Purpose:To quantify individual variations between subjective and objective refraction, explore correlations between multimodal imaging features, clinical parameters and refraction discrepancies, screen independent influencing factors, and construct a predictive model to provide technical support for personalized refractive surgery. Methods:A total of 264 myopic patients (264 eyes) were enrolled. Paired t-test and Bland-Altman analysis were used to quantify refraction differences. Correlation analysis, multivariate regression, and machine learning algorithms were applied to explore influencing mechanisms and build a prediction model. Results:There were significant individual differences between subjective and objective refraction, and the difference distribution was consistent with the normal distribution. The difference between subjective and objective refraction was moderately correlated with long-term daily maintained refraction (r=0.47, P<0.001), weakly correlated with subjective refraction, objective refraction, corneal morphological features, and OCT optic nerve imaging features (r=0.17~0.25, P<0.05), and extremely weakly correlated or uncorrelated with OCT macular imaging features and fundus color photography imaging features (r<0.10, P>0.05). Multivariate regression analysis showed that long-term daily maintained refraction, corneal higher-order aberrations, and OCT optic nerve imaging features were independent risk factors affecting the difference (P<0.05). The prediction model constructed based on 126-dimensional radiomics key features, long-term daily maintained refraction, and core clinical parameters had a prediction accuracy of 87.2% and an area under the ROC curve (AUC) of 0.89. Conclusion:Long-term daily maintained refraction is the core factor affecting the neuroperceptual difference between subjective and objective refraction. Among multimodal imaging features, only OCT optic nerve-related features have a weak correlation with the difference, and corneal higher-order aberrations are independent influencing factors. The results of this study can provide a theoretical basis and technical support for the precise diagnosis and treatment of refractive correction.

Purpose To evaluate the effects of SMART surgery (SCHWIND eye-tech-solutions GmbH) on corneal abnormalities and refractive errors compared to traditional femtosecond laser–assisted laser in situ keratomileusis (FSLASIK). Methods A retrospective case series was conducted at Xi'an Gucheng Aier-Eye Hospital, analyzing data from 83 patients who underwent FS-LASIK and SMART procedures in 2021. Pentacam (Oculus Optikgeräte GmbH) measurements were taken before surgery and at 1, 3, and 6 months postoperatively to assess corneal higher order aberrations, spherical aberrations, and coma. Statistical analyses included an independent Student test between the two groups. Visual acuities were compared by the Mann-Whitney U test, paired t -tests, and repeated measures analysis of variance. Results Comparison of visual acuity at 1 week and 1 month postoperatively showed significant differences between the FSLASIK and SMART groups. After 6 months, a higher percentage of patients in the SMART group achieved spherical equivalent within +1.00 diopter compared to the FS-LASIK group. Both groups showed a shift from negative to positive Q-values, indicating improved visual quality. Corneal spherical aberrations and horizontal coma were more prevalent at 6 months postoperatively in both groups compared to preoperatively. Conclusions In the long term, SMART surgery demonstrates comparable results to FS-LASIK for myopia and astigmatism correction. Higher order aberrations were less common after SMART surgery compared to FS-LASIK. These findings suggest that SMART surgery may be a suitable option for patients seeking refractive surgery, considering its potential benefits for visual quality and corneal health. [ J Refract Surg . 2025;41(2):e164–e172.]

Retinal organoids (ROs) offer a biomimetic in vitro model for investigating human retinal development and disease. However, current ROs face several limitations, such as the absence of vascular networks and microglial cells (MGs). Here, we developed a vascularized retinal organoids (vROs) model by coculturing vascular organoids (VOs) with ROs in a V-bottom polydimethylsiloxane (PDMS) microwell platform. Through coculturing for 30 to 120 days, we observed the presence of tubular blood vessels at the center of vROs. Transcriptomic analysis revealed that the vascularization in ROs was associated with angiogenesis and immune response. Furthermore, we observed that MGs in VOs migrated and integrated into the vROs as VOs and ROs fused, with the vROs exhibiting responsiveness to inflammatory stimuli. The vROs expressed tight junction protein claudin-5 and displayed similar characteristics to the inner blood-retinal barrier (iBRB). These vRO models, which incorporate vascular structures and MGs, provide an alternate avenue for retinal vascular disease research and hold promise for future clinical applications.

To compare clinical outcomes of trifocal intraocular lens in patients with and without prior history of laser in situ keratomileusis (LASIK). A retrospective study included patients who underwent bilateral cataract surgery and PanOptix trifocal intraocular lens (IOLs) implantation. Patients were grouped: Group A for patients with history of LASIK and Group B for patients without history of LASIK. Postoperative outcome measures comprised distance, intermediate, and near visual acuity, manifest refraction, defocus curve, contrast sensitivity, visual quality, patient satisfaction, and the rate of spectacle independence. A total of 288 eyes (144 patients) were included: 132 eyes in Group A and 156 eyes in Group B. At 6 months post-surgery, patients of both groups achieved a continuous satisfying visual acuity from 33 cm to distance. 73

Purpose: To evaluate changes in posterior corneal asphericity (ΔQ) using the tangential radius of curvature after femtosecond laser–assisted in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) procedures. Methods: One hundred twenty right eyes of myopic patients who underwent either FS-LASIK or SMILE procedures were analyzed using Sirius 3D corneal topography for assessment. The tangential radius was employed to calculate both preoperative and postoperative posterior corneal Q-values across each semimeridian. After both surgical interventions, the ΔQ value variations across the 360° semimeridional regions of the posterior corneal surface were compared. Results: A marked postoperative increase in the posterior corneal Q-value was documented. No significant differences were noted between the postoperative Q-values or ΔQ-values of the two surgical approaches. Among patients with moderate myopia, postoperative Q-value exhibited considerably lower increases and ΔQ-value significantly smaller than their counterparts with high myopia. Moreover, the fluctuation in ΔQ across semimeridional regions was less evident in patients with moderate myopia than in those with high myopia. Notably, the degree of ΔQ fluctuation across semimeridional regions was similar between both surgical categories. These data offer insights into variations in the posterior corneal surface after refractive surgeries depending on the degree of myopia, illuminating their clinical relevance. Conclusions: Both FS-LASIK and SMILE introduce notable changes to posterior corneal asphericity among patients with different myopia intensities. Furthermore, the influence on the asphericity across the entire posterior surface is similarly distributed between FS-LASIK and SMILE techniques. [ J Refract Surg . 2024;40(3):e133–e141.]

Purpose:To evaluate and compare the effect of femtosecond laser-assisted cataract surgery on corneal astigmatism in post-LASIK eyes and virgin eyes. Patients and Methods:Patients who underwent femtosecond laser-assisted cataract surgery were included in the study and categorized into two groups: Group A, consisting of patients with post-LASIK eyes, and Group B, consisting of patients with virgin eyes. Visual acuity, corneal astigmatism, and surgically induced astigmatism (SIA) were evaluated. Additionally, the correlation between SIA and preoperative corneal astigmatism, mean corneal curvature, and central corneal thickness was also analyzed. Results:A total of 168 eyes were enrolled in this study, with 62 eyes in Group A and 106 eyes in Group B. Significant differences in corneal astigmatism and SIA were observed between the two groups in the early postoperative period following cataract surgery (P<0.05). However, there was no significant difference at 6 months postoperatively (P>0.05). Corneal astigmatism demonstrated an against-The-rule shift in both groups postoperatively. No significant correlation was identified between SIA and preoperative corneal astigmatism, corneal curvature or corneal thickness. Additionally, there was no significant difference observed between the two groups in terms of uncorrected distance visual acuity (UDVA) at 6 months postoperatively. Conclusion:The effect of femtosecond laser-assisted cataract surgery on corneal astigmatism in post-LASIK eyes and virgin eyes was different in the early postoperative period. However, there was no significant difference at 6 months postoperatively. The post-LASIK eyes exhibited a delayed recovery compared to the virgin eyes.

Corneal neovascularization (CNV) is a common clinical finding seen in a range of eye diseases. Current therapeutic approaches to treat corneal angiogenesis, in which vascular endothelial growth factor (VEGF) A plays a central role, can cause a variety of adverse side effects. The technology of Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/Cas9 can edit VEGFA gene to suppress its expression. CRISPR offers a novel opportunity to treat CNV. This study shows that depletion of VEGFA with a novel CRISPR/Cas9 system inhibits proliferation, migration, and tube formation of human umbilical vein endothelial cells (HUVECs) in vitro. Importantly, subconjunctival injection of this dual AAV-SpCas9/sgRNA-VEGFA system is demonstrated which blocks suture-induced expression of VEGFA, CD31, and α-smooth muscle actin as well as corneal neovascularization in mice. This study has established a strong foundation for the treatment of corneal neovascularization via a gene editing approach for the first time.

PURPOSE: To evaluate the performance of the InnovEyes Sightmap platform (Alcon Laboratories, Inc) in refractive surgery by comparing the visual acuity and higher order aberrations (HOAs) between ray-tracing-guided laser in situ keratomileusis (LASIK) and topography-guided LASIK. METHODS: This prospective study enrolled participants who underwent either ray-tracing-guided LASIK or topography guided LASIK. Comprehensive ophthalmic evaluations were performed preoperatively, as well as at 1 day, 2 weeks, month, and 3 months postoperatively. Patients in the raytracing-guided LASIK group underwent wavefront, tomography, and biometry assessment using the InnovEyes Sightmap diagnostic device. Assessments included visual acuity, manifest refraction, and whole-eye HOAs. RESULTS: A total of 42 eyes treated with ray-tracing-guided LASIK and 42 eyes treated with topography-guided LASIK were analyzed. Both strategies demonstrated comparable good refraction accuracy and refractive stability (P > .05). The ray-tracing-guided LASIK group exhibited significantly better postoperative uncorrected distance visual acuity (UDVA) compared to the topography-guided LASIK group (-0.12 +/- 0.05 vs-0.07 +/- 0.04 logarithm of the minimum angle of resolution, respectively; P < .05), with 48% of eyes achieving a UDVA of 20/12.5 or better. Ray-tracing-guided LASIK induced a small but statistically significant increase in HOAs and vertical coma aberration, along with a significant reduction in spherical aberration (P < .05). In contrast, topography-guided LASIK resulted in a significant increase in vertical coma (P < .05) without significant changes in overall HOAs or spherical aberration (P > .05). At 3 months postoperatively, spherical aberration was significantly different between the two groups (-0.021 +/- 0.031 vs 0.054 +/- 0.122 mu m, respectively; P < .05). CONCLUSIONS: The InnovEyes Sightmap platform's ray-tracing- guided LASIK demonstrated potential advantages in visual acuity outcomes compared to topography-guided LASIK. The observed negative shift in spherical aberration, characterized by a lower absolute value, may have contributed to the enhanced visual acuity results.

Purpose: To examine the visual outcomes, particularly at 33 cm, and assess patient satisfaction following the implantation of a diffractive trifocal intraocular lens (IOL) and its toric variant. Patients and Methods: This prospective single-arm observational study involved 45 Chinese patients (90 eyes) underwent bilateral cataract surgery and PanOptix or PanOptix toric intraocular lenses (IOLs) implantation. Postoperatively, visual acuity was evaluated at various distances, including 40 cm and 33 cm, for both monocular and binocular outcomes. Patient satisfaction was evaluated using the VF-14 questionnaire. Results: 72 eyes underwent PanOptix IOLs implantation, and 18 eyes received PanOptix toric IOLs. At 3-month postoperative mark, the mean monocular UDVA, UIVA, and UNVA at 40 cm and 33 cm were -0.02 +/- 0.09, 0.00 +/- 0.07, 0.02 +/- 0.07, and 0.07 +/- 0.14 logMAR, respectively, with proportions of visual acuity exceeding 0.1 logMAR were 96.7%, 96.7%, 94.4%, and 74.4%, respectively. The mean binocular UDVA, UIVA, and UNVA at 40 cm and 33 cm were -0.05 +/- 0.06, -0.03 +/- 0.05, 0.00 +/- 0.05, and 0.04 +/- 0.07 logMAR, respectively, with proportions of visual acuity exceeding 0.1 logMAR were 97.8%, 100.0%, 100.0%, and 91.1%, respectively. When the near point shifted from 40cm to 33cm, some patients showed a decline for UDVA, but the average reduction was less than one line. The overall VF-14 questionnaire score was 4.02 +/- 4.19. Conclusion: PanOptix can provide Chinese patients with a full range of satisfying visual acuity, near to 33cm. Though the visual acuity of some patients at 33 cm did not match the level at 40 cm, the gap of one line may not carry clinical significant.

Purpose: To assess and compare the visual acuity and refractive outcomes of topography-guided laser in situ keratomileusis (LASIK) based on the fitting-shape–based refractive compensated and Phorcides software strategies. Methods: Consecutive patients who underwent topography-guided LASIK were included in this study. Through double-masked simple randomization, patients were assigned to the Zhang & Zheng Auto-compensate Refraction (ZZ AR) group (the fitting-shape–based refractive compensated strategy using the ZZ AR calculator was used) or the Phorcides group (the topography analysis algorithm in Phorcides software [Phorcides LLC] was used). Only one eye per patient with binocular correction was randomly enrolled. The preoperative and postoperative visual acuities and refraction were analyzed at the 6-month follow-up visit. Results: The ZZ AR and Phorcides groups comprised 156 and 147 eyes, respectively. At the 6-month postoperative follow-up visit, the median (range) absolute residual cylindrical refraction was 0.35 (1.01) and 0.47 (1.63) diopters (D) for the ZZ AR and Phorcides groups, respectively ( P < .001). The percentages of patients with residual cylindrical power within 0.25 D were 29.49% and 13.61% for the ZZ AR and Phorcides groups, respectively ( P = .001). Based on the percentages of patients with residual cylindrical powers within 0.50 and 1.00 D, the ZZ AR group showed better outcomes ( P = .02 and .01). The percentage of patients with visual acuity better than 20/16 was significantly higher for the ZZ AR group than for the Phorcides group ( P = .03). Conclusions: The fitting-shape–based refractive compensated strategy for topography-guided LASIK procedures can better optimize the visual acuity and astigmatic refraction than the Phorcides software strategy. [ J Refract Surg . 2024;40(5):e336–e343.]

Background To compare the long-term outcomes of stereotactic radiosurgery (SRS) with or without prior embolization in brain arteriovenous malformations (AVMs) (volume ≤10 mL) for which SRS is indicated. Methods Patients were recruited from a nationwide multicenter prospective collaboration registry (the MATCH study) between August 2011 and August 2021, and categorized into combined embolization and SRS (E+SRS) and SRS alone cohorts. We performed propensity score-matched survival analysis to compare the long-term risk of non-fatal hemorrhagic stroke and death (primary outcomes). The long-term obliteration rate, favorable neurological outcomes, seizure, worsened mRS score, radiation-induced changes, and embolization complications were also evaluated (secondary outcomes). Hazard ratios (HRs) were calculated using Cox proportional hazards models. Results After study exclusions and propensity score matching, 486 patients (243 pairs) were included. The median (IQR) follow-up duration for the primary outcomes was 5.7 (3.1–8.2) years. Overall, E+SRS and SRS alone were similar in preventing long-term non-fatal hemorrhagic stroke and death (0.68 vs 0.45 per 100 patient-years; HR=1.46 (95% CI 0.56 to 3.84)), as well as in facilitating AVM obliteration (10.02 vs 9.48 per 100 patient-years; HR=1.10 (95% CI 0.87 to 1.38)). However, the E+SRS strategy was significantly inferior to the SRS alone strategy in terms of neurological deterioration (worsened mRS score: 16.0% vs 9.1%; HR=2.00 (95% CI 1.18 to 3.38)). Conclusions In this observational prospective cohort study, the combined strategy of E+SRS does not show substantial advantages over SRS alone. The findings do not support pre-SRS embolization for AVMs with a volume ≤10 mL.

Purpose: To assess long term changes of the surgically induced astigmatism (SIA) and corneal higher -order aberrations (HOAs) after 2.2 mm clear corneal incisions (CCIs) in femtosecond laser -assisted cataract surgery and compare them between 2 types of CCIs: temporal and superior approach. Patients and Methods: Patients received the temporal CCIs (Group A) or the superior CCIs (Group B). Outcome measures included visual acuity, manifest refraction, corneal astigmatism, SIA, flattening effect, and corneal HOAs. Correlation between postoperative corneal HOA and SIA at each follow-up were analysed. Results: This study assessed data from 106 eyes, of which 64 in Group A and 42 in Group B. The two groups had similar postoperative visual acuity of distance, intermediate and near (all P > 0.05). SIA and corneal HOAs were significantly lower in Group A than Group B in the early postoperative period, while there was no significant difference in the late postoperative period. At 6 months after surgery, the arithmetic mean of SIA over corneal 4mm zone was 0.33 +/- 0.19D for temporal incision, and 0.37 +/- 0.25D for superior incision. For Group A, the correlations of HOAs and SIA persisted from 1 week to 6 months after surgery. For Group B, the changes in corneal HOAs were significantly related to the SIA at 1 week and 1 month postoperatively. Conclusion: This study suggested the consistency of increasing and recovering process of corneal HOAs and SIA after surgery. Compared to the superior incisions, temporal incisions might induce quicker corneal recovery and less change in SIA and corneal HOAs.

Purpose:To evaluate the effectiveness of Zhang and Zheng's InnovEyes (ZZ InnovEyes) strategy for optimizing outcomes of ray-tracing-guided laser in situ keratomileusis (LASIK) compared to the standard automated strategy. Methods:A total of 38 patients (71 eyes) undergoing therapeutic refractive surgery at Hangzhou MSK Eye Hospital were randomly assigned to the ZZ InnovEyes and automated groups using double-masked randomization. The study assessed visual acuity, refractive outcomes, and higher-order aberrations preoperatively and at 1-day, 2-week, 1-month, and 3-month follow-ups. Statistical analysis was done with Microsoft Excel and SPSS 19.0. Results:The exposure and control groups comprised 36 and 35 eyes, respectively. The ZZ InnovEyes group demonstrated significant advantages in manifest refraction spherical equivalent (MRSE) correction compared to the automated approach group (0.13 ± 0.30 D vs 0.62 ± 0.40 D, p < 0.001), achieving 97.22% uncorrected distance visual acuity (UDVA) of 20/16 or better compared to 85.71% in the automated group at the 3-month follow-up (p = 0.08), and achieving 50.00% UDVA of 20/12.5 or better compared to 28.57% in the automated group at the 3-month follow-up (p = 0.06). Loss lines from preoperative corrected distance visual acuity to postoperative UDVA were lower in the ZZ InnovEyes group (0.00%) than the automated group (8.57%; p = 0.07). Both groups exhibited similar astigmatism corrections and higher-order aberrations. Conclusion:The ZZ InnovEyes strategy, which incorporates manifest and wavefront refraction for ray-tracing-guided LASIK, demonstrated superior MRSE correction and potential advantages in visual acuity outcomes compared to the standard automated strategy. This study highlights the need for ongoing optimization and research in refractive surgery. Clinical Trial Registration Number:ChiCTR2300078709.

Two novel Al3+ fluorescent probes, CMCS-P1 and CMCS-P2, were independently designed and synthesized by modifying the C-2 amino group of carboxymethyl chitosan with benzoyl hydrazide derivatives. The successful incorporation of the benzoyl hydrazide-derived probes was confirmed through FT-IR and 1H NMR spectroscopy. The sensing performance demonstrated that CMCS-P1 and CMCS-P2 could selectively distinguish Al3+ from various metal ions, and the proposed probes both demonstrated excellent water solubility and exhibited a highly selective "turn-on" fluorescence response to Al3+ in pure aqueous solution. CMCS-P1 exhibited a broad linear fluorescence response to Al3+ concentrations from 1.0 to 20.0 µM, featuring a detection limit of 0.33 µM, CMCS-P2 displayed a more limited linear response in the range of 3.0-7.0 µM, with a detection limit of 1.0 µM. Additionally, a small-molecule fluorescent probe P2 was synthesized to explore binding efficiency, and fluorescence imaging in living cells was conducted to successfully detect Al3+ with promising results.

Purpose:This study was designed to compare the clinical outcomes of three cylindrical treatment strategies using manifest, topographic, and Zhang & Zheng vector-compensated refraction (ZZ VR) cylinders, for topography-guided laser-assisted in situ keratomileusis (LASIK) and to identify the laser programming strategy that optimizes refractive astigmatism outcomes and visual acuity.Methods:Consecutive patients referred for therapeutic refractive surgery between March and September 2018 at a single center were prospectively analyzed. Using double-masked simple randomization, patients were randomly assigned to undergo treatment based on manifest cylinder, topographic cylinder, and ZZ VR cylinder strategies. Uncorrected distance visual acuity and astigmatic refraction were analyzed preoperatively and 6 months postoperatively.Results:A total of 138 eyes from 71 patients met the inclusion criteria. The manifest group consisted of 46 eyes in 24 patients, the topographic group consisted of 43 eyes in 22 patients, and the ZZ VR group consisted of 49 eyes in 25 patients. The absolute residual cylindrical refractions at 6 months postoperatively in these three groups were 0.69 ± 0.32 D, 0.58 ± 0.31 D, and 0.42 ± 0.19 D, respectively (P < 0.001; adjusted P < 0.01 for manifest vs ZZ VR, adjusted P = 0.08 for topographic vs ZZ VR). The percentages of postoperative absolute residual cylindrical power within 0.50 D in the manifest, topographic, and ZZ VR groups were 30.4%, 55.8%, and 59.2%, respectively (P = 0.01; adjusted P = 0.06 for manifest vs topographic, adjusted P = 0.02 for manifest vs ZZ VR).Conclusion:The ZZ VR strategy may achieve better outcomes, as determined by cylindrical correction and visual activity, during topography-guided LASIK.Clinical Trial Registration Number:ChiCTR1900025779.

Purpose: To investigate the visual acuity and satisfaction of patients after Zhang & Zheng's corneal laser-enhanced accommodation refraction Q (ZZ-CLEAR-Q) surgery utilizing differential modulation of binocular longitudinal spherical aberration and determine its clinical significance. Patients and Methods: This prospective observational study enrolled a consecutive cohort of patients with presbyopia who underwent ZZ-CLEAR-Q surgery between December 2020 and January 2023. The study assessed visual acuity, distance-corrected defocus curve, satisfaction, Q factor, manifest spherical equivalent, and primary spherical aberration, among others, at 3 months postoperatively. Additionally, the study conducted a binocular comparison to analyze the clinical significance of setting the different longitudinal spherical aberrations. Results: A total of 232 eyes of 116 patients were included. The binocular uncorrected distance visual acuity was 20/20 for all patients. At 3 months postoperatively, the binocular uncorrected near visual acuity was Jaeger 1 for 96% of the patients and Jaeger 2 for 100% of the patients. Furthermore, 93.1% of the patients expressed satisfaction. The monocular distance-corrected defocus curve revealed that the dominant eyes had significantly better visual acuity at 0 D (P<0.001), while the non-dominant eyes had significantly better visual acuity across various defocus levels except 0 and -0.50 D (All P<0.05). At 3 months, there were no significant differences between the expected and achieved manifest spherical equivalents, corneal Q factor values, and ocular primary spherical aberration values of both groups. Conclusion: Patients with presbyopia who underwent ZZ-CLEAR-Q surgery were likely to achieve normal uncorrected visual acuity and be satisfied. The increased depth of field has clinical significance for assisting near vision.

Purpose: To analyze the corneal asphericity, longitudinal spherical aberration (LSA), and related factors in Chinese myopic adult eyes. Methods: This was a retrospective study of myopic adult patients. The corneal asphericity and LSA were measured at 3.0, 4.0, 5.0, 6.0, and 7.0 mm diameter apertures using corneal tomography. Age and refractive power were recorded for correlation analysis.Results: In total, 531 females and 384 males were included. At the above five diameter settings the corneal asphericity values (Q) of the anterior surface were -0.09 +/- 0.21, -0.14 +/- 0.16, -0.15 +/- 0.13, -0.17 +/- 0.11, and -0.20 +/- 0.11, and those of the posterior surface were 0.23 +/- 0.49, 0.06 +/- 0.29, -0.01 +/- 0.22, -0.07 +/- 0.16, and -0.08 +/- 0.15, respectively. The anterior corneal LSA values at these diameters were 0.39 +/- 0.19, 0.63 +/- 0.27, 0.97 +/- 0.36, 0.90 +/- 0.30, and 0.83 +/- 0.29 D, respectively and the whole corneal values were 0.26 +/- 0.20, 0.44 +/- 0.27, 0.70 +/- 0.36, 0.66 +/- 0.30, and 0.59 +/- 0.28 D, respectively. Corneal asphericity and peripheral LSA showed no or weak correlation with age or spherical equivalent (all r < 0.2).Conclusion: Corneal anterior and posterior Q values in myopia patients are negatively correlated with corneal diameter. Corneal anterior and whole corneal LSA increased significantly with diameter up to 5 mm, then decreased slightly with diameter. Corneal asphericity and peripheral LSA showed very weak or no correlation with age or spherical equivalent.Clinical Trial Registration Number: ChiCTR1800015985.

Background To evaluate a new method of implantable collamer lens (ICL) sizing based on ultrasound biomicroscopy (UBM) video clips. Methods This observational study included consecutive patients with myopia and myopic astigmatism scheduled for V4c toric ICL (TICL) implantation (STAAR) at Hangzhou MSK Eye Hospital (October 2020 to November 2020). Sulcus-to-sulcus (STS) distance, lens thickness (LT), and clinical refraction were measured preoperatively. The ZZ ICL formula (provides the predicted vault height and refraction based on TICL size, intraocular meridian, power, and eye parameters, including STS distance and LT) was used to select TICL size and predict vault height and residual refraction, which was also compared with the STAAR software recommended. Vault and residual refraction were measured at 3 months postoperatively. Results The analysis included 168 eyes in 84 patients. Postoperative vault size was comparable to that predicted by the ZZ ICL formula (528 ± 193 vs. 545 ± 156 μm, P = 0.227). Vault prediction error (PE) by the ZZ ICL formula was within 100, 300, and 500 μm in 40.48%, 88.10%, and 100% of eyes, respectively. Spherical equivalent (SE) and absolute cylindrical refractive error were 0.36 ± 0.48 and 0.40 ± 0.31 D at 3 months postoperatively. The SE PE, absolute cylindrical PE, and percentages of eyes with an absolute cylindrical PE within ± 0.50 D and ± 1.00 D were lower for the ZZ ICL formula than for the STAAR software ( P < 0.01). Conclusions Combining measurements obtained in UBM video clips with the ZZ ICL formula provides an effective method of sizing TICLs and predicting vault height and residual refractive error.

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