Spherical Equivalent Error Research Articles

Ten-year evaluation on efficacy, safety, and predictability of femtosecond laser corneal small incision lenticule extraction for correction of myopia and myopic astigmatism: a case series

Objective: The objective was to evaluate the 10-year long-term outcomes of patients undergoing small incision lenticule extraction (SMILE). Methods: In this continuous case series, the authors enrolled a total of 113 patients (208 eyes) who underwent SMILE 10 years prior. Measured parameters included uncorrected visual acuity (UCVA), corrected distance visual acuity (CDVA), and cycloplegia spherical equivalent error (SER). Results: One hundred thirteen patients were enrolled in this study. Patients’ age ranged from 18 to 44 years (mean: 30.2 years). One hundred ninety-three eyes (92.8%) and 176 eyes (84.6%) had an UCVA≥20/20 at 3 months and 10 years postoperatively. The mean efficacy index, measured at 3 months and 10 years postoperatively, were 1.041 and 1.023, respectively; the difference was not statistically significant. Three months after the operation, best-corrected visual acuity (BCVA) decreased by 1 line in 19 eyes (9.1%), remained unchanged in 158 eyes (76.0%), and increased by ≥1 line in 31 eyes (14.9%). Ten years after operation, BCVA decreased by 2 lines in 15 eyes (7.2%) and by 1 line in 35 eyes (16.8%); remained unchanged in 142 eyes (68.3%); increased ≥1 line in 16 eyes (7.7%). The mean safety index, measured at 3 months and 10 years postoperatively, were 1.147 and 1.331, respectively; the difference was not statistically significant. The mean SER at 3 months and 10 years postoperatively was −0.112 and −0.276, respectively; the difference was statistically significant. Conclusion: There was a decrease in SER 10 years after SMILE surgery compared with 3 months postoperatively, there was no significant decrease in the efficacy index or safety index.

Analysis of the ESCRS calculator's prediction accuracy.

To evaluate prediction accuracy of formulas included in the ESCRS online intraocular lens (IOL) calculator using standard keratometry (K) or total keratometry (TK). Hospital-based academic practice. Retrospective case-series. 523 patients with cataract (523 eyes) were included in this study. The outcome measures were trimmed means of the spherical equivalent prediction error (SEQ-PE, trueness), precision and absolute SEQ-PE (accuracy) of all 7 formulas available on the ESCRS online IOL calculator, as well as mean (Mean-All) and median (Median-All) of the predicted SEQ refraction of all formulas. Subgroup analyses evaluated the effect of axial length on formula accuracy. Trimmed-mean SEQ-PE range of all formulas varied from -0.075 to +0.071 diopters (D) for K-based and from -0.003 to +0.147 D for TK-based calculations, with TK-based being more hyperopic in all formulas ( P < .001). Precision ranged from 0.210 to 0.244 D for both K-based and TK-based calculations. Absolute SEQ-PE ranged from 0.211 to 0.239 D for K-based and from 0.218 to 0.255 D for TK-based calculations. All formulas, including Mean-All and Median-All, showed high accuracy, with 84% to 90% of eyes having SEQ-PEs within 0.50 D.Myopic trimmed-mean SEQ-PEs significantly different from zero were observed in long eyes for Pearl DGS (-0.110 D, P = .005), Hill RBF (-0.120 D, P < .001), and Hoffer QST (-0.143 D, P = .001) and in short eyes for EVO 2.0 (-0.252 D, P = .001), Kane (-0.264 D, P = .001), Hoffer QST (-0.302 D, P < .001), Mean-All (-0.122 D, P = .038), and Median-All (-0.125 D, P = .043). Prediction accuracy of all ESCRS IOL calculator formulas was high and globally comparable. TK-based calculations did not increase prediction accuracy and tended toward hyperopia. Observations indicating formula superiority in long and short eyes merit further evaluation.

Characteristics of the fundus and optical coherence tomography angiography metrics in myopic patients with myelinated retinal nerve fibers

AimsTo investigate the fundus characteristics and macular optical coherence tomography angiography (OCTA) metrics in patients with myelinated retinal nerve fibers (MRNF) and to identify the associations among myopic parameters, fundus metrics, and OCTA metrics.MethodsThe single-center case-control study included 15 patients with monocular MRNF and 15 patients without MRNF, matched for age, affected eyes’ spherical equivalent error (SER), and axial length (AL) between May 2021 and December 2021. Fundus features, including the entire MRNF area (Area1), the denser MRNF area (Area2), and the shortest distance from the fovea to the MRNF border (Df−m), along with ocular parameters, including SER, AL, best corrected visual acuity (BCVA), and OCTA metrics at the fovea, including choroidal (ChT) and retinal (ReT) thicknesses at the fovea, the foveal avascular zone area (FAZ), foveal avascular zone perimeter (FAZP), FAZ-circularity index (FAZ-CI), and foveal vessel density in a 300-µm wide region (FD-300), were assessed.ResultsThe SER, AL, and BCVA were significantly different, and the ChT was thinner in the affected eyes than in the contralateral eyes. Compared with matched eyes, affected eyes had reduced BCVA and thinner ReT. In the affected eyes, both Area1 and Area2 were negatively correlated with SER (r1 = -0.84, r2 = -0.65), △SER (r1 = -0.86, r2 = -0.61), ReT at the vertical superior 3 mm (VS) (r1 = -0.78, r2 = -0.67), and ChT_VS (r1 = -0.64, r2 = -0.62), and positively correlated with AL (r1 = 0.82, r2 = 0.52) and BCVA (r1 = 0.54, r2 = 0.59). Df−m was negatively correlated with BCVA (r = -0.57).ConclusionThe presence of MRNF affects BCVA and ReT at the fovea. The area of the MRNF, as well as the distance from the MRNF to the fovea, are closely associated with the affected eyes’ BCVA, SER, AL, and the degree of anisometropia.

Lifelong Changes in the Choroidal Thickness, Refractive Status, and Ocular Dimensions in C57BL/6J Mouse.

To investigate the changes in choroidal thickness (ChT), refractive status, and ocular dimensions in the mouse eye in vivo using updated techniques and instrumentation. High-resolution swept-source optical coherence tomography (SS-OCT), eccentric infrared photoretinoscopy, and custom real-time optical coherence tomography were used to analyze choroidal changes, refractive changes and ocular growth in C57BL/6J mice from postnatal day (P) 21 to month 22. The ChT gradually increased with age, with the thickest region in the para-optic nerve head and thinning outward, and the temporal ChT was globally thicker than the nasal ChT. Retinal thickness remained stable until 4months and subsequently decreased. The average spherical equivalent refraction error was -4.81 ± 2.71 diopters (D) at P21, which developed into emmetropia by P32, reached a hyperopic peak (+5.75±1.38D) at P82 and returned to +0.66 ± 1.86 D at 22months. Central corneal thickness, anterior chamber depth, lens thickness, and axial length (AL) increased continuously before 4months, but subsequently exhibited subtle changes. Vitreous chamber depth decreased with lens growth. ChT was correlated significantly with the ocular parameters (except for retinal thickness) before the age of 4months, but these correlations diminished after 4months. Furthermore, for mice younger than 4months, the difference in the ChT, especially temporal ChT, between the two eyes contributed most to that of axial length and spherical equivalent refraction error. Four months could be a watershed age in the growth of mouse eyes. Large-span temporal recordings of refraction, ocular dimensions, and choroidal changes provided references for the study of the physiological and pathological mechanisms responsible for myopia.

The Distribution and Influence Factors of Non-Invasive Tear Film Break-Up Time in Children.

To explore the distribution and influence factors of non-invasive tear film break-up time (NIBUT) in children. This is a hospital-based cross-sectional study. Spherical equivalent error (SER) was measured with cycloplegia. NIBUT was measured by an ocular surface integrated analyzer. A total of 1269 children (1269 eyes) were included in this study. Participants' median age was 11 (range 6-18) years. 47.1% (598/1269) of participants were boys. The median NIBUT of myopic children and non-myopic children were 9.9seconds (s) (Inter-quartile range, IQR: 6.4 to 16.1) and 10.9 s (IQR: 8.8 to 17.9), respectively, which was statistically significant (p = 0.004). In myopic children, 49.9% (573/1148) were able to achieve NIBUT of 10 s or more, compared to 67.8% (82/121) in non-myopic children, which was statistically significant (p < 0.001). There were 41 (3.57%) children in the myopic group and none (0%) in the non-myopic group with dry eye disease (p = 0.028). There was a positive correlation between NIBUT and age: NIBUT = 9.256 + 0.352*Age. 71.8% (824/1148) of myopic children used electronic products almost every day, compared to 37.2% (45/121) of non-myopic children, which was statistically significant (p < 0.001). The NIBUT of myopic children was significantly shorter than that of non-myopic children. Children with myopia are more likely to have dry eyes. NIBUT increases with age. High frequency of electronic product use may be an important cause to NIBUT shortening in children.

Comparison of keratometry and total corneal power, as measured by an SS-OCT-based optical biometer, for intraocular lens power calculation in Asian eyes.

To investigate whether standard keratometry (K) or total corneal power (TCP) leads to more accurate refractive outcomes for intraocular lens (IOL) power calculation. Public hospital. Retrospective evaluation of a diagnostic test instrument. Preoperatively, all patients underwent optical biometry with Anterion, a swept-source optical coherence tomography device providing both K and TCP. The same IOL model was implanted in all cases. The whole sample was divided into a training dataset, used to optimize the formula constants, and a testing dataset, used to investigate the spherical equivalent prediction error (SEQ-PE) of 8 IOL power formulas. Trueness, precision, and accuracy were evaluated by means of the robust 2-sample t test. Cochran Q test was performed to assess whether the percentage of eyes with an SEQ-PE within each threshold was significantly different; in such an event, the McNemar test was then applied. Both the training and testing datasets included 317 eyes. No significant differences were detected for trueness because of constant optimization. Precision and accuracy were better when K was entered, although a statistically significant difference was observed only with the EVO (precision: P = .02 and accuracy: P = .03) and Haigis ( P < .01 for both precision and accuracy) formulas. No significant differences were observed for the percentage of eyes with an absolute SEQ-PE within any threshold. With most formulas, IOL power calculation is not more accurate when TCP is used instead of K.

Spherical equivalent prediction analysis in intraocular lens power calculations using Eyetemis: a comprehensive approach.

To compare 2 different datasets, using Eyetemis, an online analytical tool designed for assessing the spherical equivalent prediction errors (SEQ-PEs) of intraocular lens (IOL) power calculation formulas after cataract surgery. Institutional. Retrospective case series. The study comprised 2 distinct datasets of patients who had undergone successful cataract surgery. Dataset 1 includes standard eyes, whereas Dataset 2 includes eyes with keratoconus. An online tool was used for SEQ-PE analysis across the 2 datasets, adhering to ISO standards for evaluating accuracy based on trueness and precision. The tool incorporates robust t tests for comparing the trimmed mean of the data, adjusting for heteroscedasticity. IOL constants in Dataset 1 were optimized for the comparison of Hoffer Q, Holladay 1, SRK/T, Haigis, and Barrett Universal II (BUII) formulas. In Dataset 2, IOL constants from the IOLCon website were used for the comparison of the BUII and its designated KCN version: Barrett TrueK Keratoconus (TrueK [KCN]). For Dataset 1, the trimmed mean SEQ-PE values of all formulas were not significantly different from zero. BUII had superior precision and accuracy compared with all other formulas, except from Haigis ( P ≤ .04). For Dataset 2, BUII's trimmed-mean SEQ-PE was significantly different from zero (0.59 diopters [D], P < .01), unlike the TrueK (KCN) (0.12 D, P = .10). In addition, TrueK (KCN) exhibited enhanced precision and accuracy relative to BUII ( P < .01). The online analysis tool provides a streamlined approach for assessing the prediction accuracy of SEQ refraction after cataract surgery, effectively evaluating trueness, precision, and overall accuracy through the use of advanced statistical methods.

Сравнительный анализ рефракционных и функциональных результатов имплантации торической интраокулярной линзы с механизмом формирования волнового фронта при хирургическом лечении катаракты у пациентов после сквозной кератопластики

Abstract Comparative analysis of the refractive and functional results of toric intraocular lens with wavefrontshaping mechanism implantation during the surgical treatment of cataracts in patients after penetrating keratoplasty. D.A. Khvan, , G.A. Fedyashev Pacific State Medical University Ministry of Health of Russia, Vladivostok, Russian Federation Primorskii center of eye microsurgery, Vladivostok, Russian Federation Relevance. This study presents a comparative analysis of the effectiveness of toric intraocular lens (IOL) with a wavefront shaping mechanism implantation in cataract surgical treatment in patients after penetrating keratoplasty (PKP). Purpose. To evaluate the effectiveness of toric IOL with a wavefront shaping mechanism implantation in cataract surgical treatment in patients after PKP. Material and methods. This prospective study included 65 patients (65 eyes) who underwent cataract surgery after prevous PKP (the time after removal of corneal sutures averaged 1.4±0.8 years). In the 1st group of patients (34 patients, 34 eyes) the AcrySof IQ Toric IOL was implanted, in the 2nd group – the AcrySof IQ Vivity IOL (31 patients, 31 eyes). In both groups, IOL power was calculated at a target refraction of (–) 0.5 D. The observation period was up to 6 months. Results. In all groups, there was a significant (p&lt;0.001) improvement in uncorrected (UCVA) and best-corrected visual acuity (BCVA) on the first day, after 1, 3 and 6 months. In 1st group, by the 6th month of observation, there was a tendency towards a slight significant (relative to the 3rd month) decrease in UCVA of 0.134±0.1 (p=0.019). In 2nd group, UCVA was significantly (p&lt;0.001) higher than in 1st group at all periods of postoperative follow-up and was 0.075±0.063 before surgery (in 1st group 0.053±0.029), on the first day after surgery 0.348± 0.139 (in the 1st group 0.097±0.05), 1st month 0.516±0.144 (in the 1st group 0.133±0.076), 3rd month 0.642±0.143 and by the 6th month 0.642±0.139 (in 1st group 0.16±0.1 and 0.134±0.1, respectively). Statistically significant (p=0.03) differences were obtained when comparing the error of the spherical equivalent of refraction (SE) from the expected result in the 1st and 2nd groups (1.22±0.875 and 0.76±0.582, respectively) during the observation period up to 6 months. Conclusion. AcrySof IQ Vivity Toric IOL implantation during the cataract surgical treatment in patients with previous keratoplasty allows to obtain significantly higher postoperative UCVA, due to more accurate access to target refraction, which confirmed by a significantly lower spherical equivalent error. Key words: wavefront, cataract, penetrating keratoplasty, EDOF, Vivity

Daily Low-Level Red Light for Spherical Equivalent Error and Axial Length in Children With Myopia

Treatments are needed to slow progression of or reduce incidence of myopia. To evaluate the efficacy and safety of daily 650-nm low-level red light (LLRL) for myopia treatment. Single-masked, randomized clinical trial at 1 site in China. Baseline measurements were completed from August to September 2021. Participants were children aged 6 to 12 years with spherical equivalent error (SER) of -6 diopters (D) to 3 D. Data were analyzed from March to July 2023. Irradiation daily with 650-nm LLRL for 3 minutes twice daily 4 or more hours apart or no intervention. Primary outcomes were changes in cycloplegia SER and axial length (AL) at 6- and 12-month follow-up visits. Safety was assessed on masked fundus photograph evaluations. A total of 336 children were randomly allocated into the LLRL group or control group in a 1:1 ratio. The control group contained 86 female patients (51.2%), and the treatment group contained 90 female patients (53.6%). The mean (SD) age, SER, and AL were 9.0 (1.9) years, -1.3 (1.5) D, and 23.8 (1.0) mm for all patients. A total of 161 (95.8%) in the LLRL group and 159 (94.6%) in the control group returned for the 6-month follow-up. A total of 157 (93.5%) in the LLRL group and 152 (90.5%) in the control group returned for the 12-month follow-up. Mean (SD) changes in SER were 0.15 (0.16) D and -0.26 (0.21) D for the LLRL group and the control group, respectively (difference, -0.41 D; 95% CI, -0.48 to -0.34 D; P < .001), at 6 months and 0.24 (0.27) D and -0.65 (0.33) D for the LLRL group and the control group, respectively (difference, -0.89 D; 95% CI, -0.95 to -0.83 D; P < .001), at 12 months. Mean (SD) changes in AL were -0.06 (0.08) mm and 0.13 (0.12) mm for the LLRL group and control group, respectively (difference, 0.19 mm; 95% CI, 0.16 to 0.22 mm; P < .001), at 6 months and -0.11 (0.10) mm and 0.26 (0.16) mm for the LLRL group and control group, respectively (difference, 0.37 mm; 95% CI, 0.34 to 0.40 mm; P < .001). Masked fundus photograph review did not identify retinal changes in either group. These findings suggest daily use of 650-nm LLRL for 1 year can slow progression of SER and AL without safety concerns identified. Confirmation of these findings at independent sites seems warranted, as well as determining whether these effects can be sustained with or without continued treatment and whether LLRL has any effect on pathological myopia. ChiCTR2200058963.

Comparison of refractive outcomes obtained with two swept-source OCT-based optical biometers after cataract surgery: A study of 152 eyes

To compare two swept-source OCT optical biometers, the Anterion® (Heidelberg Engineering GmbH, Heidelberg, Germany) and the IOLMaster 700® (Carl Zeiss Meditec AG, Jena, Germany), in the analysis of biometric data, intraocular lens (IOL) calculation and postoperative spherical equivalent predictability. This was a real-life, single-center, retrospective study including 152 eyes of 81 consecutive patients referred for cataract surgery. All patients were examined with the IOLMaster 700® and the Anterion®. Biometric data (axial length [AL], anterior chamber depth [ACD], mean keratometry [Km], K1 [flat keratometry], K2 [steep keratometry] and axis, TK1 [flat total keratometry], TK2 [steep total keratometry], central pachymetry, lens thickness [LT], white-to-white distance [WTW]), IOL calculation with the SRK/T formula, and postoperative refractive outcome at 1 month were compared. All biometric measurements were significantly different between the two biometers. Correlations were excellent for AL, pachymetry, ACD, LT and keratometry measurements, and for the IOL calculation (r>0.96, intraclass correlation coefficient=1). The IOL power for emmetropia was similar between both biometers when the SRK/T formula was used (20.84±3.24D versus 20.86±3.29D, P=0.61). The mean postoperative spherical equivalent prediction error calculated using the SRK/T formula was 0.03±0.5D for the IOLMaster 700® versus 0.01±0.47D for the Anterion® (P=0.12). This study showed excellent correlation and agreement for the biometric measurements and the IOL power calculation with the SRK/T formula between both biometers.

Effectiveness of toric intraocular lens implantation for correcting irregular corneal astigmatism in cataract eyes

A retrospective cohort study was conducted to observe the correction effect of Toric intraocular lens (IOL) implantation in cataract eyes with specific types of irregular corneal astigmatism. Thirty-four eyes with either the "asymmetric bow-tie" pattern (Type I) or the "angled bow-tie" pattern (Type II) were included. Corneal topography was assessed using Pentacam HR, and changes in preoperative corneal astigmatism, visual acuity, manifest refraction, and objective visual quality were measured and compared. The average uncorrected distance visual acuity improved significantly from 0.86 ± 0.40 logMAR to 0.22 ± 0.15 logMAR (P < 0.001). Preoperative corneal astigmatism of 2.05 ± 0.90 D was corrected to a postoperative residual astigmatism of 0.78 ± 0.57 D (P < 0.001), with 32% of eyes within 0.50 D. The residual astigmatism prediction errors in Type I and Type II cases were (0.97 ± 0.68 D) and (0.66 ± 0.37 D), respectively (P = 0.100). The mean spherical equivalent prediction error in Type II cases (0.07 ± 0.36 D) was significantly smaller than that in Type I cases (− 0.29 ± 0.52 D) (P = 0.030). This study concludes that Toric IOL implantation effectively corrects specific types of irregular corneal astigmatism in cataract surgery. Eyes with the "angled bow-tie" pattern show higher accuracy in refractive predictions compared to eyes with the "asymmetric bow-tie" pattern.

Comparison of Intraocular Lens Power Prediction Accuracy Between 2 Swept-Source Optical Coherence Tomography Biometry Devices

To compare intraocular lens (IOL) power prediction accuracy of the Eyestar 900 (EyeS900) and the IOLMaster 700 (IOLM700) based on estimated and measured posterior corneal power. Retrospective, interinstrument reliability study. Setting: Institutional. Two hundred twenty-five eyes of 225 cataract surgery patients. Patients underwent measurements by both devices preoperatively. Spherical Equivalent Prediction Error (SEQ-PE), spread of the SEQ-PE (precision) and the absolute SEQ-PE (accuracy) of each device using Barrett Universal II (BUII) formula with either estimated posterior keratometry (E-PK) or measured posterior keratometry (M-PK). Trimmed mean SEQ-PEs of EyeS900 E-PK, EyeS900 M-PK, IOLM700 E-PK, and IOLM700 M-PK were 0.03, 0.08, 0.02, and 0.09 D, respectively with no significant differences between EyeS900 E-PK and IOLM700 E-PK (P = 0.31) as well as between EyeS900 M-PK and IOLM700 M-PK (P = 0.31). Statistically significant SEQ-PE differences were found when E-PK and M-PK were compared, regardless of the device used, showing hyperopic SEQ-PE in M-PK calculations. Excellent correlation and agreement in SEQ-PE were found between the devices for both E-PK (P < 0.001, r = 0.848, mean bias: +0.01 D, 95% LOA of -0.32 to +0.34 D) and M-PK (P < 0.001, r = 0.776, mean bias: -0.01 D, 95% LOA of -0.42 to +0.39 D). No significant differences were found comparing absolute SEQ-PE and precision of the devices. The Eyestar 900 and the IOLMaster 700 show comparable IOL power prediction accuracy by the BUII formula using either estimated or measured posterior keratometry. An adjusted lens factor may be required for BUII when utilizing measured posterior keratometry in both devices.

Effects of atropine eyedrops at ten different concentrations for myopia control in children: A systematic review on meta-analysis.

To estimate the effect of atropine eyedrops at different concentrations for myopia control in children. We conducted a Bayesian random-effects network meta-analysis based on randomized controlled trials (RCT). Primary outcomes include changes in spherical equivalent error (SER) and changes in axial length (AL), mean difference (MD) together with 95% credible interval (CrI) were used to evaluate the efficacy. 28 RCTs (6608 children) were included in this review. Comparing ten atropine eyedrops (0.0025%, 0.005%, 0.01%, 0.02%, 0.025%, 0.05%, 0.1%, 0.25%, 0.5% and 1% concentrations) with the placebo, the MDs and 95%CrIs of changes in SER are -0.006 (-0.269, 0.256) D, 0.216 (-0.078, 0.508) D, 0.146 (0.094, 0.199) D, 0.167 (0.039, 0.297) D, 0.201 (0.064, 0.341) D, 0.344 (0.251, 0.440) D, 0.255 (0.114, 0.396) D, 0.296 (0.140, 0.452) D, 0.331 (0.215, 0.447) D, and 0.286 (0.195, 0.337) D, respectively. The MDs and 95%CrIs of changes in AL are -0.048 (-0.182, 0.085) mm, -0.078 (-0.222, 0.066) mm, -0.095 (-0.130, -0.060) mm, -0.096 (-0.183, -0.009) mm, -0.083 (-0.164, -0.004) mm, -0.114 (-0.176, -0.056) mm, -0.134 (-0.198, -0.032) mm, -0.174 (-0.315, -0.061) mm, -0.184 (-0.291, -0.073) mm, and -0.171 (-0.203, -0.097) mm, respectively.Whether evaluated by SER or AL, 1% concentration ranks first in efficacy, but the risk of photophobia is 17 times higher than 0.01% concentration. 0.01% or higher concentration atropine eyedrops are effective for myopia control, while 0.0025% and 0.005% concentrations may not. As the concentration increases, the effect tends to increase, 1% concentration may have the strongest effect.

Association Between Peripheral Retinal Defocus and Myopia by Multispectral Refraction Topography in Chinese Children.

To investigate the association between the peripheral refractive errors of the fundus in different regions and moderate and high myopia. In this case-control study, 320 children and adolescents aged 6 to 18 years were recruited. Peripheral refractive errors were measured using multispectral retinal refractive topography (MRT). Spherical equivalent (SE) and cylinder errors were classified into low, moderate, and high categories based on the magnitude range. Logistic regression was performed to test the factors associated with myopia. There were 152 participants with low myopia and 168 participants with moderate and high myopia included in the current study. Participants with moderate and high myopia were most likely to be older, with larger axial length (AL), lower SE, less time to watch electronic devices on the weekend, a higher difference between central refractive error and paracentral refractive error from the superior side of the retina (RDV-S), but a smaller difference between the central refractive error and paracentral refractive error from the inferior side of the retina (RDV-I) than those with low myopia (all P <0.05). After logistic analysis, female sex (odds ratio [OR] = 4.14; 95% confidence interval [CI] = 2.16-7.97, P <0.001), AL (OR = 6.88, 95% CI = 4.33-10.93, P <0.001), and RDV-I (OR = 0.52, 95% CI = 0.32-0.86, P = 0.010) were independent factors for moderate and high myopia. Our study demonstrated that the retina peripheral refraction of the eyes (RDV-I) was associated with moderate and high myopia, and RDV-S was only associated with high myopia.

Comparison of Efficacy and Safety between Immediate Sequential and Delayed Sequential Bilateral Cataract Surgery

Purpose: We compared the efficacy and safety of immediate sequential bilateral cataract surgery (ISBCS) and delayed sequential bilateral cataract surgery (DSBCS).Methods: We analyzed the best corrected visual acuity (BCVA), spherical equivalent (SE), and mean absolute error (MAE) in the ISBSC and DSBSC groups. The study population comprised 72 patients (144 eyes) who underwent ISBCS and 92 patients (184 eyes) who underwent DSBCS at Seoul St. Mary's Hospital between January 2019 and December 2021.Results: At 1 month postoperatively, the ISBCS group demonstrated a BCVA, SE, and MAE of 0.11 ± 0.09, -0.33 ± 0.42 diopters (D), and 0.38 ± 0.32 D, respectively; similarly, the DSBCS group exhibited a BCVA, SE, and MAE of 0.11 ± 0.15, -0.29 ± 0.56 D, and 0.41 ± 0.43 D, respectively. Furthermore, no significant differences were observed between the ISBCS and the DSBCS groups regarding SE and MAE at the 1-month follow-up for the first and second operated eyes. No cases of postoperative endophthalmitis and toxic anterior segment syndrome were reported.Conclusions: ISBCS is an effective and cost-effective approach that yields favorable postoperative outcomes when performed by an experienced surgeon supported by appropriate pre- and postoperative care, particularly in patients who demonstrate good cooperation.

Refractive Error and Axial Length and Their Related Factors in 8-Year-Old Japanese Children: The Yamanashi Adjunct Study of the Japan Environment and Children's Study (JECS).

To investigate the distribution of visual acuity, refractive error, and axial length in 8-year-old children who participated in an additional survey in Yamanashi Prefecture of the Japan Environmental Children's Study (hereafter referred to as JECS-Y) conducted from 2019 to 2021. Eight-year-old children who participated in the JECS-Y study were subjected to noncycloplegic measurements of refractive error and axial length. If the uncorrected visual acuity was less than 20/20, the best corrected visual acuity was evaluated in accordance with the autorefraction data. A questionnaire was administered regarding the parent's history of eyeglass wear or contact lens use. Among the 400 participating children, the rate of uncorrected visual acuity of 20/20 or better in both eyes was 70.4%. The mean equivalent spherical equivalent error for both eyes was -0.366 ± 1.016 D. The mean axial length was 23.08 ± 0.225 mm in all patients. The males showed significantly longer axial length than the females despite no differences in body height. There was a significant correlation between axial length, spherical refractive, and uncorrected visual acuity. The children of parents with a history of wearing eyeglasses or contact lenses showed a significantly more myopic equivalent refractive error than those without a history. This study clarified the current state of refractive error in 8-year-old children and the association of inheritance with refractive error. In addition, the axials were significantly longer in male patients.

Medium-term visual and refractive outcomes in patients with pseudoexfoliation implanted with a toric or multifocal intraocular lens.

To report medium-term visual acuity and refractive outcomes of patients with pseudoexfoliation implanted with toric or multifocal intraocular lenses (IOLs). We retrospectively reviewed patients with pseudoexfoliation who had undergone phacoemulsification between 2016 and 2020 with at least 24 months follow-up. Mean follow-up was 44.17 ± 14.95 months. Toric IOLs were implanted in 48 eyes: mean uncorrected LogMAR visual acuity one month after surgery was 0.03 ± 0.09, decreasing to 0.08 ± 0.11 at the last visit (p = .01). Mean refractive cylinder was -0.12 ± 0.36 diopters one month after surgery and -0.25 ± 0.44 diopters at the last follow-up visit, p = .012. Multifocal IOLs were implanted in 42 patients: binocular uncorrected distance visual acuity was -0.02 ± 0.04 one month after surgery and 0.01 ± 0.05 at the last visit (p = .004); near acuity was 0.01 ± 0.03 and 0.04 ± 0.06 respectively (p = .001). In eyes with pseudoexfoliation, absolute spherical equivalent prediction error was 0.22 ± 0.20 diopters for toric and 0.21 ± 0.19 diopters for multifocal IOLs. One month after surgery 68.6% of eyes with toric IOLs and 74.2% of eyes with multifocal IOLs were within ±0.25 diopters of target spherical equivalent and 91.6% and 90.5% were within ±0.5 diopters, respectively. Spherical equivalent did not change significantly during follow-up for either group. Prediction error in eyes with pseudoexfoliation implanted with toric or multifocal IOLs was low and similar to values reported for normal eyes. Postoperative refractive cylinder with toric IOLs was low, with little change during follow-up. Visual function in patients receiving multifocal IOLs was excellent. Therefore, the implantation of these IOLs in eyes with pseudoexfoliation does not seem to cause medium-term problems.

Size of living space as a moderator for central and peripheral refractions in children

Undesirable living environment may impose risk on myopia development. Furthermore, peripheral refractive error was suggested to contribute to juvenile eye growth modulation. This study aimed to investigate the interaction between peripheral refractive error and living environment in relation to central refractive status in Hong Kong schoolchildren. Central and peripheral refractive errors, axial length (AL), and corneal radius of curvature (CR) were measured in 573 schoolchildren (age 9.5 ± 0.9 years). The AL/CR ratio was used to represent the central refractive status, accounting for non-cycloplegic refraction. The relative peripheral refractive errors (RPRE) up to ± 20° eccentricities were converted into power vectors: spherical-equivalent error (SER) and J0 astigmatic components and fitted with quadratic equations. The second-order coefficients of SER (aSER) and J0 astigmatism (aJ0) and home size reported by parental questionnaires were analyzed to indicate their relationships with AL/CR. Our results showed that children with higher AL/CR lived in smaller homes (p = 0.01) and had a more hyperopic (p < 0.001) but less astigmatic RPRE (p = 0.01). We further analyzed the relationship between AL/CR with RPRE for children living in small (< 300 ft2), moderate (300–600 ft2), and large home sizes (> 600 ft2). Regardless of the home size, a higher AL/CR remained moderately correlated with a more hyperopic aSER (all p < 0.001). However, a higher AL/CR was associated with a more positive aJ0 only in children living in large homes, and the relationships were not significant for small and moderate home sizes. Linear regression models further indicated that home size was a significant moderator contributing to the relationship between AL/CR and aJ0. In conclusion, our results were consistent with previous studies, showing that children with axial myopia usually lived in smaller homes and had more hyperopic defocus and more positive J0 astigmatism. However, the relationship between peripheral astigmatism and axial refraction was modulated by the home size of Hong Kong schoolchildren. While peripheral astigmatism is hypothesized as a visual cue for axial refractive development in children, extrinsic environmental factors, such as home size, might interfere with the relationship and dominate refractive development.

Six-month repeated irradiation of 650nm low-level red light reduces the risk of myopia in children: a randomized controlled trial.

To evaluate whether the six-month repeated irradiation of 650nm low-level red light (LLRL) decreases the risk of myopia onset in children. This was a single-masked, randomized controlled trial. A total of 112 children (aged 6-12years) were enrolled and randomized to the treatment group or control group in a 1:1 ratio. The cycloplegic spherical equivalent error (SER) of children at baseline was -0.5 diopter (D) to 3D. Children in the treatment group were irradiated with the 650nm LLRL for 6 min daily. No intervention was given to the control. The primary outcomes are myopia incidence, change in cycloplegic SER, and change in axial length (AL). For the treatment group and control group, the six-month myopia incidence rates were 1.8% (95% confidence interval, CI: 0.2-4.9%) and 12.5% (95% CI: 5.5-21.9%), respectively. The difference was significant (p = 0.028). The median changes in AL for the treatment group and control group were -0.02 (interquartile range, IQR: -0.12 to 0.06) mm, and 0.09 (IQR: 0-0.18) mm, respectively. The difference was significant (p < 0.001). The median changes in cycloplegic SER for the treatment group and control group were 0 (IQR: 0-0.25) D, and -0.125 (IQR: -0.375 to 0) D, respectively. The difference was significant (p < 0.001). There was no adverse event. The repeated irradiation of 650nm LLRL may have a strong effect for myopia prevention in children, without risk of adverse events. this trial is retrospectively registered in the Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ), the registration number is ChiCTR2200058963.

Effect of corneal stiffness decrease on axial length elongation in myopia determined based on a mathematical estimation model.

Purpose: To investigate the relationship between the corneal material stiffness parameter stress-strain index (SSI) and axial length (AL) elongation with varying severities of myopia, based on a mathematical estimation model. Methods: This single-center, cross-sectional study included data from healthy subjects and patients preparing for refractive surgery in the Qingdao Eye Hospital of Shandong First Medical University. Data were collected from July 2021 to April 2022. First, we performed and tested an estimated AL model ( ) based on the mathematical equation proposed by Morgan. Second, we proposed an axial increment model ( ) corresponding to spherical equivalent error (SER) based on ( at SER = 0) and subject's real AL. Finally, we evaluated the variations of with SSI changes based on the mathematical estimation model. Results: We found that AL was closely associated with (r = 0.91, t = 33.8, p < 0.001) with good consistency and SER was negatively associated with (r = -0.89, t = -30.7, p < 0.001). The association of SSI with AL, , and can be summarized using the following equations: , , and . In adjusted models, SSI was negatively associated with AL (Model 1: β = -2.01, p < 0.001) and (Model 3: β = -2.49, p < 0.001) but positively associated with (Model 2: β = 0.48, p < 0.05). In addition, SSI was negatively associated with among subjects with AL ≥ 26mm (β = -1.36, p = 0.02). Conclusion: AL increased with decreasing SSI in myopia.