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.

The HIF-1α/PLOD2 axis integrates extracellular matrix organization and cell metabolism leading to aberrant musculoskeletal repair

While hypoxic signaling has been shown to play a role in many cellular processes,its role in metabolism-linked extracellular matrix(ECM)organization and downstream processes of cell fate after musculoskeletal injury remains to be determined.Heterotopicossification(HO)is a debilitating condition where abnormal bone formation occurs within extra-skeletal tissues.Hypoxia andhypoxia-inducible factor 1α(HIF-1α)activation have been shown to promote HO.However,the underlying molecular mechanisms bywhich the HIF-1αpathway in mesenchymal progenitor cells(MPCs)contributes to pathologic bone formation remain to beelucidated.Here,we used a proven mouse injury-induced HO model to investigate the role of HIF-1αon aberrant cell fate.Usingsingle-cell RNA sequencing(scRNA-seq)and spatial transcriptomics analyses of the HO site,we found that collagen ECM organizationis the most highly up-regulated biological process in MPCs.Zeugopod mesenchymal cell-specific deletion of Hif1α(Hoxa11-CreER^(T2);Hif1a^(fl/fl))significantly mitigated HO in vivo.ScRNA-seq analysis of these Hoxa11-CreER^(T2);Hif1a^(fl/fl)mice identified the PLOD2/LOXpathway for collagen cross-linking as downstream of the HIF-1αregulation of HO.Importantly,our scRNA-seq data and mechanisticstudies further uncovered that glucose metabolism in MPCs is most highly impacted by HIF-1αdeletion.From a translational aspect,a pan-LOX inhibitor significantly decreased HO.A newly screened compound revealed that the inhibition of PLOD2 activity in MPCssignificantly decreased osteogenic differentiation and glycolytic metabolism.This suggests that the HIF-1α/PLOD2/LOX axis linked tometabolism regulates HO-forming MPC fate.These results suggest that the HIF-1α/PLOD2/LOX pathway represents a promisingstrategy to mitigate HO formation.

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.

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.

Comparison of two types of visual quality analyzer for the measurement of high order aberrations

AIM： To compare the difference and agreement of KR- lW and iTrace for measurement of high order aberrations.METHODS： KR-1W and iTrace were respectively used in a group of healthy people （40 volunteers, 32 eyes） to measure the high order aberration （HOA） of corneal, internal and total ocular. The clinical difference and agreement of two instruments were respectively evaluated by paired-samples 1-test and Bland-Altman analysis. RESULTS： The paired-samples t-test showed that the corneal HOA measured by the two instruments had no statistical differences （P〉0.05）; but the internal and total ocular HOA had significant statistical differences （P〈 0.05）, and the mean results measured by iTrace were higher than that of KR-1W. However, Bland-Altman analysis revealed that the HOA of corneal and internal were all in 95% limits of agreement; and just one point of total ocular HOA was beyond the 95% limits of agreement. CONCLUSION： KR-1W and iTrace were consistent well in the measurement of corneal, internal and total ocular HOA, especially for the cornea.

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.

The correlation and overlaps between PD-L1 expression and classical genomic aberrations in Chinese lung adenocarcinoma patients: a single center case series

Objective:To investigate the correlation and overlaps between PD-L1 expression and classical genomic aberrations in Chinese lung adenocarcinoma(LADC)patients.Methods:We reviewed 428 consecutive,surgically resected cases of LADC from October 2015 to December 2016 from our center.PD-L1 expression was evaluated based on tumor proportion score(TPS).Correlation and co-occurrence of PD-L1 expression level with those of classical driver genes,such as EGFR,ALK,ROS-1,and KRAS and with clinical variables and disease-free survival(DFS)were analyzed.Results:Seventy of the 428 cases(16.4%)showed TPS≥1%,and 21 cases(4.9%)showed TPS≥50%.PD-L1 positive expression was significantly associated with male gender,smoking,advanced TNM stage,and solid histologic subtype.Both TPS≥1% and ≥50%were correlated with the absence of an EGFR mutation(P<0.001)and the presence of ALK rearrangement(P=0.024).KRAS mutation was associated with TPS≥50%(P=0.035).PD-L1 positivity commonly overlapped with the alterations of classical driver oncogenes(58.5%with TPS≥1% and 42.9% with TPS≥50%).Approximately three-quarters of PD-L1 positive cases co-occurred with classical therapeutic-gene aberrations in cases with stage III/IV cancer or cancer progression.LADC could be divided into four subgroups based on the expression profile of current routine biomarkers for potential therapeutic strategies.Conclusions:PD-L1 expression is not only closely correlated with classic gene alterations but also commonly overlaps with the aberrations of classical driver oncogenes in Chinese LADC patients.These findings provide a useful overview of clinical strategies that rely on the profile of routinely used molecular biomarkers.

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.

Comparative study of visual acuity and aberrations after intralase femtosecond LASIK:small corneal flap versus big corneal flap

AIM:To study the effects of different flap sizes on visual acuity,refractive outcomes,and aberrations after femtosecond laser for laser in situ keratomileusis(LASIK).METHODS:In each of the forty patients enrolled,1 eye was randomly assigned to receive treatment with a 8.1mm diameter corneal flap,defined as the small flap,while the other eye was treated with a 8.6mm diameter corneal flap,defined as the big flap.Refractive errors,visual acuity,and higher-order aberrations were compared between the two groups at week 1,month 1 and 3 postoperatively. RESULTS:The postoperative refractive errors and visual acuity all conformed to the intended goal.Postoperative higher-order aberrations were increased,especially in spherical aberration(Z12) and vertical coma(Z7).There were no statistically significant differences between the two groups in terms of postoperative refractive errors,visual acuity,root mean square of total HOAs(HO-RMS),trefoil 30°(Z6),vertical coma(Z7),horizontal coma(Z8),trefoil 0°(Z9),and spherical aberration(Z12) at any point during the postoperative follow-up.CONCLUSION:Both the small and big flaps are safe and effective procedures to correct myopia,provided the exposure stroma meets the excimer laser ablations.The personalized size corneal flap is feasible,as we can design the size of corneal flap based on the principle that the corneal flap diameter should be equal to or greater than the sum of the maximum ablation diameter and apparatus error.

Clinical study inpatient-reported outcomes after binocular implantation of aspheric intraocular lens of different negative spherical aberrations

Objective: To compare patient-reported outcomes after implantation of the ZA9003 intraocular lens(IOLs), or the MCX11 ASP IOLs or the spherical IOLs(HQ-201HEP). Methods: Prospective nonrandomized controlled trial was used. A total of 105 patients(210 eyes) were divided into three groups according to the type of IOLs: ZA9003(35 patients, 70 eyes), MCX11 ASP(35 patients, 70 eyes) or HQ-201HEP(35 patients, 70 eyes). The main outcome was scores of Catquest nine-item short-form questionnaire. Additional outcome was best corrected visual acuities, spherical aberration(SA) and total higher-order aberrations(HOAs). Results: The global score was significantly lower in the spherical IOL group than the aspherical IOL group of-020 μm SA(P < 0.05) and the aspherical IOL group of-027 μm SA(P < 0.05), and no significant difference was found in the global score between the aspherical IOL group of-020 μm SA than the aspherical IOL group of-027 μm SA(P > 0.05). Significant differences were also found in question 2, question 5, question 6 and question 8 between the spherical IOLs and the aspherical IOLs. Conclusion: Implantation of an aspherical IOL could improve vision-related quality of life compared with a spherical IOL. However, there were no statistically significant differences in vision-related quality of life between aspheric IOLs with different negative spherical aberrations.

Correcting dynamic residual aberrations of conformal optical systems using AO technology

This paper analyses the dynamic residual aberrations of a conformal optical system and introduces adaptive optics （AO） correction technology to this system. The image sharpening AO system is chosen as the correction scheme.Communication between MATLAB and Code V is established via ActiveX technique in computer simulation.The SPGD algorithm is operated at seven zoom positions to calculate the optimized surface shape of the deformable mirror.After comparison of performance of the corrected system with the baseline system,AO technology is proved to be a good way of correcting the dynamic residual aberration in conformal optical design.

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.

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.

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.

The effects of implantable collamer lens implantation on higher order aberrations

AIM: To evaluate the changes in higher order aberrations(HOAs) after implantable collamer lens(ICL;Staar Surgical, Nidau, Switzerland) implantation. METHODS: Totally 30 eyes of 18 patients with myopia were included in this study with an average age of 25.77y(min: 21, max: 40). Refraction, uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), HOAs(entire, corneal and internal) were evaluated preoperatively and three months postoperatively. Ocular aberrations were measured by using iT race(Tracey Technology, Houston, Texas, USA). SPSS(IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp) was used for the statistical analysis and the interpretation of the data. P values of less than 0.05 were considered statistically significant. RESULTS: The preoperative mean spherical power was -9.01 D(min:-5.00, max:-13.00) and the mean cylindrical error was -2.40 D(min:-0.50, max:-4.75). The postoperative mean residual spherical power was -0.73 D(min:-0.20, max:-1.75) and the mean cylindrical error was -0.89 D(min:-0.18, max:-2.09). Analyses were made on root mean square(RMS) values of total HOAs(tH OAs), spherical aberration, coma and trefoil as entire, corneal and internal components. The differences in entire t HOAs and in internal t HOAs were significant. There was no significant change found in spherical aberrations. The differences in entire coma and in internal coma were significant. There was no significant change found in corneal coma. With respect to trefoil, the only significant difference was in internal trefoil. CONCLUSION: The ICL implantation corrects the refractive error successfully and changes entire and internal HOAs of the eye.

Efficacy, safety, predictability, aberrations and corneal biomechnical parameters after SMILE and FLEx: Metaanalysis

AIM： To identify possible differences of efficacy, safety predictability, higher-order aberrations and cornea biomechnical parameters after small-incision lenticule extraction（SMILE） and femtosecond lenticule extraction（FLEx）.· METHODS： A systematic literature retrieval was conducted in Medline,Embase and the Cochrane Library up to October, 2015. The included studies were subject to a Meta-analysis. Comparison between SMILE and FLEx was measured as pooled odds ratio（OR） or weighted mean differences（WMD）. Of 95% confidence intervals（CI） were used to analyze data.·RESULTS： A total of seven studies were included Firstly, there were no differences in uncorrected distance visual acuity（UDVA） 20/20 or better（OR, 1.37; 95% CI0.69 to 2.69; P =0.37） and log MAR UDVA（WMD,-0.02;95% CI,-0.05 to 0.01; P =0.17） after SMILE versus FLEx We found no differences in corrected distance visua acuity（CDVA） unchanged（OR, 0.98; 95% CI, 0.46 to 2.11;P =0.97） and log MAR CDVA（WMD,-0.00; 95% CI,-0.01 to 0.01; P =0.90） either. Secondly, we found no differences in refraction within ±1.00 D（OR, 0.98; 95% CI0.13 to 7.28; P =0.99） and ±0.50 D（OR, 1.62; 95% CI0.62 to 4.28; P =0.33） of target postoperatively. Thirdly for higher-order aberrations, we found no differences in the total higher-order aberrations（WMD,-0.04; 95%CI,-0.09 to 0.01;P =0.14）, coma（WMD,-0.04; 95% CI,-0.09 to 0.01; P =0.11）, spherical（WMD, 0.01; 95% CI,-0.02 to0.03; P =0.60） and trefoil（WMD,-0.00; 95% CI,-0.04 to0.03; P =0.76）. Furthermore, for corneal biomechanica parameters, we also found no differences（WMD, 0.08;95% CI,-0.17 to 0.33; P =0.54） after SMILE versus FLEx.·CONCLUSION： There are no statistically differences in efficacy, safety, predictability, higher-order aberrations and corneal biomechnical parameters postoperative between SMILE and FLEx.

Copy Number Aberrations of Multiple Genes Identified as Prognostic Markers for Extrahepatic Metastasis-free Survival of Patients with Hepatocellular Carcinoma

Extrahepatic metastasis confers unfavorable patient prognosis in patients with hepatocellular carcinoma(HCC),however,reliable markers allowing prediction of extrahepatic metastasis at the time of initial diagnosis are still lacking.This study was to identify gene-level copy number aberrations(CNAs)related to extrahepatic metastasis-free survival of HCC patients,and further examine the associations between CNAs and gene expression.Array comparative genomic hybridization(aCGH)and expression array were used to analyze gene CNAs and expression levels,respectively.The associations between CNAs of a panel of 20 genes and extrahepatic metastasis-free survival were analyzed in 66 patients with follow-up period of 1.6-90.5 months.The gene expression levels between HCCs with and without gene CNA were compared in 109 patients with HCC.We observed that gains at MDM4 and BCL2L1,and losses at APC and FBXW7 were independent prognostic markers for extrahepatic metastasis-free survival of HCC patients.Integration analysis of aCGH and expression data showed that MDM4 and BCL2L1 were significantly upregulated in HCCs with gene gain,while APC and FBXW7 were significantly downregulated in HCCs with gene loss.We concluded that gene gains at MDM4 and BCL2L1,and losses at APC and FBXW7,with concordant expression changes,were associated with extrahepatic metastasis-free survival of HCC patients and have potential to act as novel prognostic markers.

Evaluations of wavefront aberrations and corneal surface regularity in dry eye patients measured with OPD Scan Ⅲ

AIM: To compare the wavefront aberrations and corneal surface regularity between dry eye(DE) patients and normal subjects and assess its diagnostic performance for DE measured with OPD Scan-Ⅲ.METHODS: Fifty right eyes of 50 DE patients and 31 right eyes of normal subjects were included.The examinations for ocular surface including logarithm of the minimum angle of resolution best-corrected distance visual acuity(logMAR BCVA) the ocular surface disease index(OSDI), tear film break-up time(TBUT) and corneal fluorescein staining(CFS).OPD Scan-Ⅲ was used to measure anterior corneal aberrations including total corneal aberrations, high order aberration(HOA), coma, trefoil, spherical aberration(SA), standard deviation of corneal power(SDP), surface regularity index(SRI) and surface asymmetry index(SAI).Statistical analysis were assessed with nonparametric tests and Spearman’s correlations.All parameters were also analyzed for sensitivity, specificity, and receiver operating characteristics(ROC) curves.RESULTS: Wavefront aberrations parameters including total corneal aberrations, HOA, coma, trefoil, and SA in DE group were significantly higher than those in normal group(P<0.001).Corneal surface regularity parameters including SRI and SAI in DE group were significantly higher than both in normal group(P<0.05).All the wavefront aberrations parameters had significant correlations with ocular surface parameters(P<0.05).The logMAR BCVA had positive correlations with SAI and SRI(all P<0.001).CFS scores had positive correlations with SAI and SRI(all P<0.001).All the wavefront aberrations parameters showed good diagnosis sensitivity and specificity, however, the corneal regularity parameters showed only good specificity but poor sensitivity.The cut-off value selected for trefoil in diagnosis DE showed the highest area under the curve(AUC, 0.921) values as compared to the other parameters with sensitivity of 0.955 and specificity of 0.867.CONCLUSION: Wavefront aberrations and corneal surface regularity are increased in DE patients and also correlated with ocular surface parameters.Wavefront aberrations parameters have potential to be indicators to diagnosis and monitor DE.

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.

Measurement of the peripheral aberrations of human eyes:A comprehensive review

It has been nearly 50 years since the first glimpse of the relationship between myopia and peripheral refractive errors. According to experiments on both animals and humans, the eyes with hyperopic peripheral vision appear to be at higher risk of developing myopia than those with myopic peripheral refractive errors. Despite the first measurement of peripheral refraction being achieved by a modified manual optometer, the concept of emmetropization triggered a rapidly increasing number of studies on peripheral aberrations. Not only the horizontal off-axis aberrations but also the meridional aberrations at different angles are measured by researchers during the development of peripheral aberrations measuring techniques. According to the differences among the working principles, a variety of techniques have been adopted for performing such measurements. The methods developed to realize the high-performance measurement involve the subject cooperating actively by rotating the head or eyes, the rotation of the whole optical path, and the combination of measurements of many light paths. This paper provides a review of the peripheral aberrations measuring techniques and their current status. This article also highlights the development trend of the measuring techniques of peripheral aberrations and practical applications of peripheral aberration measurements, such as the control of the accommodation, the measuring time, and the dynamic range problem of the wavefront sensor. Although wavefront sensing peripheral measurement is widely recognized for its capability to reveal both lower-order aberrations and higher-order aberrations, the efficiency of an autorefractometer is incomparable. The current study reveals that the most widely used peripheral aberration measurement methods are the use of an open field autorefractometer and Hartman-shack wavefront sensor-based techniques.