目的：建立并评估儿童Ⅱ期人工晶状体(intraocular lens,IOL)植入术后青光眼相关不良事件(glaucoma-related adverse events,GRAEs)的预测模型。方法：选取于中山大学中山眼科中心行Ⅱ期IOL植入术的无晶状体眼患儿205例(356眼)，并在术后对其随访3年。采用Cox比例风险模型确定GRAEs的预测因子，并建立列线图预测模型。采用随时间变化的受试者工作特征(receiver operating characteristic,ROC)曲线、决策曲线分析、Kaplan-Meier曲线评估模型性能，并通过Bootstrapping的C指数和校准图进行内部验证。结果：行Ⅱ期IOL植入术时年龄较大(HR=1.50, 95% CI: 1.03 ~2.19)、术后一过性高眼压(HR=9.06, 95% CI: 2.97~27.67)和IOL睫状沟植入术(HR=14.55, 95% CI: 2.11~100.57)是GRAEs的危险因素(均P<0.05)，并据此建立了两个列线图预测模型。在术后1、2、3年，模型1的ROC曲线下面积(area under curve,AUC)分别为0.747(95% CI: 0.776 ~0.935)、0.765 (95% CI: 0.804 ~0.936)和0.748 (95% CI: 0.736~0.918)，模型2的AUC分别为0.881 (95% CI: 0.836 ~0.926)、0.895 (95% CI: 0.852 ~0.938)和0.848 (95% CI: 0.752~0.945)。在内部验证和评价中，两种模型均表现出良好的性能和临床净效益。Kaplan-Meier曲线显示两个不同的风险组在两个模型中都能被显著且稳健地区分。此外，本研究也构建了在线风险计算器。结论：两种列线图均能灵敏、准确地识别Ⅱ期IOL植入术后GRAEs的高危患儿，有助对其进行早期识别和及时干预。

Aims: To establish and evaluate predictive models for glaucoma-related adverse events (GRAEs) following secondary intraocular lens (IOL) implantation in paediatric eyes. Methods: 205 children (356 aphakic eyes) receiving secondary IOL implantation at Zhongshan Ophthalmic Center with a 3-year follow-up were enrolled. Cox proportional hazard model was used to identify predictors of GRAEs and developed nomograms. Model performance was evaluated with time-dependent receiver operating characteristic (ROC) curves, decision curve analysis, Kaplan-Meier curves and validated internally through C-statistics and calibration plot of the bootstrap samples. Results: Older age at secondary IOL implantation (HR=1.5, 95% CI: 1.03 to 2.19), transient intraocular hypertension (HR=9.06, 95% CI: 2.97 to  27.67) and ciliary sulcus implantation (HR=14.55, 95% CI: 2.11 to 100.57) were identified as risk factors for GRAEs (all p<0.05). Two nomograms were established. At postoperatively 1, 2 and 3 years, model 1 achieved area under the ROC curves (AUCs) of 0.747 (95% CI: 0.776 to 0.935), 0.765 (95% CI: 0.804 to 0.936) and 0.748 (95% CI: 0.736 to 0.918), and the AUCs of model 2 were 0.881 (95% CI: 0.836 to 0.926), 0.895 (95% CI: 0.852 to 0.938) and 0.848 (95% CI: 0.752 to 0.945). Both models demonstrated fine clinical net benefit and performance in the interval validation. The Kaplan-Meier curves showing two distinct risk groups were well discriminated and robust in both models. An online risk calculator was constructed. Conclusions: Two nomograms could sensitively and accurately identify children at high risk of GRAEs after secondary IOL implantation to help early identification and timely intervention.

Backgrounds: To assess changes in anterior segment biometry during accommodation using a swept source anterior segment optical coherence tomography (SS-OCT).

Methods: One hundred-forty participants were consecutively recruited in the current study. Each participant underwent SS-OCT scanning at 0 and -3 diopter (D) accommodative stress after refractive compensation, and ocular parameters including anterior chamber depth (ACD), anterior and posterior lens curvature, lens thickness (LT) and lens diameter were recorded. Anterior segment length (ASL) was defined as ACD plus LT. Lens central point (LCP) was defined as ACD plus half of the LT. The accommodative response was calculated as changes in total optical power during accommodation.

Results: Compared to non-accommodative status, ACD (2.952±0.402 vs. 2.904±0.382 mm, P<0.001), anterior (10.771±1.801 vs. 10.086±1.571 mm, P<0.001) and posterior lens curvature (5.894±0.435 vs. 5.767±0.420 mm, P<0.001), lens diameter (9.829±0.338 vs. 9.695±0.358 mm, P<0.001) and LCP (4.925±0.274 vs. 4.900±0.259 mm, P=0.010) tended to decreased and LT thickened (9.829±0.338 vs. 9.695±0.358 mm, P<0.001), while ASL (6.903±0.279 vs. 6.898±0.268 mm, P=0.568) did not change significantly during accommodation. Younger age (β=0.029, 95% CI: 0.020 to 0.038, P<0.001) and larger anterior lens curvature (β= -0.071, 95% CI: -0.138 to -0.003, P=0.040) were associated with accommodation induced greater steeping amplitude of anterior lens curvature. The optical eye power at 0 and -3 D accommodative stress was 62.486±2.284 and 63.274±2.290 D, respectively (P<0.001). Age was an independent factor of accommodative response (β= -0.027, 95% CI: -0.038 to -0.016, P<0.001).

Conclusions: During -3 D accommodative stress, the anterior and posterior lens curvature steepened, followed by thickened LT, fronted LCP and shallowed ACD. The accommodative response of -3 D stimulus is age-dependent.

Backgrounds: To assess changes in anterior segment biometry during accommodation using a swept source anterior segment optical coherence tomography (SS-OCT).

Methods: One hundred-forty participants were consecutively recruited in the current study. Each participant underwent SS-OCT scanning at 0 and -3 diopter (D) accommodative stress after refractive compensation, and ocular parameters including anterior chamber depth (ACD), anterior and posterior lens curvature, lens thickness (LT) and lens diameter were recorded. Anterior segment length (ASL) was defined as ACD plus LT. Lens central point (LCP) was defined as ACD plus half of the LT. The accommodative response was calculated as changes in total optical power during accommodation.

Results: Compared to non-accommodative status, ACD (2.952±0.402 vs. 2.904±0.382 mm, P<0.001), anterior (10.771±1.801 vs. 10.086±1.571 mm, P<0.001) and posterior lens curvature (5.894±0.435 vs. 5.767±0.420 mm, P<0.001), lens diameter (9.829±0.338 vs. 9.695±0.358 mm, P<0.001) and LCP (4.925±0.274 vs. 4.900±0.259 mm, P=0.010) tended to decreased and LT thickened (9.829±0.338 vs. 9.695±0.358 mm, P<0.001), while ASL (6.903±0.279 vs. 6.898±0.268 mm, P=0.568) did not change significantly during accommodation. Younger age (β=0.029, 95% CI: 0.020 to 0.038, P<0.001) and larger anterior lens curvature (β= -0.071, 95% CI: -0.138 to -0.003, P=0.040) were associated with accommodation induced greater steeping amplitude of anterior lens curvature. The optical eye power at 0 and -3 D accommodative stress was 62.486±2.284 and 63.274±2.290 D, respectively (P<0.001). Age was an independent factor of accommodative response (β= -0.027, 95% CI: -0.038 to -0.016, P<0.001).

Conclusions: During -3 D accommodative stress, the anterior and posterior lens curvature steepened, followed by thickened LT, fronted LCP and shallowed ACD. The accommodative response of -3 D stimulus is age-dependent.

Background: Surgically induced astigmatism (SIA) and corneal high-order aberrations (HOAs) are the two main causes of poor visual quality after cataract surgery. Changes in the parameters of corneal HOAs after cataract surgery and their effects on and relationships with changes in corneal curvature have not yet been reported. This study aimed to explore changes in anterior, posterior and total corneal curvature, astigmatism and HOAs after microincision cataract surgery.

Methods: Sixty-one age-related cataract patients (61 eyes) were included in this prospective study. The total, anterior and posterior corneal astigmatism and corneal HOAs were analyzed by anterior segment optical coherence tomography (AS-OCT) and iTrace before, one day, one week and three months after 2.2 mm temporal microincision coaxial phacoemulsification to evaluate the changes in anterior, posterior and total corneal curvature, astigmatism and corneal HOAs.

Results: The mean J0 and J45 values of anterior, posterior and total corneal curvature obtained by AS-OCT showed no statistically significant difference between preoperatively and any postoperative follow-up. SIA occurred on the anterior, posterior and total corneal surfaces and showed no statistically significant difference at any postoperative follow-up. No significant changes in 3rd-order oblique trefoil, vertical coma or 4th-order spherical aberrations were observed after surgery except for a significant increase in horizontal coma at postoperative day 1 (POD1).

Conclusions: There were no significant changes in corneal curvature after 2.2 mm temporal microincision coaxial phacoemulsification, and the corneal HOAs were not changed significantly except for the increase in horizontal coma at POD1, which may be one of the main reasons of poor visual quality at POD1 in some cataract patients who have good uncorrected or corrected distance vision.

Background: Surgically induced astigmatism (SIA) and corneal high-order aberrations (HOAs) are the two main causes of poor visual quality after cataract surgery. Changes in the parameters of corneal HOAs after cataract surgery and their effects on and relationships with changes in corneal curvature have not yet been reported. This study aimed to explore changes in anterior, posterior and total corneal curvature, astigmatism and HOAs after microincision cataract surgery.

Methods: Sixty-one age-related cataract patients (61 eyes) were included in this prospective study. The total, anterior and posterior corneal astigmatism and corneal HOAs were analyzed by anterior segment optical coherence tomography (AS-OCT) and iTrace before, one day, one week and three months after 2.2 mm temporal microincision coaxial phacoemulsification to evaluate the changes in anterior, posterior and total corneal curvature, astigmatism and corneal HOAs.

Results: The mean J0 and J45 values of anterior, posterior and total corneal curvature obtained by AS-OCT showed no statistically significant difference between preoperatively and any postoperative follow-up. SIA occurred on the anterior, posterior and total corneal surfaces and showed no statistically significant difference at any postoperative follow-up. No significant changes in 3rd-order oblique trefoil, vertical coma or 4th-order spherical aberrations were observed after surgery except for a significant increase in horizontal coma at postoperative day 1 (POD1).

Conclusions: There were no significant changes in corneal curvature after 2.2 mm temporal microincision coaxial phacoemulsification, and the corneal HOAs were not changed significantly except for the increase in horizontal coma at POD1, which may be one of the main reasons of poor visual quality at POD1 in some cataract patients who have good uncorrected or corrected distance vision.

Backgrounds: To assess changes in anterior segment biometry during accommodation using a swept source anterior segment optical coherence tomography (SS-OCT).

Methods: One hundred-forty participants were consecutively recruited in the current study. Each participant underwent SS-OCT scanning at 0 and ?3 diopter (D) accommodative stress after refractive compensation, and ocular parameters including anterior chamber depth (ACD), anterior and posterior lens curvature, lens thickness (LT) and lens diameter were recorded. Anterior segment length (ASL) was defined as ACD plus LT. Lens central point (LCP) was defined as ACD plus half of the LT. The accommodative response was calculated as changes in total optical power during accommodation.

Results: Compared to non-accommodative status, ACD (2.952±0.402 vs. 2.904±0.382 mm, P<0.001), anterior (10.771±1.801 vs. 10.086±1.571 mm, P<0.001) and posterior lens curvature (5.894±0.435 vs. 5.767±0.420 mm, P<0.001), lens diameter (9.829±0.338 vs. 9.695±0.358 mm, P<0.001) and LCP (4.925±0.274 vs. 4.900±0.259 mm, P=0.010) tended to decreased and LT thickened (9.829±0.338 vs. 9.695±0.358 mm, P<0.001), while ASL (6.903±0.279 vs. 6.898±0.268 mm, P=0.568) did not change significantly during accommodation. Younger age (β=0.029, 95% CI: 0.020 to 0.038, P<0.001) and larger anterior lens curvature (β=?0.071, 95% CI: ?0.138 to ?0.003, P=0.040) were associated with accommodation induced greater steeping amplitude of anterior lens curvature. The optical eye power at 0 and ?3 D accommodative stress was 62.486±2.284 and 63.274±2.290 D, respectively (P<0.001). Age was an independent factor of accommodative response (β=?0.027, 95% CI: ?0.038 to ?0.016, P<0.001).

Conclusions: During ?3 D accommodative stress, the anterior and posterior lens curvature steepened, followed by thickened LT, fronted LCP and shallowed ACD. The accommodative response of ?3 D stimulus is age-dependent.

Backgrounds: To assess changes in anterior segment biometry during accommodation using a swept source anterior segment optical coherence tomography (SS-OCT).

Methods: One hundred-forty participants were consecutively recruited in the current study. Each participant underwent SS-OCT scanning at 0 and ?3 diopter (D) accommodative stress after refractive compensation, and ocular parameters including anterior chamber depth (ACD), anterior and posterior lens curvature, lens thickness (LT) and lens diameter were recorded. Anterior segment length (ASL) was defined as ACD plus LT. Lens central point (LCP) was defined as ACD plus half of the LT. The accommodative response was calculated as changes in total optical power during accommodation.

Results: Compared to non-accommodative status, ACD (2.952±0.402 vs. 2.904±0.382 mm, P<0.001), anterior (10.771±1.801 vs. 10.086±1.571 mm, P<0.001) and posterior lens curvature (5.894±0.435 vs. 5.767±0.420 mm, P<0.001), lens diameter (9.829±0.338 vs. 9.695±0.358 mm, P<0.001) and LCP (4.925±0.274 vs. 4.900±0.259 mm, P=0.010) tended to decreased and LT thickened (9.829±0.338 vs. 9.695±0.358 mm, P<0.001), while ASL (6.903±0.279 vs. 6.898±0.268 mm, P=0.568) did not change significantly during accommodation. Younger age (β=0.029, 95% CI: 0.020 to 0.038, P<0.001) and larger anterior lens curvature (β=?0.071, 95% CI: ?0.138 to ?0.003, P=0.040) were associated with accommodation induced greater steeping amplitude of anterior lens curvature. The optical eye power at 0 and ?3 D accommodative stress was 62.486±2.284 and 63.274±2.290 D, respectively (P<0.001). Age was an independent factor of accommodative response (β=?0.027, 95% CI: ?0.038 to ?0.016, P<0.001).

Conclusions: During ?3 D accommodative stress, the anterior and posterior lens curvature steepened, followed by thickened LT, fronted LCP and shallowed ACD. The accommodative response of ?3 D stimulus is age-dependent.

Backgrounds: To assess changes in anterior segment biometry during accommodation using a swept source anterior segment optical coherence tomography (SS-OCT). Methods: One hundred-forty participants were consecutively recruited in the current study. Each participant underwent SS-OCT scanning at 0 and -3 diopter (D) accommodative stress after refractive compensation, and ocular parameters including anterior chamber depth (ACD), anterior and posterior lens curvature, lens thickness (LT) and lens diameter were recorded. Anterior segment length (ASL) was defined as ACD plus LT. Lens central point (LCP) was defined as ACD plus half of the LT. The accommodative response was calculated as changes in total optical power during accommodation. Results: Compared to non-accommodative status, ACD (2.952±0.402 vs. 2.904±0.382 mm, P<0.001), anterior (10.771±1.801 vs. 10.086±1.571 mm, P<0.001) and posterior lens curvature (5.894±0.435 vs. 5.767±0.420 mm, P<0.001), lens diameter (9.829±0.338 vs. 9.695±0.358 mm, P<0.001) and LCP (4.925±0.274 vs. 4.900±0.259 mm, P=0.010) tended to decreased and LT thickened (9.829±0.338 vs. 9.695±0.358 mm, P<0.001), while ASL (6.903±0.279 vs. 6.898±0.268 mm, P=0.568) did not change significantly during accommodation. Younger age (β=0.029, 95% CI: 0.020 to 0.038, P<0.001) and larger anterior lens curvature (β=-0.071, 95% CI: -0.138 to -0.003, P=0.040) were associated with accommodation induced greater steeping amplitude of anterior lens curvature. The optical eye power at 0 and -3 D accommodative stress was 62.486±2.284 and 63.274±2.290 D, respectively (P<0.001). Age was an independent factor of accommodative response (β=-0.027, 95% CI: -0.038 to -0.016, P<0.001). Conclusions: During -3 D accommodative stress, the anterior and posterior lens curvature steepened, followed by thickened LT, fronted LCP and shallowed ACD. The accommodative response of -3 D stimulus is age-dependent.

Background: Surgically induced astigmatism (SIA) and corneal high-order aberrations (HOAs) are the two main causes of poor visual quality after cataract surgery. Changes in the parameters of corneal HOAs after cataract surgery and their effects on and relationships with changes in corneal curvature have not yet been reported. This study aimed to explore changes in anterior, posterior and total corneal curvature, astigmatism and HOAs after microincision cataract surgery.

Methods: Sixty-one age-related cataract patients (61 eyes) were included in this prospective study. The total, anterior and posterior corneal astigmatism and corneal HOAs were analyzed by anterior segment optical coherence tomography (AS-OCT) and iTrace before, one day, one week and three months after 2.2 mm temporal microincision coaxial phacoemulsification to evaluate the changes in anterior, posterior and total corneal curvature, astigmatism and corneal HOAs.

Results: The mean J0 and J45 values of anterior, posterior and total corneal curvature obtained by AS-OCT showed no statistically significant difference between preoperatively and any postoperative follow-up. SIA occurred on the anterior, posterior and total corneal surfaces and showed no statistically significant difference at any postoperative follow-up. No significant changes in 3rd-order oblique trefoil, vertical coma or 4th-order spherical aberrations were observed after surgery except for a significant increase in horizontal coma at postoperative day 1 (POD1).

Conclusions: There were no significant changes in corneal curvature after 2.2 mm temporal microincision coaxial phacoemulsification, and the corneal HOAs were not changed significantly except for the increase in horizontal coma at POD1, which may be one of the main reasons of poor visual quality at POD1 in some cataract patients who have good uncorrected or corrected distance vision.

Background: Surgically induced astigmatism (SIA) and corneal high-order aberrations (HOAs) are the two main causes of poor visual quality after cataract surgery. Changes in the parameters of corneal HOAs after cataract surgery and their effects on and relationships with changes in corneal curvature have not yet been reported. This study aimed to explore changes in anterior, posterior and total corneal curvature, astigmatism and HOAs after microincision cataract surgery.

Methods: Sixty-one age-related cataract patients (61 eyes) were included in this prospective study. The total, anterior and posterior corneal astigmatism and corneal HOAs were analyzed by anterior segment optical coherence tomography (AS-OCT) and iTrace before, one day, one week and three months after 2.2 mm temporal microincision coaxial phacoemulsification to evaluate the changes in anterior, posterior and total corneal curvature, astigmatism and corneal HOAs.

Results: The mean J0 and J45 values of anterior, posterior and total corneal curvature obtained by AS-OCT showed no statistically significant difference between preoperatively and any postoperative follow-up. SIA occurred on the anterior, posterior and total corneal surfaces and showed no statistically significant difference at any postoperative follow-up. No significant changes in 3rd-order oblique trefoil, vertical coma or 4th-order spherical aberrations were observed after surgery except for a significant increase in horizontal coma at postoperative day 1 (POD1).

Conclusions: There were no significant changes in corneal curvature after 2.2 mm temporal microincision coaxial phacoemulsification, and the corneal HOAs were not changed significantly except for the increase in horizontal coma at POD1, which may be one of the main reasons of poor visual quality at POD1 in some cataract patients who have good uncorrected or corrected distance vision.