Relative peripheral refraction in school children with different refractive errors using a novel multispectral refraction topographer

AIM:To compare relative peripheral refraction(RPR)in Chinese school children with different refractive errors using multispectral refraction topography(MRT).METHODS:A total of 713 eyes of primary school children[172 emmetropia(E),429 low myopia(LM),80 moderate myopia(MM),and 32 low hypermetropia(LH)]aged 10 to 13y were analyzed.RPRs were measured using MRT without mydriasis.MRT results showed RPR at 0-15°(RPR 0-15),15°-30°(RPR 15-30),and 30°-45°(RPR 30-45)annular in the inferior(RPR-I),superior(RPR-S),nasal(RPR-N),and temporal(RPR-T)quadrants.Spherical equivalent(SE)was detected and calculated using an autorefractor.RESULTS:There were significant differences of RPR 15-30 between groups MM[0.02(-0.12;0.18)]and LH[-0.13(-0.36;0.12)](P<0.05),MM and E[-0.06(-0.20;0.10)](P<0.05),and LM[-0.02(-0.15;0.15)]and E(P<0.05).There were also significant differences of RPR 30-45 between groups MM[0.45(0.18;0.74)]and E[0.29(-0.09;0.67)](P<0.05),and LM[0.44(0.14;0.76)]and E(P<0.001).RPR values increased from the hyperopic to medium myopic group in each annular.There were significant differences of RPR-S between groups MM[-0.02(-0.60;0.30)]and E[-0.44(-0.89;-0.04)](P<0.001),and LM[-0.28(-0.71;0.12)]and E(P<0.05).There were also significant differences of RPR-T between groups MM[0.37(0.21;0.78)]and LH[0.14(-0.52;0.50)](P<0.05),LM[0.41(0.06;0.84)]and LH(P<0.05),and LM and E[0.29(-0.10;0.68),P<0.05].A Spearman’s correlation analysis showed a negative correlation between RPR and SE in the 15°-30°(P=0.005),30°-45°(P<0.05)annular(P=0.002),superior(P<0.001),and temporal(P=0.001)quadrants.CONCLUSION:Without pupil dilation,values for RPR 15-30,30-45,RPR-S,and T shows significant differences between myopic eyes and emmetropia,and the differences are negatively correlated with SE.

Prevalence of visual impairment and estimation of refractive errors among school children in Kakamega,Kenya

AIM:To investigate the prevalence of visual impairment(VI)and provide an estimation of uncorrected refractive errors in school-aged children,conducted by optometry students as a community service.METHODS:The study was cross-sectional.Totally 3343 participants were included in the study.The initial examination involved assessing the uncorrected distance visual acuity(UDVA)and visual acuity(VA)while using a+2.00 D lens.The inclusion criteria for a subsequent comprehensive cycloplegic eye examination,performed by an optometrist,were as follows:a UDVA<0.6 decimal(0.20 logMAR)and/or a VA with+2.00 D≥0.8 decimal(0.96 logMAR).RESULTS:The sample had a mean age of 10.92±2.13y(range 4 to 17y),and 51.3%of the children were female(n=1715).The majority of the children(89.7%)fell within the age range of 8 to 14y.Among the ethnic groups,the highest representation was from the Luhya group(60.6%)followed by Luo(20.4%).Mean logMAR UDVA choosing the best eye for each student was 0.29±0.17(range 1.70 to 0.22).Out of the total,246 participants(7.4%)had a full eye examination.The estimated prevalence of myopia(defined as spherical equivalent≤-0.5 D)was found to be 1.45%of the total sample.While around 0.18%of the total sample had hyperopia value exceeding+1.75 D.Refractive astigmatism(cil<-0.75 D)was found in 0.21%(7/3343)of the children.The VI prevalence was 1.26%of the total sample.Among our cases of VI,76.2%could be attributed to uncorrected refractive error.Amblyopia was detected in 0.66%(22/3343)of the screened children.There was no statistically significant correlation observed between age or gender and refractive values.CONCLUSION:The primary cause of VI is determined to be uncorrected refractive errors,with myopia being the most prevalent refractive error observed.These findings underscore the significance of early identification and correction of refractive errors in school-aged children as a means to alleviate the impact of VI.

Fabrication of UV-Curing Linalool-Polysiloxane Hybrid Films with High Refractive Index and Transparency

In this article,a series of high refractive indices(1.50-1.53)thiol phenyl polysiloxane(TPS)were synthesized via hydrolytic sol-gel reaction.The Fourier transform infrared spectra(FT-IR)and nuclear magnetic resonance spectra(NMR)results showed that TPS conformed to the predicted structures.Natural terpene linalool was exploited as photocrosslinker to fabricate UV-curing linalool-polysiloxane hybrid films(LPH)with TPS via photoinitiated thiol-ene reaction.LPH rapidly cured under UV irradiation at the intensity of 80 mW/cm^(2) in 30 s,exhibiting good UV-curing properties.The optical transmittance of LPH in the wavelength of 300-800 nm was over 90%,exhibiting good optical transparency.The water contact angle and water vapor permeability results showed that the introduction of phenyl groups enhance the hydrophobicity and water vapor barrier properties of LPH.The results indicated the potential of LPHs in the applications of optical functional coatings.

Determination of the time of refractive stability after uneventful phacoemulsification in Indian eyes

BACKGROUND Knowledge about refractive stabilization and the accuracy of postoperative refractive error measurements are crucial for improved patient outcomes after phacoemulsification.Existing guidelines typically recommend waiting 4-6 wk before prescribing corrective lenses.Our research focused on identifying factors that influence refractive errors in the early stages of post-cataract surgery,thus contributing to the existing literature on this topic.AIM To investigate the time required for refraction stability after uneventful phacoemulsification surgery.METHODS We compared the variation and statistical significance of the difference in spherical,cylindrical components,and the spherical equivalent between the 1-and 6-wk follow-up period in a group of 257 eyes that underwent uneventful phacoemulsification with foldable intraocular lens implantation,all performed by a single experienced surgeon.The Wilcoxon-Signed Rank Test was utilized to assess the magnitude of the change and determine its statistical significance.The refractive stability was defined as the point at which the change in spherical equivalent was within±0.5 dioptres for two consecutive visits.RESULTS The average age of the patients was 64.9±8.9 yr.The differences observed in both the visits in spherical power(0.1±0.2),cylinder power(0.3±0.4),and spherical equivalent(0.2±0.2)were minimal and not statistically significant.The majority of eyes(93.4%)achieved refractive stability within 6 wk after the surgery.The cylindrical power differed between age groups at the 6th wk post-operative and the difference was statistically significant(P value 0.013).There were no significant differences in refractive stability when considering sex and axial length.CONCLUSION Phacoemulsification with foldable intraocular lens implantation results in no significant changes in refraction for the majority of cases during the 6-wk follow-up period.Therefore,a spectacle prescription can be given at the completion of 1 wk.

Prevalence of refractive errors in children of Puerto Rico

AIM:To determine the prevalence of refractive error in 5-to 17-year-old schoolchildren in Puerto Rico.METHODS:A quantitative descriptive study of 2867 children aged 5 to 17y from all seven educational regions of Puerto Rico was conducted from 2016–2019.Refractive error was determined via static and subjective refraction.Children with distance acuity≤20/40 or near visual acuity≤20/32 had a cycloplegic refraction.Data analysis included descriptive statistics,correlation coefficient,Kruskal-Wallis,Chi-square,and t test calculations.RESULTS:Twenty percent of the children had a spherical equivalent refractive error≤-0.50 D,3.2%had a spherical equivalent≥+2.00 D,and 10.4%had astigmatism≥1 D.There was a statistically(but non-clinically)significant myopic change in spherical equivalent refractive error with age(P<0.001).The prevalence of myopia increased with age(P<0.001)but not hyperopia(P=0.59)or astigmatism(P=0.51).Males had a significantly higher hyperopic spherical equivalent than females(P<0.001).Females had a higher prevalence of myopia(P<0.001)than males,but there was no difference in the hyperopia(P=0.74)or astigmatism prevalence(P=0.87).CONCLUSION:The prevalence of a spherical equivalent equal to or less than-0.50 D(myopia,20.7%)is one of the highest among similar-aged children worldwide.Further studies should explore the rate of myopia progression in children in Puerto Rico.Individual children must be monitored to examine the need for treatment of myopia progression.

Predictive methods for density and refractive index of naphthenic lubricating oils during solvent extraction process

Lubricating oils are usually produced by solvent extraction to separate aromatics in order to achieve the desired specifications and better quality products.Among the different properties of lubricating oils,density and refractive index are some of the most important properties which can both be used for petroleum fluid characterization.Predictions of density and refractive index for naphthenic oils during solvent extraction by DMSO obtained by the pseudo-component approach and the quadratic correlation were both examined.The pseudo-component approach is a method to predict density and refractive index from composition while the latter merely relates density to refractive index.Results indicated that the predictions yielded by the pseudo-component method were in good agreement with experimental data for naphthenic oils.And the use of a function of refractive index(FRI_(20))as a pseudo-component property remarkably improved n_(20)predictions for the naphthenic mixtures.However,the density and refractive index predictions obtained by the quadratic correlation exhibited significantly higher de-viations for naphthenic oils than those for paraffinic oils.Thus a new modified correlation of the same functional form was proposed for naphthenic oils.The modification significantly improved predictions for naphthenic oils,which presented similar accuracy as the pseudo-component approach.And the previous correlation was still used for paraffinic oils.Additionally,effect of temperature on density and refractive index of naphthenic oils was examined.Results showed that the modified quadratic correlation was accurate for describing the relationship between density and refractive index of naphthenic oils at 20-90℃.The temperature dependence of density and refractive index for the raffinates and the extracts could be accurately described by the thermal coefficients for saturates and aromatics,respectively.Regarding the refractive index variation of the extracts with temperature,the empirical equation was proved to be a better option compared with the method using the thermal coefficient for aromatics.

Bibliometric analysis of research relating to refractive cataract surgery over a 20-year period:from 2003 to 2022

AIM:To investigate the research trend on refractive cataract surgery,compare the contributions of different countries,institutions,journals,and authors in the past 20y,and explore its potential research hotspots.METHODS:All publications were extracted relating to refractive cataract surgery from 2003 to 2022 from Web of Science.Document types were limited to original articles and reviews,and the language was limited to English.Quantitatively and qualitatively of the publications were analyzed through Microsoft Excel and GraphPad Prism.VOSviewer and CiteSpace were used for bibliometric and visualized analysis.RESULTS:A total of 2090 publications were enrolled.The United States contributed the most publications(434,20.8%),followed by China(345,16.5%)and England(163,7.80%).Publications from the United States were cited more frequently(9552 citations)with the highest H-index of 48.China ranked second in the total number of publications,the papers were not cited that frequently(3237 citations),and the H-index ranked sixth(H-index=29).Journal of Cataract and Refractive Surgery published the most papers(333,15.9%),and the University of London had the highest number of publications(75,3.59%).Dick HB from Germany published the most papers.Corneal astigmatism-related research,cataract surgery methodrelated research,postoperative visual-quality relate to research,and postoperative complications-relate research are the hotspots in this field.The most significant limitation was that the database was updated frequently and the latest publications were not included.CONCLUSION:The bibliometric analysis shows a brief summarization of the contribution of the authors,institutions,countries,and journals.Corneal astigmatism,cataract surgery method,postoperative visual-quality and postoperative complications related researches have become the emerging hotspots,which can give a direction in the future researches.

A 3-month comparison study of subjective and objective visual quality of small incision lenticule extraction and transepithelial photorefractive keratectomy in patients with low and moderate myopia

AIM:To compare the subjective and objective visual quality between small incision lenticule extraction(SMILE)and transepithelial photorefractive keratectomy(t PRK)in patients with low and moderate myopia.METHODS:Patients undertaking SMILE or t PRK for the correction of low and moderate myopia were consecutively recruited in this prospective cohort study with a 3-month follow-up period.Objective evaluation[visual acuity test,manifest refraction,wavefront aberrations,the total cut-off value of the total modulation transfer function(MTFcut-off),and Strehl ratio(SR)]and subjective evaluation of visual quality(quality-of-life questionnaire)were conducted before surgery and at days 1,7,30,and 90 after surgery.RESULTS:A total of 47 patients(94 eyes)with SMILE and 22 patients(22 eyes)with t PRK were enrolled.The uncorrected visual acuity(UCVA)was better in SMILE patients on day 7 after surgery(1.13±0.13 vs 0.99±0.17,t=4.85,P<0.001)but was comparable at days 30 and 90.At day 90,the SMILE group had a lower spherical equivalent(SE)than the t PRK group(0.04±0.31 vs 0.19±0.43,t=2.08,P=0.042).Total higher order aberrations(HOAs)were induced in both surgical types,which were more evident in the t PRK group with 3-mm pupil diameter(0.16±0.07 vs0.11±0.05,t=4.27,P<0.001)and 5-mm pupil diameter(0.39±0.17 vs 0.36±0.11,t=2.33,P=0.022).The MTFcut-offand SR showed a trend of improvement in both SMILE and t PRK patients but were statistically better in the SMILE group with both pupil diameters.There was a significant improvement of contrast sensitivity(CS)over baseline levels at the spatial frequency of 18 cycles/degree(c/d)in the SMILE group(F=2.72,P=0.033)and at 3 c/d(F=3.03,P=0.031),12 c/d(F=3.72,P=0.013),and 18 c/d(F=4.62,P=0.004)in the t PRK group.The subjective quality of life questionnaire showed a steady improvement in the SMILE group(F=8.31,P<0.001)but not the t PRK group.CONCLUSION:SMILE and t PRK are both safe and effective ways to correct low and moderate myopia.A generally better and quicker recovery of visual quality favors the application of SMILE in qualified patients.

Axial length,vitreoretinal pathology,and anterior chamber depth can predict postoperative refractive outcomes in phacovitrectomy/silicone oil removal

AIM:To evaluate the postoperative refractive prediction error(PE)and determine the factors that af fect the refractive outcomes of combined pars plana vitrectomy(PPV)or silicone oil removal(SOR)with cataract surgery.METHODS:The study is a retrospective,case-series study.Totally 301 eyes of 301 patients undergoing combined PPV/SOR with cataract surgery were enrolled.Eligible individuals were separated into four groups according to their preoperative diagnoses:silicone oil-filled eyes after PPV(group 1),epiretinal membrane(group 2),macular hole(group 3),and primary retinal detachment(RD;group 4).The variables af fecting postoperative refractive outcomes were analyzed,including age,gender,preoperative best-corrected visual acuity(BCVA),axial length(AL),keratometry average,anterior chamber depth(ACD),intraocular tamponade,and vitreoretinal pathology.The outcome measurements include the mean refractive PE and the proportions of eyes with a PE within±0.50 diopter(D)and±1.00 D.RESULTS:For all patients,the mean PE was-0.04±1.17 D,and 50.17%of patients(eyes)had a PE within±0.50 D.There was a significant difference in refractive outcomes among the four groups(P=0.028),with RD(group 4)showing the least favorable refractive outcome.In multivariate regression analysis,only AL,vitreoretinal pathology,and ACD were strongly associated with PE(all P<0.01).Univariate analysis revealed that longer eyes(AL>26 mm)and a deeper ACD were correlated with hyperopic PE,and shorter eyes(AL<26 mm)and a shallower ACD were correlated with myopic PE.CONCLUSION:RD patients have the least favorable refractive outcome.AL,vitreoretinal pathology,and ACD are strongly associated with PE in the combined surgery.These three factors affect refractive outcomes and thus can be used to predict a better postoperative refractive outcome in clinical practice.

Uncorrected refractive errors are important causes of avoidable visual impairment in Hungary: re-evaluation of two existing national data sets

·AIM: To review existing data for the prevalence of corrected, uncorrected, and inadequately corrected refractive errors and spectacle wear in Hungary.·METHODS: Data from two nationwide cross-sectional studies were analysed. The Rapid Assessment of Avoidable Blindness study collected population-based representative national data on the prevalence of visual impairment due to uncorrected refractive errors and spectacle coverage in 3523 people aged ≥50y(Group I). The Comprehensive Health Test Program of Hungary provided data on the use of spectacles in 80 290 people aged ≥18y(Group Ⅱ).·RESULTS: In Group I, almost half of the survey population showed refractive errors for distant vision, about 10% of which were uncorrected(3.2% of all male participants and 5.0% of females). The distance spectacle coverage was 90.7%(91.9% in males;90.2% in females). The proportion of inadequate distance spectacles was found to be 33.1%. Uncorrected presbyopia was found in 15.7% of participants. In all age groups(Group Ⅱ), 65.4% of females and 56.0% of males used distance spectacles,and approximately 28.9% of these spectacles were found to be inappropriate for dioptric power(with 0.5 dioptres or more). The prevalence of inaccurate distance spectacles was significantly higher in older age groups(71y and above) in both sexes.·CONCLUSION: According to this population-based data, uncorrected refractive errors are not rare in Hungary. Despite recent national initiatives, fur ther steps are required to reduce uncorrected refractive errors and associated negative effects on vision, such as avoidable visual impairment.

Refractive State and Macular Abnormalities at Oct in Albino at Chu Iota

Introduction: A rare genetic disease, albinism is globally characterized by specific deficits of the visual system associated with a variable hypopigmentation phenotype depending on the disruption of melanin production [1]. It is linked to a hereditary defect in the biosynthesis of melanin. Disease results in a generalized decrease in the pigmentation of the appendages, skin and eyes [2]. The aim of this study is to determine the different refractive errors and the different macular anomalies during the OCT examination in oculocutaneous albinism at the CHU-IOTA. Patients and Method: We conducted a prospective study in patients over 10 years of age with oculocutaneous or ocular albinism who consulted at the CHU-IOTA between July 1, 2020, and September 30, 2021. Results: Over the period, 105 cases of oculocutaneous albinism were collected out of a total of 42,024 consultations, which corresponds to a frequency of 0.2%. The average age was 26.2 years, (11 years to 48 years). The sex ratio was 1.6. Astigmatism was the most found refractive error in 50.48% of cases, followed by myopia in 29.52% of cases and farsightedness in 20% of cases. The macular thickness between 251 - 350 was the most commonly found in both eyes, i.e. 47.25% on the right and 53.55% on the left. The bulging macula was the most frequent pathology on the OCT at the level of the two eyes, i.e. 41.42% on the right and 50.6% on the left. Conclusion: Following the visual impairments linked to albinism, early optical care and access to OCT are necessary. Thus the accompaniment of a subject with albinism and associations of albinism must be global and meet specific needs, in order to prevent or avoid ocular complications.

Residual refractive errors in pseudophakic eyes and related factors:a population-based study

AIM: To determine residual refractive error after cataract surgery in pseudophakic eyes and its relationship with age, sex, and axial length(AL).METHODS: In this population-based cross-sectional study, the sampling was performed on individuals aged 60y and above in Tehran, Iran using a multi-stage stratified random cluster sampling method. Pseudophakic eyes with a best-corrected visual acuity of 20/32 or better were analyzed and their refractive results were reported.RESULTS: The mean spherical equivalent(SE) refraction was-0.34±0.97 diopters(D) and the mean absolute SE was 0.72±0.74 D with a median of 0.5 D. Moreover, 32.68%(n=546, 95%CI: 30.27%-35.08%), 53.67%(n=900, 95%CI: 51.23%-56.1%), 68.99%(n=1157, 95%CI: 66.96%-71.02%), and 79.73%(n=1337, 95%CI: 77.69%-81.76%) of the eyes had a residual SE within ±0.25, ±0.50, ±0.75, and ±1.00 D of emmetropia, respectively. According to the multiple logistic regression model, increasing age was associated with a statistically significant decrease in predictability for all cut points. Moreover, the predictability based on all cut points was significantly lower in individuals with an AL longer than 24.5 mm than in those with an AL between 22 to 24.5 mm.CONCLUSION: Based on the results, the accuracy of intraocular lens(IOL) power calculation is lower for those who underwent cataract surgery during the last 5y in Tehran, Iran. Among the most important influential factors, the choice of IOL or it's power disproportionate to eye conditions and age can be mentioned.

Design of a coated thinly clad chalcogenide long-period fiber grating refractive index sensor based on dual-peak resonance near the phase matching turning point

A novel method for designing chalcogenide long-period fiber grating(LPFG) sensors based on the dual-peak resonance effect of the LPFG near the phase matching turning point(PMTP) is presented. Refractive index sensing in a high-refractive-index chalcogenide fiber is achieved with a coated thinly clad film. The dual-peak resonant characteristics near the PMTP and the refractive index sensing properties of the LPFG are analyzed first by the phase-matching condition of the LPFG. The effects of film parameters and cladding radius on the sensitivity of refractive index sensing are further discussed. The sensor is optimized by selecting the appropriate film parameters and cladding radius. Simulation results show that the ambient refractive index sensitivity of a dual-peak coated thinly clad chalcogenide LPFG at the PMTP can be 2400 nm/RIU, which is significantly higher than that of non-optimized gratings. It has great application potential in the field of chemical sensing and biosensors.

Two different autorefractors for vision screening in children and adolescents

AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 909 subjects(age 4–18y)were measured using both autorefractors without cycloplegia.The data were analyzed using Fourier decomposition and the correlation coefficients,intraclass correlation coefficients(ICC),and Bland-Altman limits of agreement(LoA)for each parameter were calculated.RESULTS:There was a strong correlation between the spherical equivalent(SE),sphere diopter(DS),and cylinder diopter(DC)readings of the Tianle RM-9000 and those of the Topcon KR-800,with correlation coefficient values of 0.98,0.98 and 0.83 and ICC values of 0.99,0.99 and 0.93,respectively.However,the correlation coefficients and ICC values of J0 and J45 were unreliable(R=-0.004,-0.034;both ICC<0.10).Bland-Altman analysis revealed that SE,DS,and DC measured by the Tianle RM-9000 were significantly biased toward myopia compared with the Topcon KR-800,and the mean differences were-0.072,-0.026,-0.091 D,respectively(all P<0.01).The minimum absolute value of the difference within the 95%LoA for SE,DS,and DC was 0.63 D,0.50 D,0.62 D,respectively;all these values were in the clinically acceptable range.For J0 and J45,the mean differences were close to zero(P=0.43,0.84);however,the 95%LoA were relatively wide(J0 SD:0.53;95%CI:-1.00,1.10;J45 SD:0.52;95%CI:-1.00,1.00).CONCLUSION:The two autorefractors are consistent with each other,as the differences in SE,DS,and DC were within the clinically acceptable range.Readers can compare the data measured by either device in different studies and use the two devices in the same study to generate a dataset that can be analyzed together.However,the J0 and J45 vectors are unreliable and should not be used to assess astigmatism.

A robust triaxial localization method of AE source using refraction path

Acoustic emission(AE)localization algorithms based on homogeneous media or single-velocity are less accurate when applied to the triaxial localization experiments.To the end,a robust triaxial localization method of AE source using refraction path is proposed.Firstly,the control equation of the refraction path is established according to the sensor coordinates and arrival times.Secondly,considering the influence of time-difference-of-arrival(TDOA)errors,the residual of the governing equation is calculated to estimate the equation weight.Thirdly,the refraction points in different directions are solved using Snell’s law and orthogonal constraints.Finally,the source coordinates are iteratively solved by weighted correction terms.The feasibility and accuracy of the proposed method are verified by pencil-lead breaking experiments.The simulation results show that the new method is almost unaffected by the refraction ratio,and always holds more stable and accurate positioning performance than the traditional method under different ratios and scales of TDOA outliers.

The Refractive Effect of k-Factor on Radio Propagation over Lokoja, Nigeria

The effective earth radius factor(k-factor)has a refractive propagation effect on transmitted radio signals thus making its study necessary for the proper planning of terrestrial radio links and power budget.This study was carried out over the city of Lokoja,Nigeria,using ten years(2011 to 2020)atmospheric data of temperature,pressure and humidity both at the surface(12 m)and at 100 m AGL.The data were retrieved from European Centre for Medium-Range Weather Forecasts(ECMWF)ERA5.The k-factor yearly variation follows the same trend with minimum and maximum values obtained during dry and wet season months respectively.In addition,the highest mean value of 1.00042 was recorded in the month of August while the lowest value of 1.00040 was recorded in the month of January with an overall mean value of 1.0003.This value is less than the recommended standard of 1.33 by ITU-R.The propagation effect corresponding to k<1.33 is sub-refractive.The implication of this on radio wave propagation,especially terrestrial communications is that transmitted wireless signal is prone to losses.This can be mitigated through an effective power budget:Choice of transmitting antenna’s height and gain,so as to improve the Quality of Service over the study area.

Refractive errors in high myopic eyes after phacovitrectomy for macular hole

AIM: To examine the refractive prediction error in high myopic eyes after phacovitrectomy.METHODS: This retrospective comparative case series included 91 eyes(18 high myopic eyes and 73 non-high myopic eyes) of 91 patients who underwent successful phacovitrectomy(phacoemulsification, intraocular lens implantation, and pars plana vitrectomy). The high myopic eyes were defined as the eye with more than 26.0mm of axial length. The postoperative prediction error of mean error and mean absolute error were evaluated at4 mo postoperatively. Axial length and keratometry measurement were performed preoperatively and 4mo postoperatively using the IOL Master.RESULTS: The refractive outcome after phacovitrectomy showed significantly greater myopic shift in the high myopic eyes [-1.08 ±0.87 diopters(D)] than that in the non-high myopic eyes(-0.43 ±0.63 D, P =0.004). Axial length and keratometric value in the high myopic eyes were significantly increased(P =0.043, 0.037 respectively),whereas those in the non-high myopic group were not significantly increased(P =0.135, 0.347 respectively). The change of the axial length in the myopic eye(0.46±0.28 mm)was greater than that in the non- high myopic eye(0.11 ± 0.34 mm; P 【0.001).CONCLUSION: High myopic eyes showed more myopic shift than non-high myopic eyes after phacovitrectomy.The cause of myopic shift in high myopic eyes seems tobe attributed to actual elongation of the axial length in high myopia.

Correlation analysis and multiple regression formulas of refractive errors and ocular components

The multiple regression formulas and correlation of ocular components with refractive errors are presented by Gaussian optics. The refractive error changing rate for the cornea and lens power, the axial length, anterior chamber depth(ACD) and vitreous chamber depth(VCD) are calculated, including nonlinear terms for more accurate rate functions than the linear theory. Our theory, consistent with the empirical data, shows that the Pearson correlation coefficients for spherical equivalent(SE) and ocular components are highest for SE with axial length, ACD and VCD and weakest for corneal power, lens power and lens thickness. Moreover, our regression formulas show the asymmetric feature of the correlation that the axial length, ACD and VCD are more strongly correlated(with higher negative regression constants) with refractive errors in eyes with hyperopia than in eyes with myopia, particularly for severe hyperopia.

Axial length/corneal radius of curvature ratio and refractive development evaluation in 3-to 4-year-old children: the Shanghai Pudong Eye Study

AIM: To measure and analysis axial length(AL)/corneal radius of curvature(CRC) ratio and other refractive parameters, provide a medical reference range for refractive development evaluation and earlier visual impairment screening of 3 to 4 y kindergarten students.METHODS: Between April and June 2017, a total of 4350 participants aged 3-to 4-year-old(8700 eyes) from 10 cluster random sampling kindergartens in Shanghai, Pudong District were involved. According to the measurement and analysis of the unaided visual acuity(VA), AL, CRC, AL/CRC ratio, astigmatism and other refractive parameters, the data distribution and reference range were obtained.RESULTS: Uncorrected VA of examined children was 0.23±0.08(logMAR, mean±SD) [95% confidence interval(CI) range ≤0.36];AL was 22.10±0.79 mm(95%CI 20.55-23.65);CRC was 7.86±0.26 mm(95%CI, 7.35-8.37);AL/CRC ratio was 2.81±0.12(95%CI, 2.57-3.05). The median of astigmatism was-0.5 D, a total of 56.3% had astigmatism <-0.50 D, 85.3%<-1.00 D, 6.7%>-1.50 D;71% were astigmatism with the rule. Eye-specific analyses were conducted. Statistical difference of VA was in right and left eyes. There were no significant differences between two eyes of AL, CRC, AL/CRC ratio and astigmatism(P>0.05).CONCLUSION: VA and AL/CRC ratio reference could be used to assess refractive development in children and screening uncorrected refractive errors or amblyopia. Astigmatism needs to be considered in the diagnosis.

The prevalence of vision impairment and refractive error in 3654 first year students at Tianjin Medical University

AIM：To determine the prevalence of vision impairment（VI）and refractive error in first year university students at the Tianjin Medical University.METHODS：This is a cross-sectional observational cohort study of VI and refractive error among first year university students at the Tianjin Medical University.The first year university students were involved in this study and were given a detailed questionnaire including age,birth date,and spectacle wearing history.A standardized ophthalmologic examination including visual acuity（VA）,slit-lamp examination,non-cycloplegic auto-refraction,objective refraction,fundus photography,and examination of their spectacles were recorded.RESULTS：A total of 3654 participants were included in this study.Totally 3436（94.03%） individuals had VI in this population.Totally 150（4.10%） individuals had VI due to ocular disease,including amblyopia,congenital cataract,retinal atrophy or degeneration,strabismus,congenital nystagmus,refractive surgery orthokeratology.Totally 3286（89.93%） subjects had VI due to refractive error.Only 218（5.97%） students were emmetropia.Moreover,refractive error was the main cause for the VI（95.63%）.Totally 3242（92.52%） students were myopia and the prevalence of mild,moderate,and high myopia subgroup was 27.05%,44.35%,and 21.26% respectively.Totally 44（1.29%） subjects were hyperopic.The rates of uncorrected visual acuity（UCVA）,presenting visual acuity（PVA）and best corrected visual acuity（BCVA）which better than 20/20 in both eyes were 5.65%,22.32% and 82.13% respectively.The rates of correction,under correction and well correction in myopia subjects were 82.73%,84.39% and 15.61%,respectively. CONCLUSION：We present a high prevalence of refractive errors and high rates of under correction refractive error among first year university students.These results may help to promote vision protection work in young adults.