The prevalence of uncorrected refractive error in urban, suburban, exurban and rural primary school children in Indonesian population

Uncorrected refractive error（URE） is a major health problem among school children. This study was aimed to determine the frequency and patterns of URE across 4 gradients of residential densities（urban, exurban, suburban and rural）. This was a cross-sectional study of school children from 3 districts in Yogyakarta and 1 district near Yogyakarta, Indonesia. The information regarding age, sex, school and school grader were recorded. The Snellen＇s chart was used to measure the visual acuity and to perform the subjective refraction. The district was then divided into urban, suburban, exurban and rural area based on their location and population. In total, 410 school children were included in the analyses（urban=79, exurban=73, suburban=160 and rural=98 school children）. Urban school children revealed the worst visual acuity（P〈0.001） and it was significant when compared with exurban and rural. The proportion of URE among urban, suburban, exurban and rural area were 10.1%, 12.3%, 3.8%, and 1%, respectively, and it was significant when compared to the proportion of ametropia and corrected refractive error across residential densities（P=0.003）. The risk of URE development in urban, suburban, exurban, and rural were 2.218（95%CI： 0.914-5.385）, 3.019（95%CI： 1.266-7.197）, 0.502（95%CI： 0.195-1.293）, and 0.130（95%CI：0.017-0.972）, respectively. Urban school children showed the worst visual acuity. The school children in urban and suburban residential area had 2 and 3 times higher risk of developing the URE.

Transepithelial photorefractive keratectomy for myopia:effect of age and keratometric values

AIM:To investigate demographic and preoperative factors increasing the risk of ametropia following transepithelial photorefractive keratectomy(trans PRK)in myopia and myopic astigmatism.METHODS:This retrospective cohort study included myopic eyes(-0.50 to-8.75 D)with or without astigmatism(up to 3.50 D)enrolled at Dr.Yap Eye Hospital Yogyakarta.Trans PRK was performed using Technolaz 217 z100 excimer laser.Subjects were clustered into ametropia and emmetropia group based on uncorrected distance visual acuities(UDVA)3 mo post-operatively.Multiple preoperative and intraoperative parameters were analyzed using Logistic regression to obtain their effect on ametropia risk following trans PRK.RESULTS:A total of 140 eyes of 87 consecutive subjects were studied.Prevalence of ametropia following trans PRK was 20(14.29%)eyes.Subjects in ametropia group were significantly older than the emmetropia group(31.80±14.23 vs 18.88±2.41,respectively;P<0.001).Bivariate Logistic regression analysis showed that older age(OR=1.23),higher preoperative spherical equivalent(>-6 D;OR=12.78),steeper anterior keratometric readings(Kmax>45 D and mean K>44 D;OR=4.28 and 4.35,respectively)increased the risk of ametropia following trans PRK.Adjusted multivariate Logistic regression analysis showed that age was the strongest predictor for the incidence of ametropia following trans PRK.Complications of trans PRK were overcorrection,suspected posterior keratoectasia and accommodation insuffiency.CONCLUSION:Older age can be the strongest factor for increasing ametropia risk following trans PRK.Cut-off points of Kmax and mean K at 45 and 44 D respectively are proposed as the predictors for ametropia following trans PRK.