Objective:To evaluate the accuracy of the formula for calculating the power of implanted intraocular lenses in cataract patients with previous refractive correction surgery.Methods:This was an evidence-based medical research study. The Cochrane library, PubMed, CNKI, WanFang and Metstr databases were searched to collect all the studies reporting the accuracy of the intraocular lens calculation formula after refractive surgery. The search time was self-limited to November 2020. ADDIS software was used for data merging and mesh meta-analysis. The recording parameter is the probability that the predictive error rangefor refractive error after cataract surgery was within ±0.50 D and ±1.00 D. Based on ADDIS software, the statistical test is carried out by using the Node-Split Model.Results:A total of 10 studies were included,with 475 cases and 659 eyes. The results of Network meta-analysis showed that for cataract patients with previous myopic refractive surgery correction history, the most accurate formulas within the refractive error range of ±0.50 D and ±1.00 D were the Modify Hoffer Q and OCT formulas. The highest accuracy formulas for a refractive error range within ±0.50 D and ±1.00 D for hyperopic patients were HolladayⅡand Haigis. The Haigis formula was the most accurate for predicting refractive error of the range within±0.50 D and ±1.00 D for patients undergoing radial keratotomy.Conclusions:For cataract patients who have a history of refractive surgery, the calculation and prediction of intraocular lens power must be comprehensively evaluated based on their refractive state and the type of refractive surgery.

Objective:To detect and analyze the genetic etiology of retinoblastoma patients, and to provide a theoretical basis for gene diagnosis, genetic counseling and prenatal diagnosis of patients and theirfamilies.Methods:This was an experimental study. Clinical material from 12 families were collected and genomic DNA was extracted from the peripheral blood of patients and related subjects. An FFPE sample was collected from adeceased patient and genomic DNA was extracted. Genomic DNA was extracted from the amniotic ?uid cells of the pregnant women. The mutation was screened by using targeted sequencing,and PCR-Sanger sequencing was used to verify the selected mutations. PubMed and related databases were searched. Pathogenic analysis of the mutation and the mutation effect was interpreted by protein prediction software. The pathogenicity of candidate mutations was determined and graded according to a joint consensus recommended by the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. According to the pathogenic mutation of the proband in the family, the relatedpregnant women underwentRB1gene prenatal diagnosis.Results:Different pathogenic gene variations,6 of which were known pathogenic variations, were detected in 8 of the 12 selected families, and the positive rate was 67%. And theRB1gene c.2404dupG (p.N803Efs*12) and c.1380_1381insCTTA (p.K462Tfs*2)detected in this study were novel genes. All of them were pathogenic based on comprehensive analysisof the eight differentRB1gene mutations detected in this study.Conclusions:Eight of the twelve families with retinoblastoma were diagnosed withRB1mutation. The study found two new mutations in retinoblastoma. Based on the results of the genetic diagnosis, the related families received effective genetic counseling and prenatal diagnosis.

Objective:To evaluate the ef?cacy and safety of the rigid gas permeable contact lens (RGPCL) for myopia correction.Methods:In a prospective randomized controlled study, patients were recruited from June 2016 to July 2017 from the Eye Hospital, Wenzhou Medical University, the People's Hospital of Guangxi Zhuang Autonomous Region, and the Eye and ENT Hospital of Fudan University. Binocular myopia patients were randomly assigned to a study group or a control group. The study group wore the iBright®RGPCL made by Eyebright Medical Technology (Beijing) Co., Ltd. (model: RAR, RAS), and the control group wore the RGPCL made by E & E OPTICS LIMITED (HongKong), (model: XO RGP). Both eyes were evaluated on the ?rst day of wearing the lenses and 1 week, 1 month, and 3 months after wearing the lenses. Measurements included uncorrected distance visual acuity (UCDVA), best corrected distance visual acuity (BCDVA) with frame lenses, RGPCL corrected distance visual acuity (RGPCL CDVA), spherical equivalent (SE), corneal K value, corneal endothelial cells, lens fitting status, lens condition, adverse reactions, etc. An independent samplesttest, Wilcoxon rank-sum test, CMH test, etc., were used for data analysis.Results:A total of 155 patients (76 patients in the study group and 79 patients in the control group) completed the initial wearing. On the ?rst day of wearing the RGPCLs, the RGPCL CDVA of the study group and the control group were 0(-0.10, 0), 0(-0.20, 0) for the right eye, and 0(-0.20, 0),0(-0.20, 0) for the left eye, respectively. There was no signi?cant difference between the two groups for the CMH test. At each follow-up time after wearing, there were no statistically signi?cant differences in the left and right eyes between the two groups for UCDVA, frame lens BCDVA, RGPCL CDVA, naked-eye and RGPCL subjective refraction SE, and corneal K value. After wearing the lenses for 3 months, none of the patients had serious complications. In the study and control groups, the incidence of conjunctival hyperemia, and the incidence of corneal epithelial punctate staining showed no statistically significant differences.Conclusions:The iBright®RGPCL and the control RGPCL (model: XO RGP) have the same ef?cacy and high safety for the correction of myopia.

Objective::To investigate the ef?cacy and safety of orthokeratology for the control of myopia in patients with flat keratometry (Kf<41.00 D).Methods:This was a prospective controlled study. A total of 80 patients (120 eyes) with orthokeratology lenses were enrolled in the study group and 76 patients (120 eyes) with glasses were enrolled in the control group. The two groups were divided into low (-3.00-0 D) and medium (-6.00--3.25 D) arrays based on spherical equivalent (SE). The myopia increment,axial increment, endothelial cell number, corneal thickness and corneal dot were analyzed in each group.In the data, an independent samplest-test was used for the increase in myopia and axial length, and a paired samplest-test was used for the number of endothelial cells and corneal thickness.Results:Myopia increased when wearing either orthokeratology lenses or glasses for 6 array: 6 months:t=3.204,P=0.002; 1 year:t=4.613,P<0.001; 1.5 years:t=5.160,P<0.001) and axial growth (low degree array: 6 months:t=-2.103,P=0.038; 1 year:t=-2.129,P=0.037; 1.5 years:t=-2.398,P=0.020; medium array: 6 months:t=-2.094,P=0.039; 1 year:t=-2.402,P=0.019; 1.5 years:t=-2.464,P=0.018). The orthokeratology lens group had significantly lower values than the frame glasses group.1.5 years after wearing orthokeratology lenses, corneal endothelial cell density, average cellular area,coef?cient of variation, percentage of hexagonal cells, and corneal thickness had no signi?cant changes compared to values before wearing the lenses. No serious ocular complications occurred while wearing orthokeratology lenses.Conclusions:Orthokeratology lenses can control the growth of the ocular axis significantly and myopia increases more slowly compared with glasses in patients with relatively flat corneal curvature. months, 1 year and 1.5 years (low degree array: 6 months:t=2.314,P=0.023; 1 year:t=3.215,P=0.002; 1.5 years:t=4.159,P<0.001; medium

Objective:To investigate accommodative ability in pediatric patients with intermittent exotropia concomitant after surgery.Methods:Twenty-four pediatric patients with intermittent exotropia were recruited for a prospective study at the Eye Center, People's Hospital, Peking University, from September 2020 to December 2020. Binocular and monocular accommodative facility was tested using a ±2.00 diopter (D)flip. Accommodative responses and negative/positive relative accommodation under binocular viewing conditions at 40 cm were tested. The evaluation parameters were measured before surgery and 1 and 3 months after surgery. The data were analyzed by repeated measures ANOVA.Results:The binocular accommodative response was 0.28±0.24 D 3 months after surgery compared to 0.08±0.24 D before surgery, the former was signi?cant higher than the latter (95%CI: 0.033-0.363 D,P=0.015). The NRA was 2.46±0.39 D 3 months after surgery, which was signi?cantly higher than that before surgery, which was 2.17±0.36 D (95%CI: 0.012-0.571 D,P=0.039). The PRA before surgery was-2.08±0.95 D,-2.56±1.14 D and -3.13±1.65 D, respectively, at 1 and 3 months after surgery. The PRA before surgery was signi?cant higher than the data 1 month after surgery (95%CI: 0.125-1.979 D,P=0.023). The binocular accommodative facility was 8.58±2.21 and 9.33±2.39 cycles per minute (cpm) at 1 and 3 months, respectively, after surgery. This was significantly higher than the data before surgery, which was 6.00±2.00 cpm [95%CI:1.485-3.681 cpm,P<0.001; 95%CI: 1.937-4.729 cpm,P<0.001]. The accommodative facility of the dominant eye 1 month after surgery was significant higher than the data before surgery (95%CI:1.644-3.523 cpm,P<0.001), which was the same as 3 months after surgery (95%CI: 3.665-6.085 cpm,P<0.001). The accommodative facility of the non-dominant eye before surgery was signi?cant higher than the data 1 month after surgery (95%CI: 1.019-2.898 cpm,P<0.001), which was the same as 3 months after surgery (95%CI: 3.915-6.335 cpm,P<0.001). The accommodative facility of the dominant eyes 1 month after surgery was also signi?cant higher than the data of the non-dominant eyes (95%CI: 0.130-2.537 cpm, P=0.031).Conclusions:The binocular vergence-accommodation system and the accommodative abilities of children with intermittent exotropia concomitant obviously improve after surgery.

Objective:To compare the real-time accommodative response and accommodative microfluctuations during sustained reading/viewing of rapid serial visual presentations (RSVP) and different target presentations.Methods:This was a prospective study. A total of 33 subjects aged from 15 to 28 years were included at Eye Hospital, Wenzhou Medical University from April to October in 2019. The mean age ofthe subjects was 22.1±4.8 years and the mean spherical equivalent was-3.81±1.67 D. Accommodative response and micro?uctuations were measured using the Grand Seiko WAM-5500 auto-refractor while the subject was continuously tested with different targets for 5 minutes. The targets were as follows: RSVP (a rapid serial visual presentation paradigm), Rand-RSVP (a random word rapid serial visual presentation paradigm), Maltese Cross (a target with a Maltese cross) and Windows Text (a window of reading material for 5 minutes). The accommodative response and microfluctuations for different types of visual targets were compared. One-way ANOVA was used to compare the differences in accommodation while reading or viewing the different visual targets. A pairedt-test was used to compare the difference between the initial 10-second measurement and 5-minute accommodative response.Results:While viewing the Maltese Cross, all subjects had a lower mean accommodative response (t=2.45,P=0.016;t=2.57,P=0.011;t=3.85,P<0.001) and a larger accommodative variability (t=4.32,P<0.001;t=1.86,P=0.065;t=2.93,P=0.04).Power spectrum analysis showed that subjects exhibited greater power at low temporal frequencies while viewing the Maltese Cross (t=30.32,P<0.001), and more power at medium and high temporal frequencies when reading the Window Text (t=32.41,P<0.001;t=38.26,P<0.001). Subjects had a higher accommodative response in the ?rst 10 seconds than the averageaccommodative response within 5 minutes when reading/viewing RSVP, random RSVP and Maltese Cross (t=2.30,P=0.028;t=2.45,P=0.020;t=3.71,P=0.001).Conclusions:Different presentation paradigms produce different accommodative responses and micro?uctuations. Accommodative response in the early stage varied after sustained reading/viewing during continuous testing.

Objective:To evaluate the consistency between the Kay Picture Test Linear Crowded Book and the standard logarithmic visual acuity chart in preschool children's vision screening and to help the children who could not complete the standard logarithmic visual acuity chart.Methods:A prospective self-controlled study design was performed. One hundred fifty-two preschool children were enrolled from January 2021 to May 2021, who had completed a comprehensive ophthalmological examination and vision test with the KayPictureTestLinearCrowdedBook and the standard logarithmic visual acuity chart. The Wilcoxon sign rank test, Spearman rank correlation analysis and Bland-Altman were used for analysis. Results:One hundred ?fty-two preschool children participated in the screening and 129 children who were without refractive errors and who completed the 2 visual acuity tests were included. There were 74 males and 55 females among the 129 children with a mean age of 52.3±7.0 months. Acuities were 0.1(0.09, 0.1)LogMAR measured by the KayPictureTestLinearCrowdedBook and were 0.1(0.1, 0.22) LogMAR for the standard logarithmic visual acuity chart. There was a good correlation between the two charts (r=0.436,P<0.001). The visual acuity level measured by the Kay Picture Test Linear Crowded Book was higher by 0.04 LogMAR than with the other chart (Z=-6.124,P<0.001). Bland and Altman scatter plots showed that 98.4% of the points were within the 95% limits of agreement. The degree of cooperation for the KayPicture TestLinearCrowdedBook was higher than for the standard logarithmic visual acuity chart (χ2=18.007,P<0.001). The visual acuities measured by the Kay Picture Test Linear Crowded Book were signi?cantly different for different ages groups (H=13.791,P=0.003), with a trend that increased with age.Conclusions:The KayPictureTestLinearCrowdedBook can be used for vision screening in preschool children with a good measurement consistency and higher completion rate compared to the standard logarithmic visual acuity chart. The visual acuity level measured by the KayPictureTestLinearCrowdedBook is higher by 0.04 LogMAR than measurements by the other visual acuity chart, so visual acuity standards should be adjusted appropriately.

Objective:To analyze the treatment ef?cacy of an intravitreal injection of conbercept (IVC) or ranibizumab (IVR) for type 1 retinopathy of prematurity (ROP).Methods:In this retrospectively case-control study,clinical records of 45 preterm infants (86 eyes) treated by IVC and 62 preterm infants (122 eyes) treated by IVR were retrospectively analyzed from January 2017 to June 2019. The intraocular in?ammatoryreaction,ROP disease regression and recurrence were observed regularly after the operation. In the IVC group, therewere 16 cases (32 eyes) in zone I and 29 cases (54 eyes) in zone II; In the IVR group, there were 23 cases (46 eyes) in zone I and 39 cases (76 eyes) in zone II. At-test and Chi-square test were used for data analysis.Results:There were no signi?cant differences in gender, gestational age, birth weight, corrected gestational age, lesion zoning or aggressive posterior retinopathy of prematurity between the two groups.The recurrence of treatment rates for IVR and IVC were 45% and 35%, respectively, of which 61% and 63% were in zone I, and 37% and 19% in zone II. The time of recurrence of treatment after injection was 8.8±2.5 and 11.2±3.1 weeks in zone II, and the difference is insigni?cant. There were signi?cant differencesin the rate of recurrence between the two groups (χ2=5.214,P=0.024).Conclusions:Intravitreal injection of conbercept and ranibizumab is an effective choice for ROP. The recurrence after treatment is related to the lesion area, the rate of recurrence was lower after injection of comber cept in zone II, but long-term safety needs to be evaluated further.