speed digital video system working at 500 frames per second,each eye was calibrated during monocular fixation. Twenty-six recorded nystagmus data were selected randomly. Using nystagmus waveforms,the best vision position(foveation period) and visual acuity were analyzed in three groups of subjects,and then all outputs were compared with the well-known expanded nystagmus acuity function(NAFX) and ANAF. Standard descriptive statistics were used to summarize the outputs of the two programs. ·RESULTS: Foveation periods were brief intervals in the CN waveform when the image was on or near the fovea and eye velocity was relatively slow. Results showed good visual acuity happened during the period when velocity was low and the eye position was near the zero position,which fitted the foveation periods. The data analyzed with NAFX and ANAF had a correlation coefficient of 0.934276,with an average error of-0.00973. · CONCLUSION: The results from ANAF and NAFX analyses showed no significant difference. The NAFX manually identifies foveation eye positions and produces accurate measurements. The ANAF,however,can be calculated simply using the factors eye position andvelocity,and it automatically calculates the ANAF without the need to manually identify foveation eye positions.

Visual acuity of urban and rural adults in a coastal province of southern China:the Fujian Eye Study

AIM:To evaluate the vision status and sociodemographic associations of visual acuity(VA)in an urban and rural population in a coastal province of southern China.METHODS:The Fujian Eye Study,a population-based cross-sectional study,was performed from May 2018 to October 2019.Totally 10044 participants over 50 years old from all nine cities in Fujian Province were enrolled,and underwent a questionnaire and a series of standard physical and ocular examinations.VA was measured by E Standard Logarithmic Visual Acuity Chart(GB 11533-1989).Data was double entered with Epi Data v3.1 for data collation and Stata/SE statistical software v15.1 was used to analyze the data.RESULTS:Totally 8211(81.8%)participants were finally included and were divided into urban populations(4678 subjects),rural populations(n=3533),coastal residents(n=6434),and inland residents(1777 subjects);4836 participants were female.The mean age was 64.39±8.87 y(median 64 y;range 50-98 y).The mean presenting VA was 0.61±0.30(0.23±0.27 log MAR),and the mean best correctedvisual acuity(BCVA)was 0.82±0.28(0.08±0.19 log MAR).In the multiple regression analysis,BCVA was significantly correlated with several socioeconomic and biologic factors,including age(P<0.001),education level(P<0.001),income(P=0.005),rural residency(P<0.001),inland residency(P=0.001)and refractive error(P<0.001),while sex(P=0.194)was independent with BCVA.CONCLUSION:Accessible services and eye health policies targeting the elderly,people with high myopia and people living in rural or inland areas are needed.

Adaptive Rendering Based on Visual Acuity Equations

A new method of adaptable rendering for interaction in Virtual Environment(VE) through different visual acuity equations is proposed. An acuity factor equation of luminance vision is first given. Secondly, five equations which calculate the visual acuity through visual acuity factors are presented, and adaptive rendering strategy based on different visual acuity equations is given. The VE system may select one of them on the basis of the host’s load, hereby select LOD for each model which would be rendered. A coarser LOD is selected where the visual acuity is lower, and a better LOD is used where it is higher. This method is tested through experiments and the experimental results show that it is effective.

Association between Anisometropia as Well as Visual Acuity, Aniseikonia, and Stereopsis in the Absence of Strabismus

Objective: The current study aimed to assess the association between the type of anisometropia and its effects on monocular and binocular best-corrected vision acuity (BCVA), aniseikonia, and stereopsis in the absence of strabismus. Methods: In total, 162 individuals with anisometropia and healthy eyes and without a previous history of amblyopia therapy and eye surgery were included in the analysis. According to spherical and cylindrical components and spherical equivalent, they were divided into the spherical hyperopic anisometropia (SHA, n = 31), spherical myopic anisometropia (SMA, n = 45), astigmatic or cylindrical hyperopic anisometropia (CHA, n = 22), and astigmatic or cylindrical myopic anisometropia (CMA, n = 64) groups. Patients without anisometropia (NA, n = 188) were classified under the control group. The effects of anisometropia on monocular and binocular BCVA, aniseikonia, and stereoacuity were examined. Results: The NA group had a significantly lower LogMAR of BCVA of the right eye (RE), left eye (LE), worse eye than the SHA, SMA, CMA, and CHA groups. Moreover, the SMA group had significantly lower LogMAR of BCVA than the CHA group (p Conclusion: Worse visual levels of the RE, LE, worse eye, BCVA difference, and lower stereopsis were evidenced in each type of anisometropia defined in this study. Cylindrical hyperopic anisometropia (CHA) resulted in a statically significant worsening VA level and stereopsis than cylindrical myopic (CMA) or spherical myopic anisometropia.

Amniotic membrane covering promotes healing of cornea epithelium and improves visual acuity after debridement for fungal keratitis

AIM:To investigate the effect of amniotic membrane covering(AMC) on the healing of cornea epithelium and visual acuity for fungal keratitis after debridement.METHODS:Twenty fungal keratitis patients were divided into two groups randomly, the AMC group and the control group, ten patients each group. Both debridement of the infected cornea tissue and standard anti-fungus drugs treatments were given to every patients, monolayer amniotic membrane were sutured to the surface of the entire cornea and bulbar conjunctiva with 10-0 nylon suture for patients in the AMC group.The diameter of the ulcer was determined with slit lamp microscope and the depth of the infiltration was determined with anterior segment optical coherence tomography. Uncorrected visual acuity(UCVA) was tested before surgery and three month after healing of the epithelial layer. The healing time of the cornea epithelium, visual acuity(VA) was compared between the two groups using t- test.RESULTS:There was no statistical difference of the diameter of the ulcer, depth of the infiltration, height of the hypopyon and VA between the two groups beforesurgery(P 】0.05). The average healing time of the AMC group was 6.89 ±2.98 d, which was statistically shorter than that of the control group(10.23±2.78d)(P 【0.05).The average UCVA of the AMC group was 0.138 ±0.083,which was statistically better than that of the control group(0.053±0.068)(P 【0.05).CONCLUSION:AMC surgery could promote healing of cornea epithelium after debridement for fungal keratitis and lead to better VA outcome.

Contrast visual acuity after multifocal intraocular lens implantation: aspheric versus spherical design

AIM: To evaluate contrast visual acuity(CVA) after implantation of an aspheric apodized diffractive intraocular lens(IOL) or a spherical apodized diffractive IOL in cataract surgery. ·METHODS: This prospective randomized controlled study with a 12-month follow-up compared the results of cataract surgery with implantation of an aspheric AcrySof ReSTOR SN6AD3 IOL(30 eyes) and a spherical AcrySof ReSTOR SN60D3 IOL(30 eyes). CVA with best distance correction was measured at 4 contrast levels(100%,25%,10% and 5%) under 3 levels of chart luminance [250,85 and 25 candelas per square meter(cd/m2)] using a multi-functional visual acuity tester(MFVA-100). ·RESULTS: At 12 months after surgery,there were no statistically significant differences in 100% CVA and 25% CVA under 250cd/m2(P100% =0.875 and P25% =0.057) and 85cd/m2(P100% =0.198 and P25% =0.193) between the aspheric group and the spherical group. However,the 10% CVA and 5% CVA were significant better in aspheric group than spherical group under 250cd/m2(P10% =0.042 and P5% = 0.007) and 85cd/m2(P10% =0.002 and P5%=0.039). Under the luminance level of 25cd/m 2,no significant differences was found in the 100% CVA between the 2 group(P100% = 0.245),while aspheric group had better visual acuity in the remaining 3 contracts(P25% =0.023,P10% =0.026 and P5% = 0.002,respectively). ·CONCULSION: The aspheric AcrySof ReSTOR SN6AD3 IOL provided patients with better low-contrast visual acuity than the spherical AcrySof ReSTOR SN60D3 IOL.

Applications of dynamic visual acuity test in clinical ophthalmology

Dynamic visual acuity test(DVAT)plays a key role in the assessment of vestibular function,the visual function of athletes,as well as various ocular diseases.As the visual pathways conducting dynamic and static signals are different,DVATs may have potential advantages over the traditional visual acuity tests commonly used,such as static visual acuity,contrast sensitivity,and static perimetry.Here,we provide a review of commonly applied DVATs and their several uses in clinical ophthalmology.These data indicate that the DVAT has its unique clinical significance in the evaluation of several ocular disorders.

Influence of severity and types of astigmatism on visual acuity in school-aged children in southern China

AIM： To investigate the influence of astigmatism on visual acuity in school-aged children, and to define a cutoff for clinically significant astigmatism. METHODS： This is a population-based, cross-sectional study. Among 5053 enumerated children aged 5-15 y in Guangzhou, 3729（73.8%） children aged 7-15 with successful cycloplegic auto-refraction（1% cyclopentolate） and a reliable visual acuity measurement were included. Ocular measurement included external eye, anterior segment, media and fundus and cycloplegic auto-refraction. Primary outcome measures included the relationship between severity and subtypes of astigmatism and the prevalence of visual impairment. Three criteria for visual impairment were adopted： best-corrected visual acuity（BCVA） ≤0.7, uncorrected visual acuity（UCVA） ≤0.5 or 〈0.7 in the right eye.RESULTS： Increases of cylinder power was significantly associated with worse visual acuity（UCVA： β=0.051, P〈0.01; BCVA： β=0.025, P〈0.001）. A substantial increase in UCVI and BCVI was seen with astigmatism of 1.00 diopter（D） or more. Astigmatism ≥1.00 D had a greater BCVI prevalence than cylinder power less than 1.00 D（OR=4.20, 95%CI： 3.08-5.74）, and this was also true for hyperopic, emmetropic and myopic refraction categories. Oblique astigmatism was associated with a higher risk of BCVI relative to with the rule astigmatism in myopic refractive category（OR=12.87, 95%CI： 2.20-75.38）.CONCLUSION： Both magnitude and subtypes of astigmatism influence the prevalence of visual impairment in school children. Cylinder ≥1.00 D may be useful as a cutoff for clinically significant astigmatism.

Comparison of visual acuity of the patients on the first day after sub-Bowman keratomileusis or laser in situ keratomileusis

AIM：To compare recovery of the visual acuity in patients one day after sub-Bowman keratomileusis（SBK）or laser in situ keratomileusis（LASIK）.· METHODS：Data from 5923 eyes in 2968 patients that received LASIK（2755 eyes） or SBK（3168 eyes） were retrospectively analyzed.The eyes were divided into 4groups according to preoperative spherical equivalent：between-12.00 to-9.00 D,extremely high myopia（n =396,including 192 and 204 in SBK and LASIK groups,respectively）;-9.00 to-6.00 D,high myopia（n=1822,including 991 and 831 in SBK and LASIK groups,respectively）,-6.00 to-3.00 D,moderate myopia（n=3071,including 1658 and 1413 in SBK and LASIK groups,respectively）,and-3.00 to 0.00 D,low myopia（n =634,including 327 and 307 in SBK and LASIK groups,respectively）.Uncorrected logMAR visual acuity values of patients were assessed under standard natural light.Analysis of variance was used for comparisons among different groups.· RESULTS：Uncorrected visual acuity values were0.0115±0.1051 and 0.0466±0.1477 at day 1 after operation for patients receiving SBK and LASIK,respectively（P〈0.01）;visual acuity values of 0.1854±0.1842,0.0615±0.1326,-0.0033±0.0978,and-0.0164±0.0972 were obtained for patients in the extremely high,high,moderate,and low myopia groups,respectively（P〈0.01）.In addition,significant differences in visual acuity at day 1 after operation were found between patients receiving SBK and LASIK in each myopia subgroup.· CONCLUSION：Compared with LASIK,SBK is safer and more effective,with faster recovery.Therefore,SBK is more likely to be accepted by patients than LASIK for better uncorrected visual acuity the day following operation.

Characteristics of Pattern Visual Evoked Potential in Two Eyes with Varying Visual Acuity in One Eye and Forensic Application

In this study, we aimed to study the pattern visual evoked potentials （P-VEPs） in two eyes with varying visual acuity in one eye and to provide an objective estimation of visual acuity by comparing P-VEPs in one and two eyes. Thirty subjects were chosen, who had one eye with an acuity of 5.0, 4.85, 4.6, 4.0, or scieropia and obstructed vision and the other eye with an acuity of 5.0, respectively. P-VEPs were detected under the large grating stimuli at 3x4 spatial frequency, moderate grating stimuli （12× 16 spatial frequency） and small grating stimuli （48×64 spatial frequency）. Under large grating stimuli, there was no significant difference in P100 peak latency between the groups, nor was there a significant difference between the amplitude of two eyes and the amplitude of one normal-vision eye. Under moderate and small grating stimuli, there was a significant difference in P100 peak latency between the group with both eyes having an acuity of 5.0 and the group with visual acuity below 4.0 in one eye. There was a significant difference in P100 amplitude between the group with visual acuity of 5.0 in both eyes and the group with one normal-vision eye. There was no significant difference in the amplitude of two eyes and the amplitude of one normal-vision eye between any other two groups. In forensic identification, characteristics and variability of P-VEPs in one and two eyes can be used to identify malingering or decline in visual acuity.