AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The rel...AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The relationship between the AL/TCRP ratio and the diagnosis of MFS for 192 eyes in 97 children were evaluate.The biological characteristics,including age,sex,AL,and TCRP,were collected from medical records.Receiver operating characteristic(ROC)curve analysis was performed to investigate whether the AL/TCRP ratio effectively distinguishes MFS from other subjects.The Youden index was used to re-divide the whole population into two groups according to an AL/TCRP ratio of 0.59.RESULTS:Of 96 subjects(mean age 7.46±3.28 y)evaluated,56(110 eyes)had a definite diagnosis of MFS in childhood based on the revised Ghent criteria,41(82 eyes)with diagnosis of congenital ectopia lentis(EL)were included as a control group.AL was negatively correlated with TCRP,with a linear regression coefficient of-0.36(R2=0.08).A significant correlation was found between age and the AL/TCRP ratio(P=0.023).ROC curve analysis showed that the AL/TCRP ratio distinguished MFS from the other patients at a threshold of 0.59.MFS patients were present in 24/58(41.38%)patients with an AL/TCRP ratio of≤0.59 and in 34/39(87.18%)patients with an AL/TCRP ratio of>0.59.CONCLUSION:An AL/TCRP ratio of>0.59 is significantly associated with the risk of MFS.The AL/TCRP ratio should be measured as a promising marker for the prognosis of children MFS.Changes in the AL/TCRP ratio should be monitored over time.展开更多
AIM:To detect an earlier improvement in mild to moderate keratoconus following corneal cross-linking(CXL)with total corneal refractive power(TCRP)using ray tracing method.METHODS:A total of 40 eyes of 30 consecutive p...AIM:To detect an earlier improvement in mild to moderate keratoconus following corneal cross-linking(CXL)with total corneal refractive power(TCRP)using ray tracing method.METHODS:A total of 40 eyes of 30 consecutive patients who underwent CXL for progressive keratoconus were retrospectively enrolled.The following keratometric parameters provided by Pentacam HR,including maximum keratometry(Kmax),steepest keratometry(Ksteep),3 mm zonal TCRP centered over corneal apex(TCRPapex,zone 3 mm),zonal mean keratometry and TCRP centered over corneal cone(Kmcone,zone and TCRPcone,zone 1,2,3 mm)were evaluated preoperatively and 1,3,6,and 12 mo postoperatively.Groups 1 and 2 were defined based on Kmax at postoperative 1 mo as improved(the initial improvement group)or worsen(the initial deterioration group)compared to the preoperative level.RESULTS:In the overall group,only keratometric parameters based on ray tracing method displayed significant improvement early at 3 mo postoperatively,in which TCRPcone,zone 1 mm and 2 mm exhibited the largest flattening(0.57 D and 0.53 D,respectively).In Group 1,only Kmax,Kmcone,zone 2 mm and TCRPcone,zone 2 mm showed significant improvement initially at 1 mo postoperatively,in which Kmax exhibited the largest improvement(1.05 D),followed by TCRPcone,zone 2 mm(0.82 D).In Group 2,only keratometric parameters based on ray tracing method and Kmcone,zone 3 mm showed slight but not significant improvement early at 3 mo,in which TCRPcone,zone 3 mm displayed the most improvement(0.19 D),followed by TCRPcone,zone 2 mm(0.15 D).CONCLUSION:The findings indicate that a 2 mm zonal TCRP centered over Kmax could earlier detect keratometric improvement by CXL compared to other commonly used parameters in mild to moderate keratoconic eyes.展开更多
AIM: To investigate the incidence of preoperative dry eye and related factors in patients undergoing corneal refractive surgery to correct myopia.METHODS: A total of 141 patients with myopia who underwent corneal refr...AIM: To investigate the incidence of preoperative dry eye and related factors in patients undergoing corneal refractive surgery to correct myopia.METHODS: A total of 141 patients with myopia who underwent corneal refractive surgery were surveyed by questionnaires, tear film break-up time(BUT) test, Schimer I test(SIt), corneal fluorescein staining(FL) test and diagnosed according to the currently recognized domestic diagnostic criteria for dry eye. Correlation analysis of factors such as age, gender, regular wearing of contact lens(CL), diopter(spherical equivalent), corneal thickness, and corneal curvature that may affect the onset of dry eye was carried out to clarify the main influencing factors. RESULTS: There were 64 patients(45.39%) diagnosed with dry eye. The male patients(20.31%) was significantly less than that of non-dry eye subjects(41.56%;χ~2=7.260, P=0.007);the proportion of patients with dry eye wearing CL(81.25%) was significantly higher than that of non-dry eye subjects(51.95%;χ~2=13.234, P<0.001);the median diopter level of dry eye patients was-6.59(IQR:-8.87,-4.58) D, and the median diopter level of non-dry eye subjects was-5.69(IQR:-7.15,-4.03) D. The diopter level of dry eye patients was significantly higher(Z=-2.086, P=0.019). However, the age, best corrected visual acuity, and intraocular pressure of dry eye patients were not statistically different from those of non-dry eye subjects(t=-0.257,-0.383 and 0.778, P=0.798, 0.702, and 0.438);the corneal thickness and corneal curvature(K1 and K2) were also not statistically different either(Z=-1.487,-1.036 and-1.707, P=0.137, 0.300, and 0.088). The research further analyzes the three significant factors in the single factor analysis(gender, CL wear, and diopter) in a multi-factor way: CL wear and diopter were the influencing factors of dry eye disease. Among them, CL wear increased the risk of dry eye by 2.934 times compared with no CL wear;for every 1 D increase in diopter, the risk of dry eye increased by 0.761 times.CONCLUSION: Preoperative dry eye is relatively common in patients who undergo corneal refractive surgery to correct myopia, especially in patients who have a history of CL wear and a high diopter level before surgery. Therefore, it is necessary to carry out preoperative screening and timely treatment of dry eye to obtain the best treatment outcome and postoperative satisfaction.展开更多
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:Patie...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.展开更多
基金Supported by the National Natural Science Foundation of China(No.81770908)the Shanghai Science and Technology Commission(Scientific Innovation Project,No.20Y11911000)。
文摘AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The relationship between the AL/TCRP ratio and the diagnosis of MFS for 192 eyes in 97 children were evaluate.The biological characteristics,including age,sex,AL,and TCRP,were collected from medical records.Receiver operating characteristic(ROC)curve analysis was performed to investigate whether the AL/TCRP ratio effectively distinguishes MFS from other subjects.The Youden index was used to re-divide the whole population into two groups according to an AL/TCRP ratio of 0.59.RESULTS:Of 96 subjects(mean age 7.46±3.28 y)evaluated,56(110 eyes)had a definite diagnosis of MFS in childhood based on the revised Ghent criteria,41(82 eyes)with diagnosis of congenital ectopia lentis(EL)were included as a control group.AL was negatively correlated with TCRP,with a linear regression coefficient of-0.36(R2=0.08).A significant correlation was found between age and the AL/TCRP ratio(P=0.023).ROC curve analysis showed that the AL/TCRP ratio distinguished MFS from the other patients at a threshold of 0.59.MFS patients were present in 24/58(41.38%)patients with an AL/TCRP ratio of≤0.59 and in 34/39(87.18%)patients with an AL/TCRP ratio of>0.59.CONCLUSION:An AL/TCRP ratio of>0.59 is significantly associated with the risk of MFS.The AL/TCRP ratio should be measured as a promising marker for the prognosis of children MFS.Changes in the AL/TCRP ratio should be monitored over time.
基金National Natural Science Foundation of China(No.81970769)Hunan Province Technology Innovation Guidance Program(No.2018SK50108)+1 种基金Wuhan City Medicine Research Project(No.WX19C12)Ophthalmology and Otorhinolaryngology College of Hubei University of Science and Technology Research Development Fund Project(No.2020XZ38)。
文摘AIM:To detect an earlier improvement in mild to moderate keratoconus following corneal cross-linking(CXL)with total corneal refractive power(TCRP)using ray tracing method.METHODS:A total of 40 eyes of 30 consecutive patients who underwent CXL for progressive keratoconus were retrospectively enrolled.The following keratometric parameters provided by Pentacam HR,including maximum keratometry(Kmax),steepest keratometry(Ksteep),3 mm zonal TCRP centered over corneal apex(TCRPapex,zone 3 mm),zonal mean keratometry and TCRP centered over corneal cone(Kmcone,zone and TCRPcone,zone 1,2,3 mm)were evaluated preoperatively and 1,3,6,and 12 mo postoperatively.Groups 1 and 2 were defined based on Kmax at postoperative 1 mo as improved(the initial improvement group)or worsen(the initial deterioration group)compared to the preoperative level.RESULTS:In the overall group,only keratometric parameters based on ray tracing method displayed significant improvement early at 3 mo postoperatively,in which TCRPcone,zone 1 mm and 2 mm exhibited the largest flattening(0.57 D and 0.53 D,respectively).In Group 1,only Kmax,Kmcone,zone 2 mm and TCRPcone,zone 2 mm showed significant improvement initially at 1 mo postoperatively,in which Kmax exhibited the largest improvement(1.05 D),followed by TCRPcone,zone 2 mm(0.82 D).In Group 2,only keratometric parameters based on ray tracing method and Kmcone,zone 3 mm showed slight but not significant improvement early at 3 mo,in which TCRPcone,zone 3 mm displayed the most improvement(0.19 D),followed by TCRPcone,zone 2 mm(0.15 D).CONCLUSION:The findings indicate that a 2 mm zonal TCRP centered over Kmax could earlier detect keratometric improvement by CXL compared to other commonly used parameters in mild to moderate keratoconic eyes.
文摘AIM: To investigate the incidence of preoperative dry eye and related factors in patients undergoing corneal refractive surgery to correct myopia.METHODS: A total of 141 patients with myopia who underwent corneal refractive surgery were surveyed by questionnaires, tear film break-up time(BUT) test, Schimer I test(SIt), corneal fluorescein staining(FL) test and diagnosed according to the currently recognized domestic diagnostic criteria for dry eye. Correlation analysis of factors such as age, gender, regular wearing of contact lens(CL), diopter(spherical equivalent), corneal thickness, and corneal curvature that may affect the onset of dry eye was carried out to clarify the main influencing factors. RESULTS: There were 64 patients(45.39%) diagnosed with dry eye. The male patients(20.31%) was significantly less than that of non-dry eye subjects(41.56%;χ~2=7.260, P=0.007);the proportion of patients with dry eye wearing CL(81.25%) was significantly higher than that of non-dry eye subjects(51.95%;χ~2=13.234, P<0.001);the median diopter level of dry eye patients was-6.59(IQR:-8.87,-4.58) D, and the median diopter level of non-dry eye subjects was-5.69(IQR:-7.15,-4.03) D. The diopter level of dry eye patients was significantly higher(Z=-2.086, P=0.019). However, the age, best corrected visual acuity, and intraocular pressure of dry eye patients were not statistically different from those of non-dry eye subjects(t=-0.257,-0.383 and 0.778, P=0.798, 0.702, and 0.438);the corneal thickness and corneal curvature(K1 and K2) were also not statistically different either(Z=-1.487,-1.036 and-1.707, P=0.137, 0.300, and 0.088). The research further analyzes the three significant factors in the single factor analysis(gender, CL wear, and diopter) in a multi-factor way: CL wear and diopter were the influencing factors of dry eye disease. Among them, CL wear increased the risk of dry eye by 2.934 times compared with no CL wear;for every 1 D increase in diopter, the risk of dry eye increased by 0.761 times.CONCLUSION: Preoperative dry eye is relatively common in patients who undergo corneal refractive surgery to correct myopia, especially in patients who have a history of CL wear and a high diopter level before surgery. Therefore, it is necessary to carry out preoperative screening and timely treatment of dry eye to obtain the best treatment outcome and postoperative satisfaction.
基金Supported by the Science&Technology Department of Sichuan Province (China)Funding Project (No.2021YFS0221)the Postdoctoral Research Funding of West China Hospital (No.2020HXBH044)1.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University (No.2022HXFH032,ZYJC21058)。
文摘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.
