Analysis of ocular structural parameters and higher-order aberrations in Chinese children with myopia

BACKGROUND Myopia and high myopia are global public health concerns.Patients with high myopia account for 0.5%-5.0%of the global population.AIM To examine diopters,axial length(AL),higher-order aberrations,and other ocular parameters in Chinese children with myopia,to analyze the influence of structural parameters associated with myopia on visual quality,and to provide a theoretical basis for the prevention and treatment of childhood myopia and high myopia.METHODS This study included 195 children aged 6–17 years with myopia.The AL was measured with an ultrasonic ophthalmic diagnostic instrument,and the aberrations,corneal curvature(minimum K1,maximum K2,and average Km),central corneal thickness,anterior chamber depth,and anterior chamber angle were measured using a Sirius three-dimensional anterior segment analyzer.Using a standard formula,the corneal radius of curvature R(337.3/Km)and AL/R values were obtained.RESULTS The diopter of high myopia compared with low-middle myopia was correlated with age and AL(r=-0.336,-0.405,P<0.001),and AL of high myopia was negatively correlated with K1,K2,and Km(r=-0.673,-0.661,and-0.680,respectively;P<0.001),and positively correlated with age and the anterior chamber depth(r=0.214 and 0.275,respectively;P<0.05).AL/R was more closely related to diopter than AL in children with myopia,and 94.4%of children with myopia had an AL/R of>3.00.CONCLUSION The ocular structural parameters of children change because of different diopters.AL/R is more specific and sensitive than AL in evaluating the refractive status of myopia in children.An AL/R of>3.00 may be used as a specific index of myopia in children.There are differences in AL/R between high myopia and low-middle myopia,which can be used for the classification of ametropia.The degree of myopia has a certain influence on higher-order aberrations.

Effects of higher-order aberrations on contrast sensitivity in normal eyes of a large myopic population

AIM：To study the relation between higher-order aberrations（HOAs）and contrast sensitivity（CS）in normal eyes among a population of laser in situ keratomileusis（LASIK）candidates.METHODS：In 6629 eyes of 3315 LASIK candidates,CS were measured under dark environment at the spatial frequencies of 1.5,3,6,12 and 18 cycles per degree（c/d）,respectively,using an Optec 6500 visual function tester.Meanwhile,ocular HOAs were measured for a 6.0 mm pupil with a Hartmann-Shack wavefront analyzer.RESULTS：In the study,the subjects with an average spherical equivalent of-4.86±2.07 D were included.HOAs decreased from the third to the sixth order aberrations with predominant aberrations of third-order coma,trefoil and fourth-order spherical aberration.At low and moderate spatial frequencies,CS was negatively correlated with the third-order coma and trefoil aberrations,and decreased with increasing Z31,but increased with increasing Z3-3and Z5-1.At high spatial frequencies,CS decreased with increasing Z3-3and increased with increasing Z5-1.CONCLUSION：At a large pupil size of 6.0 mm,the thirdorder aberrations,but not the total aberrations,are the main factors affecting CS.Vertical coma is negatively correlated with CS.

Relationship between higher-order aberrations and myopia progression in schoolchildren: a retrospective study

AIM: To investigate the relationship between higher- order aberration (HOA) and myopic progression in schoolchildren. ·METHODS: Between April 23 2011 and August 29, 2011 in the children’s myopia outpatient clinic of the West China Hospital of Sichuan University, 148 eyes of 74 schoolchildren were reviewed. HOAs for a 6 -mm pupil were measured with an aberrometer. Myopic progression rate was defined according to the change in spherical equivalent refraction (SER) divided by the time span (years). Subjects with myopic progression rate of ≥0.50 diopters (D) were classified as the ’fast’group and the subjects with myopic progression rate of 【0.50D were classified as the’slow’group. A retrospective study was conducted to compare HOA between the two groups, using root mean square (RMS) values and Zernike coefficients. ·RESULTS: The RMS values of HOA (t =2.316, P =0.02), HOA without Z 4 0 (t =2.224, P =0.03),third-order aberrations (t’ =2.62, P =0.01), and coma (t’ =2.49, P =0.01) were significantly higher in the fast group than those in the slow group. The individual Zernike coefficients of Z 3 -1 (t = -2.072, P =0.04) and Z 5 1 (Z =-2.627, P =0.01) displayed statistically significant differences between the two groups. Significant correlations were found between the RMS values of HOA (r =0.193, P =0.019), RMS values of HOA without Z 4 0 (r =0.23, P =0.005), RMS values of coma(r =0.235,P =0.004),RMS values of third-order aberrations (r =0.243, P =0.003), and the progression rate. · CONCLUSION: Our results provide evidence of a relationship between HOA and myopic progression. In a future prospective longitudinal study, we aim to verify whether HOA is a risk factor for myopic progression.

Ocular higher-order aberrations and mesopic pupil size in individuals screened for refractive surgery

AIM: To study the distribution of ocular higher-order aberrations(HOAs) and mesopic pupil size in individuals screened for refractive surgery. · METHODS: Ocular HOAs and mesopic pupil size were studied in 2 458 eyes of 1 240 patients with myopia, myopic astigmatism and compound myopic astigmatism and 215 eyes of 110 patients with hyperopia, hyperopic astigmatism and compound hyperopic astigmatism using the Zywave aberrometer (Busch& Lomb). All patients had correctable refractive errors without a history of refractive surgery or underlying diseases. Root-mean-square values of HOAs, total spherical aberration, total coma and mesopic pupil size were analyzed. Ocular HOAs were measured across a ≥ 6.0 mm pupil, and pupil size measurements were performed under the mesopic condition. · RESULTS: The mean values of HOAs, total spherical aberration and total coma in the myopic group were 0.369 μm, ±0.233, 0.133±0.112μm and 0.330±0.188μm, respectively. In the hyperopic group the mean values of HOAs, total spherical aberration and total coma were 0.418μm±0.214, 0.202±0.209μm and 0.343±0.201μm, respectively. Hyperopes showed greater total HOAs (P <0.01) and total spherical aberration (P <0.01) compared to myopes. In age-matched analysis, only the amount of total spherical aberration was higher in the hyperopic group (P =0.05). Mesopic pupil size in the myopic group was larger (P ≤0.05). · CONCLUSION: The results suggested that significant levels of HOAs were found in both groups which are important for planning refractive surgeries on Iranians. There were significantly higher levels of total spherical aberration in hyperopes compared to myopes. Mesopic pupil size was larger in myopic group.

Study on the Corneal Higher-Order Aberrations and Correlation in Patients with Different Degrees of Myopia Suitable for Wavefront-Guided FS-LASIK

Background: Individualized corneal refractive surgery requires an understanding of the basis of higher-order aberrations before surgery. To investigate the characteristics and distribution of anterior surface wavefront aberrations in patients suitable for corneal refractive surgery. Methods: A total of 121 myopic patients (121 eyes, 18 - 45 years old) who underwent corneal refractive surgery were recruited from January to May 2016 at Affiliated Hospital, Yanbian University. Patients were randomly selected by the Pentacam anterior segment analysis system with a spherical equivalent (SE) of -0.25 to -10.00 D. The corneal anterior aberrations (total higher-order aberration;spherical aberration;Coma;Trefoil) and Q and K values were detected, and a correlation analysis of the relevant parameters was carried out. Results: The root-mean-square (RMS) of the third to sixth order aberrations of the corneal anterior wavefront aberrations at a 6 mm analysis diameter showed a decreasing trend in patients suitable for the corneal refractive surgery, and the RMS of the third order aberrations accounted for 62.92% of the total HOAs. The coma ratio (coma/total cornea higher-order aberrations) was increased with the increasing diopters, while the spherical aberration ratio (spherical aberration/total cornea higher-order aberrations) was not changed. In addition, the spherical aberration was 0.203 ± 0.082 μm (range: 0.061 to 0.503 μm), and the Q30 was -0.19 ± 0.03 (range: -0.58 to 0.31). There were significant differences in the coma aberrations of preoperative corneal anterior surface (3, 1) between the low, middle and high myopia groups (P = 0.013). The spherical equivalent was positively correlated with the corneal coma of the anterior corneal surfaces (R =?-0.241, P = 0.009), and the Q value was positively correlated with the total higher-order aberrations (R = 0.326, P Conclusions: Individual wavefront aberrations on the anterior surfaces of the cornea are comparatively different, and the Zernike coefficients are related to the degree of myopia. Spherical aberrations are the most overriding aberrations of the cornea.

Comparison of correcting myopia and astigmatism with SMILE or FS-LASIK and postoperative higher-order aberrations

AIM:To compare the effect of myopia and astigmatism correction and postoperative change in higher-order aberration as results of receiving small-incision lenticule extraction(SMILE)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK).METHODS:A prospective and non-randomized controlled study was conducted.The subjects are divided into two groups according to different operations received:229 eyes of 116 patients in the SMILE group and 168 eyes of 86 patients in the FS-LASIK group.All subjects were followed up for 3 mo by monitoring their uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),spherical equivalent,higher-order aberrations,and the preoperative and postoperative complications.RESULTS:At 1 wk,1,and 3 mo post-surgery,224 eyes(97.8%),227 eyes(99.1%)and 229 eyes(100%)had UCVA≥20/20 in the SMILE group,while 165 eyes(98.2%),167 eyes(99.4%)and 167 eyes(99.4%)had UCVA≥20/20 in the FS-LASIK group,respectively(χ^(2)=0.146,2.135,and 1.124;all P>0.05).BCVA reduction was not observed in both groups at 1 and 3 mo of post-surgery(χ^(2)=0.734 and 1.898,P>0.05).There was no statistically significant difference in the spherical equivalent between the two groups at 1 and 3 mo post-surgery,though the percentage of the spherical equivalent within±0.50 D at 3 mo postsurgery was 98%in the SMILE group,which was higherthan that of the FS-LASIK group(92%,χ^(2)=1.872,P>0.05).The root mean square(RMS)values of total high-order aberration,coma,and spherical aberration of the two groups increased significantly in the early postoperative period and decreased after 3 mo,but the values were still higher than the preoperative levels(P<0.05);there was no significant difference between the two groups in the RMS values of total higher-order aberrations and specific higherorder aberrations(P>0.05).The incidence of complications in the SMILE group was lower than that in the FS-LASIK group(χ^(2)=14.52,P<0.05).CONCLUSION:SMILE and FS-LASIK can effectively treat myopia,significantly improve visual acuity,and increase the total high-order aberration,spherical aberration,and coma.The incidence of complications after SMILE is relatively low.

EFFECTS OF PREOPERATIVE SOFT CONTACT LENS WEAR ON HIGHER-ORDER ABERRATIONS AFTER LASER IN SITU KERATOMILEUSIS

Objective To evaluate the effects of preoperative soft contact lens (SCL) wear on higher-order aberrations(HOAs)correction after wavefront-guided and conventional laser in situ keratomileusis (LASIK). Methods A prospective randomized double-masked comparative study was conducted in 180 eyes of 90 patients scheduled for LASIK, including 92 eyes of 46 patients with previous SCL wear. The patients were divided into four groups: no SCL-conventional group, SCL-conventional group, no SCL-wavefront group and SCL-wavefront group. Preoperative and postoperative examinations included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), contrast sensitivity and HOAs. Results The UCVA and BSCVA were 20/20 in all patients at 6 months postoperatively. And 36.3%, 22.7%, 18.1% and 35.4% gained one line or more of BSCVA in no SCL-wavefront group, SCL-wavefront group, no SCL-conventional group and SCL-conventional group, respectively. Both the safety index and efficacy index surpassed one in 4 groups and were highest in no SCL-wavefront group. The increase in root-mean-square (RMS) values of HOAs was significantly lower in no SCL-wavefront group and higher in SCL-wavefront group. At 6 months postoperatively, the increase in RMS of HOAs (RMSh) were 0.67, 1.58, 1.17 and 1.28 in no SCL-wavefront group, SCL-wavefront group, no SCL-conventional group and SCL-conventional group, respectively. Conclusion Preoperative contact lens wear has significant influence on the efficacy of HOAs correction in wavefront-guided LASIK. Patients with contact lens wear preoperatively should be cautious when scheduled for wavefront-guided LASIK.

Repeatability and reproducibility of corneal higher-order aberrations measurements after small incision lenticule extraction using the Scheimpfug-Placido topographer

Background:To evaluate the precision of corneal higher-order aberrations measurements after small incision lenticule extraction(SMILE)using the Sirius Scheimpfug-Placido topographer(CSO,Italy).Methods:Seventy-fve eyes from 75 postoperative subjects were included in this prospective study.Three consecutive corneal aberrometric measurements were obtained with the Scheimpfug-Placido topographer by two experienced operators to assess intra-and inter-observer reproducibility.The within-subject standard deviation(Sw),test-retest repeatability(TRT)and the intraclass correlation coefcient(ICC)were calculated.Results:For intraobserver repeatability of anterior and total corneal aberrations,all ICCs were more than 0.922,except for trefoil(0.722 to 0.768).The ICCs of total root mean square(RMS),coma Z(3,±1),and spherical aberration Z(4,0)were over 0.810 while higher-order RMS,trefoil Z(3,±3),and astigmatism II Z(4,±2)were below 0.634 for posterior corneal surface aberrations.All Sw values for all types of aberrations were equal to or below 0.07μm.Regarding interobserver reproducibility,all TRT values were no more than 0.12μm,0.05μm,and 0.11μm for anterior,posterior,and total corneal aberrations,respectively.The ICC values ranged from 0.875 to 0.989,from 0.686 to 0.976 and over 0.834 for anterior,posterior,and total corneal aberrations,respectively.Conclusions:The repeatability of measurements of anterior and total corneal aberrations with the Sirius system in corneas after SMILE surgery was high,except for trefoil.There was some variability in posterior corneal aberrometric measurements.High reproducibility of corneal aberrometric measurements was observed between measurements of both examiners,except for trefoil,with poor to moderate reproducibility.

Comparison of higher-order aberrations and contrast sensitivity between Tecnis Z9001 and CeeOn 911A intraocular lenses:a prospective randomized study

Background The advent of wavefront technology in the past five years has provided some insight into the optical outcomes of cataract surgery. The Tecnis Z9001 intraocular lens （Tecnis IOL, AMO） with a modified prolate anterior surface was claimed to reduce or even eliminate ocular spherical aberration to improve the visual quality. The purpose of this study was to determine whether Tecnis IOLs can improve the quality of vision as evaluated by measuring visual acuity, wavefront aberration, and contrast sensitivity. Methods In an intraindividual prospective study, 20 patients with bilateral cataract were randomly assigned to receive a modified prolate anterior surface IOL （Tecnis Z9001, AMO） in one eye and a biconvex spherical surface IOL （CeeOn 911A, AMO） in the other. After 3 months, the following were investigated： best corrected visual acuity, pupil diameter, photopic and mesopic contrast sensitivity, and wavefront aberration of the whole eye （ocular）, cornea, and internal plane. Results The differences in the best corrected visual acuity and pupil diameter between the two groups were not statistically significant. Negative 4th-order spherical aberration （Z4^0） was found in the Tecnis group, whereas positive Z4^0 found in the CeeOn group for the internal and ocular plane. Statistically significant differences were found at the ocular higher-aberrations between the two IOLs. Contrast sensitivity testing showed significantly better results in the Tecnis group at visual angles higher than 1.0 degree under photopic conditions and at visual angles higher than 1.6 degree under mesopic conditions both without glare and with glare in comparison with the CeeOn group. Conclusions The Tecnis Z9001 IOL with a modified prolate anterior surface produces negative spherical aberration and consequently reduces the higher-order aberrations in pseudophakic eyes. This leads to enhanced contrast sensitivity and improved functional vision compared to conventional spherical IOLs.

Laboratory evaluation of higher-order aberrations and light scattering in explanted opacified intraocular lenses

Background:Intraocular lens(IOL)calcification is a serious condition that can only be treated by removing the clouded lens.Since explantation bears the risk of complications,it is often deferred until the patient finds the symptoms intolerable.Usually,as the IOL opacifies,visual acuity is minimally affected early on.In this study,we assessed the impact of IOL opacification on optical quality.Methods:We analyzed ten opacified explanted IOLs(Oculentis GmbH).Wavefront aberrations were obtained with a SHSOphthalmic device(Optocraft GmbH),which features a Hartmann-Shack sensor.The root mean square(RMS)of higher-order aberrations(HOAs)was compared.The effect of calcification on image quality was assessed through the Strehl ratio(SR).We detected light scattering with a C-Quant(Oculus GmbH)and expressed it as a straylight parameter.Results:At 2 mm,3mm and 4 mm,the mean RMS(±standard deviation)was 0.033μm(±0.026μm),0.044μm(±0.027),and 0.087μm(±0.049),respectively.The mean SR value was 0.81±0.15 at 3 mm,with four IOLs showing a nearly diffraction-limited performance,but in two explants,opacification precluded reliable measurements.Increased straylight was found in all opacified IOLs with a mean value of 150.2±56.3 deg^(2)/sr at 3 mm.Conclusions:We demonstrated that IOL opacification induces HOAs.However,the RMS remained low,which resulted only in a slight reduction of the SR-derived optical quality.On the other hand,we found a severe straylight elevation in the opacified lenses,which may result in dysphotopsia,such as glare,and subjective complaints,despite good visual acuity.

Changes in higher-order aberrations after central corneal regularization-a comparative two-year analysis of a semi-automated topography-guided photorefractive keratectomy combined with corneal cross-linking

Background:The optical quality in progressive keratoconus deteriorates due to ectasia and distortion of the corneal shape and optics.While corneal cross-linking(CXL)aims at stopping disease progression,"CXL-Plus"combines CXL with excimer laser ablation to improve visual function.Central corneal regularization(CCR)represents a therapeutic excimer laser modality specifically designed to smoothen the ectatic corneal shape and to reduce higher-order aberrations(HOA).We set out to compare CXL-Plus,consisting of CXL combined with CCR,with CXL by itself for patients with progressive keratoconus.Methods:Retrospective 2-year matched group analysis of patients who either underwent CXL-Plus{n=28)or CXL as a sole procedure(n=28)for progressive keratoconus.Main outcome parameters were HOA,visual function and tomographic results 12 and 24 months postoperatively.Results:After 12 months,the total HOA root mean square wavefront error was reduced from 0.79±0.30 to 0.40±0.19 pm(CXL-Plus;P<0.0001)and changed from 0.71±0.28 to 0.73±0.36 pm(CXL;P=0.814).Uncorrected distance visual acuity improved from 0.70±0.35 to 0.36±0.29 logMAR(CXL-Plus;P=0.0002)and from 0.65±0.39 to 0.46±0.37 logMAR(CXL;P=0.067),translating to gains of three or more lines in 50%(CXL-Plus)and 36%(CXL)of patients.The steepest keratometry value(Kmax)regressed by 5.84 D(CXL-Plus;P<0.0001)and 0.66 D(CXL;P=0752).For none of the investigated parameters a statistically significant change could be shown between 12 and 24 months.Conclusions:CXL-Plus in the form of a CCR reduces HOA and Kmax more effectively than CXL as a sole procedure.

Photoinduced Floquet higher-order Weyl semimetal in C_(6) symmetric Dirac semimetals

Topological Dirac semimetals are a parent state from which other exotic topological phases of matter, such as Weyl semimetals and topological insulators, can emerge. In this study, we investigate a Dirac semimetal possessing sixfold rotational symmetry and hosting higher-order topological hinge Fermi arc states, which is irradiated by circularly polarized light. Our findings reveal that circularly polarized light splits each Dirac node into a pair of Weyl nodes due to the breaking of time-reversal symmetry, resulting in the realization of the Weyl semimetal phase. This Weyl semimetal phase exhibits rich boundary states, including two-dimensional surface Fermi arc states and hinge Fermi arc states confined to six hinges.Furthermore, by adjusting the incident direction of the circularly polarized light, we can control the degree of tilt of the resulting Weyl cones, enabling the realization of different types of Weyl semimetals.

Higher-order expansions of powered extremes of logarithmic general error distribution

In this paper,Let M_(n)denote the maximum of logarithmic general error distribution with parameter v≥1.Higher-order expansions for distributions of powered extremes M_(n)^(p)are derived under an optimal choice of normalizing constants.It is shown that M_(n)^(p),when v=1,converges to the Frechet extreme value distribution at the rate of 1/n,and if v>1 then M_(n)^(p)converges to the Gumbel extreme value distribution at the rate of(loglogn)^(2)=(log n)^(1-1/v).

A Study of a Moral Dilemma Stories Teaching Model Focusing on the Development of Higher-Order Thinking --"Synthetic polymers" as an example

Cultivating students'higher-order thinking is one of the important goals of modern education,and innovative teaching model is an effective way to achieve this goal.Aiming at the inadequacy of the existing moral dilemma stories approach in the transformation of knowledge and behavior,this research constructs a new Project Based Learning-Ethical Dilemma Stories(PBL-EDS)Teaching Model applicable to China's secondary education stage based on the innovative features of the moral dilemma stories approach on the core competencies,taking the chemistry subject as an example to carry out practice,and puts forward suggestions for the implementation of the teaching model.Chemistry as an example to carry out the practice,and suggestions are made for the implementation of the teaching model.

Ocular higher-order aberrations features analysis after corneal refractive surgery

Background The recent studies have shown that visual performance might be affected by the ocular aberration after the corneal refractive surgery, and try to minimize it. This study was to investigate the effects of photorefractive keratectomy （PRK） and laser in situ keratomileusis （LASIK） on the higher order of wavefront aberration and analysis of their characteristics. Method This prospective study involved 32 eyes with similar refractive powers （-5.0 D to -6.0 D preoperatively）. LASIK and PRK were performed with the same parameters of 6 mm diameter optical zone and 7 mm diameter transition zone ablation. Wavefront aberrations were tested using a ray tracing technique preoperatively and 3 months postoperatively. Three measurements were obtained for each condition; the root mean squared wavefront error （RMS）, values for overall wavefront aberrations and each order of the Zernike aberrations were analyzed using the Matlab software. The 2-tailed t test was used for statistical analysis. Results Overall higher order aberrations were increased from （0.55±0.26） pm preoperatively to （0.93±0.37） pm for PRK and （0.79±0.38） pm for LASlK postoperatively. This was a 1.69 fold increase in the PRK group （t=3.95, P〈0.001） and a 1.43 fold increase in the LASIK group （t=2.60, P〈0.05）. At 3 months, the mean RMS value for higher-order （3rd to 6th） were significantly increased compared with the corresponding preoperative values （P〈0.05）. The fourth order aberrations, spherical like aberration, were dominant by a 2.64 fold in PRK and a 2.31 fold in LASIK. Different influences of the PRK group and LASIK group were shown in the various zernike components. The statistically significant differences were seen in C4^0. C4^4. C5^3,C5^3. C5^5 and C6^2 of the PRK group and C3^-3, C4^0, C5^-5, C5^5, C6^-2 of the LASIK group, which represents a 7.42, 3.58, 9.21,2.72 and 5.3 ford increases in PRK group, and 6.40, 10.80, 11.06, 3.47 and 6.09 fold increases in LASIK group, respectively. C3^3 in LASIK was higher and C5^＋1 and C5^＋3 were lower than those in the PRK group. C4^0 （spherical aberration） values were similar between PRK and LASIK, however, C3^-1 and C3^1 （coma） in LASIK were higher than those in PRK, but these differences are of no statistical significance. Conclusions PRK and LASIK may increase ocular higher-order aberrations, but they both have their own features. The difference between the two types of surgery may be correlated with the change of the corneal shape, the conversion of biodynamics, the healing of the corneal cut, and re-structured corneal epithelium and/or the stroma.

Contrast sensitivity and higher-order aberrations in patients with astigmatism

Background Astigmatism is one of the most significant obstacles for achieving satisfactory visual function. This study was to evaluate the influence of astigmatism on contrast sensitivity （CS） and higher-order aberrations. Methods CS, accommodation response and wavefront aberration were measured in 113 patients with astigmatism, aged 18-36 years. Both single and binocular visual performance were examined under four lighting conditions： photopia, photopia with glare, scotopia and scotopia with glare respectively. Accommodation response was classified as normal, abnormal and low. The contribution of the power and axis of astigmatism to CS, accommodation response and wavefront aberration was analyzed. Results As the dioptric power of astigmatism increased, the loss of CS spatial frequency changed from high to intermediate, and then to low frequency. CS scores varied at different illuminance levels, descending in the following sequence： photopia, photopia with glare, scotopia, and scotopia with glare. However, the normal accommodation group showed better CS values under photopia with glare than without glare. The range of influenced direction of sine-wave gratings remained mostly at the meridian line of high dioptric power, which would be expanded when optical accommadation attenuated. The patients with symmetrical astigmatism got higher CS scores with binoculus vision than with dominant eye vision, while the patients with asymmetrical astigmatism did this only at scotopia with glare. Among higher-order aberrations, coma aberration, secondary coma aberration and the total higher order aberration were influenced by astigmatism, all of which rising with the power of astigmatism increased. Conclusions Reducing astigmatism might improve the performance of visual function. Not only the power of astigmatism should be cut down, but also the binocular axes should be made symmetrically.

Efficacy of custom-made soft keratoconus lenses on corneal aberrations and photic phenomena in patients with keratoconus:a corneal topography imaging based study

AIM:To evaluate the efficacy of custom-made soft keratoconus(KC)lenses on corneal aberrations and photic phenomena in two different optical zones in patients with KC.METHODS:Sixty eyes of 42 patients with KC were examined at baseline and after fitting HydroCone(Toris K)soft silicone hydrogel lenses.Best spectacle-corrected visual acuity(BSCVA)and contact lens-corrected visual acuity(CLCVA)were recorded.Lower-and higher-order corneal aberrations(LOAs and HOAs)were measured with and without Toris K lenses and compared in central 4.5 mm and 7 mm zones.Mesopic pupil diameter and subjective photic phenomena were also assessed.RESULTS:Mean CLCVA was significantly improved compared to BSCVA(P<0.0001).Corneal curvature and refractive measurements were found to be significantly reduced by the use of Toris K lenses,except for posterior corneal curvature values.In the 4.5 mm central optical zone,all wavefront aberrations decreased significantly after lens fitting(P<0.0001).In contrast,in the 7 mm(peripheral)optical zone,values for HOAs,spherical and residual aberrations,and optical path differences were increased,while LOAs,trefoil,and quadrifoil coefficients were decreased.The rate of photic phenomena was significantly higher in participants with a pupil size>6.00 mm(85.7%).CONCLUSION:Toris K lenses provide good visual results and a significant reduction in central corneal aberrations in patients with KC but could cause an increase in peripheral aberrations.This practical and nonsurgical approach appears to be an effective method for the visual management of KC.

Effect of incision types for Artisan phakic intraocular lens implantation on ocular higher order aberrations

AIM： To evaluate the effect of incision types for Artisan phakic intraocular lens （PIOL） implantation on ocular higher-order aberrations （HOAs）.METHODS： A retrospective review was conducted of the patients who had undergone Artisan PIOL implantation for the correction of myopia and followed up for at least 6mo. Patients are classified into 2 groups considering the incision type： cornea group with patients undergone clear corneal incision; sclera group with patients undergone sclera tunnel incision. All patients with postoperative astigmatism of under 1 diopter （D） were included to minimize the effect of residual astigmatism on postoperative HOAs. Visual acuity, special equivalents, astigmatism, predictability （±1 D from target refraction）, HOAs （coma, trefoil, spherical aberration）, and corneal endothelial counts were analyzed preoperatively and 6mo postoperatively.RESULTS： At the postoperative 6mo, all patients of both groups achieved uncorrected visual acuity of 16/20 or better, and significantly decreased the spherical equivalents compared with preoperative values. The predictability of refractive correction was 96% in the former, and 94% in the latter. Unlike the sclera group, preoperative astigmatism decreased significantly in cornea group at postoperative 6mo. The HOAs increased significantly at postoperative 6mo compared to the preoperative values in both groups, and the root mean square （RMS） total and trefoil wavefront aberration of cornea group were significantly higher than those of sclera group.CONCLUSION： Although corneal incision significantly reduces preexisting astigmatism, the postoperative 6mo of total RMS and trefoil aberration change may deteriorate the visual quality after Artisan PIOL implantation.

APPLICATIONS OF HIGHER-ORDER UPWIND SCHEME FOR PROJECTILES IN TRANSONIC FLOW

针对弹丸跨音速粘性绕流流场进行了数值仿真研究，并与实验进行了对比。数值仿真的控制方程为雷诺平均的Navier-Stokes方程，湍流模型采用Baldwin-Lomax模型，应用了四阶的MUSCL TVD格式。结果表明，该方法可以取得高清晰度的流场结构。

MicroRNA aberrations:An emerging field for gallbladdercancer management

Gallbladder cancer(GBC) is infrequent but most lethal biliary tract malignancy characterized by an advanced stage diagnosis and poor survival rates attributed to absence of specific symptoms and effective treatment options. These necessitate development of early prognostic/predictive markers and novel therapeutic interventions. Micro RNAs(mi RNAs) are small, noncoding RNA molecules that play a key role in tumor biology by functioning like tumor suppressor- or oncogenes and their aberrant expression are associated with the pathogenesis of several neoplasms with overwhelming clinical implications. Since mi RNA signature is tissue specific, here, we focused on current data concerning the mi RNAs abberations in GBC pathogenesis. In GBC, mi RNAs with tumor suppressor activity(mi R-135-5p, mi R-335, mi R-34 a, mi R-26 a, mi R-146b-5p, Mir-218-5p, mi R-1, mi R-145, mir-130a) were found downregulated, while those with oncogenic property(mi R-20 a, mi R-182, mir-155) were upregulated. The expression profile of mi RNAs was significantly associated with GBC prognosis and prediction, and forced over-expression/ inhibition of these mi RNAs was shown to affect tumor growth and development. Further, differential expression of mi RNAs in the blood samples of GBC patients suggest mi RNAs as promising noninvasive biomarker. Thus, mi RNAs represent potential candidate for GBC management, though many hurdles need to be overcome before mi RNAs therapy can be clinically applied to GBC prevention and treatment.