Exploring the barriers and facilitators of palliative care in the adult intensive care unit from nurses' perspectives in China: A qualitative study.

BACKGROUND: Intensive care units (ICUs) in China primarily focus on active rescue efforts, and it is not common to provide palliative care services within the ICU. As nurses play a primary role as caregivers for end-of-life patients in the ICU, it is necessary to explore the factors that impede or facilitate palliative care from their perspective. AIM: To explore the barriers and facilitators associated with implementing palliative care in Chinese adult ICUs from nurses' perspectives. STUDY DESIGN: This study utilized a descriptive phenomenological research approach and purposive sampling to conduct face-to-face semi-structured interviews with nurses working in adult ICUs from three comprehensive hospitals in China during the period between February and May 2023. A total of 17 nurses were interviewed, and the collected data were transcribed, coded, and synthesized thematically. RESULTS: Two themes of barriers and facilitators of palliative care in the Chinese adult ICU were extracted. The three sub-themes of hindering factors are as follows: (1) The influence of Chinese traditional culture. (2) The specificity of the ICU context. (3) Lacking sufficient attention in the ICU. The three sub-themes of the promoting factors are as follows: (1) Government and society value palliative care. (2) Patients and their families have palliative care needs. (3) Nurses view palliative care positively. CONCLUSION: Currently, integrating palliative care into the ICU may face challenges such as cultural factors, the specificity of the ICU context, and insufficient attention. However, it is worth noting that as the government and society place more emphasis on palliative care, more and more people are gradually paying attention to the palliative care needs of critically ill patients and their families. RELEVANCE TO CLINICAL PRACTICE: This study serves as a reference for exploring an ICU palliative care service model that is suitable for China's national conditions, such as education and training, resource allocation, service processes, and the palliative care environment, among others.

Chinese Experiences on Orthokeratology.

The prevalence of myopia in Chinese children has been rising each year. Research has shown that orthokeratology is a good method for controlling the progression of myopia. In this article, we review the current prevalence of myopia, the development and management of orthokeratology, and the myopia control methods used in China. A physical and health survey release indicated that the ratio of poor vision in every range of ages is still high in China. During the past 17 years, Chinese doctors have developed a standard fitting procedure and medical management of orthokeratology patients. This article also reviews the clinical studies in China for Ortho-K lenses, such as myopia control, effects and safety, corneal change, and lens design and fitting. Finally, we review the development of the International Academy of Orthokeratology Asia in China.

The Safety of Orthokeratology--A Systematic Review.

OBJECTIVES: The aim of this review is to evaluate the ocular safety of orthokeratology (OrthoK) treatment of myopia correction and retardation. DATA SOURCES: Clinical studies published in English and Chinese were identified from MEDLINE, EMBASE CNKI, CQVIP, and WANFANG DATA (all from 1980 to April 2015). The reference lists of the studies and the Science Citation Index were also searched. SELECTION CRITERIA: Relevant clinical studies including case series, case reports, patient/practitioner surveys, retrospective and prospective cohort studies, and clinical trials were all included in the review. The material of OrthoK lenses was limited to gas-permeable lens. MAIN RESULTS: This review incorporated a total of 170 publications, including 58 English and 112 Chinese literature. The risk of microbial keratitis in overnight OrthoK was similar to that of other overnight modality. The most common complication was corneal staining. Other clinically insignificant side effects included epithelial iron deposit, prominent fribrillary lines, and transient changes of corneal biomechanical properties. There was no long-term effect of OrthoK on corneal endothelium. CONCLUSIONS: There is sufficient evidence to suggest that OrthoK is a safe option for myopia correction and retardation. Long-term success of OrthoK treatment requires a combination of proper lens fitting, rigorous compliance to lens care regimen, good adherence to routine follow-ups, and timely treatment of complications.

[Visual quality needs to be improved in non-surgical optical correction].

Optical correction is the basis of optometry. Optimized visual quality through optical correction is more challenging and more scientific as visual quality is becoming more closely related to social integration and development. There are many visual quality problems associated with various non-surgical optical correction methods in different aspects and degrees. This article discusses in depth some of the problems regarding optical correction with spectacles for different age groups, from children to seniors. The use of soft contact lenses, rigid gas-permeable contact lenses, and orthokeratology lenses is also evaluated. Moreover, some suggestions and recommendations on promoting visual quality through optical correction are provided.

[Orthokeratology for the high myopia and high astigmatism is worth watching].

The prevalence of high myopia in teenagers is rising. Due to both genetic factors and environmental factors, most of myopia occurs in early age with rapid progress, and the prevention and control are very difficult. Orthokeratology is considered as one of the most effective ways of controlling myopia for children. It is proved effective through many years of clinical studies not only for low to moderate myopia, but also for high myopia with astigmatism. However, professional knowledge is lacking domestically. This paper introduces the local and overseas research results in recent years, and discusses the necessity and feasibility of high diopter orthokeratology correction, implementation methods and requirements, and safety and effectiveness evaluation standards for reference.

[Observation of orthokeratology discontinuation].

OBJECTIVE: To observe the change of teenagers with short-time and long-time orthokeratology discontinuation, including diopters, corneal curvature, corneal topography, axial length, and central corneal thickness, and to investigate the refractive correction methods after long-time orthokeratology discontinuation. METHODS: Retrospective study. A total of 141 patients (257 eyes) with a history of wearing and discontinuing wearing orthokeratology lenses in our center were collected. According to the spherical equivalent diopters, the patients were divided into two groups (< or = -4.00 D for group I and -4.00 D for group II). Each group was further divided into two sub-groups by the discontinuation time (1 to 3 months for sub-group A and more than 3 months for sub-group B). Four sub-groups were named as I A, II A, I B, and II B. Some optical examinations were performed for the patients before orthokeratology lens wearing and after orthokeratology discontinuation, such as refraction, corneal curvature, corneal topography, corneal endothelial cells, axial length, and central corneal thickness measurement. The refractive correction methods used by patients who had long-term orthokeratology discontinuation were recorded. The observed data were analyzed with paired t-test and one-way ANOVA by SPSS16. RESULTS: The statistically significant changes (t = 3.222, 3.404, 3.141, 5.012, P < 0.05) of spherical diopter values were (-0.31 +/- 0.58) D, (-0.48 +/- 0.68) D, (-0.35 +/- 0.65) D, and (-0.57 +/- 0.58) D for groups IA, IB, IIA, and IIB, respectively. astigmatism of the four sub-groups had no significant change (P > 0.05) The average annual spherical growth was (-0.08 +/- 0.17) D, (-0.12 +/- 0.17) D, (-0.07 +/- 0.19) D, and (-0.15 +/- 0.16) D, respectively, for the four sub-groups, and there was no statistically significant difference among them (F = 1.180, P > 0.05). Compared to the state before wearing orthokeratology lenses, the corneal curvature measured by an autorefractor was statistically different for groups I A and I A, but not statistically different for groups I B and II B. For the long-time discontinuation groups, only the SRI of the corneal topography had a statistically significant decrease compared to the value before wearing orthokeratology lenses, and others had no significant change. The average annual increase of axial length was (0.22 +/- 0.16) mm and (0.16 +/- 0.10) mm for groups IA and IB, respectively, and the increase was statistically significant (P < 0.05), but there was no significant difference between the two sub-groups (F = 1.908, P > 0.05). The central corneal thickness had no significant change (t = 1.971, 2.017, P > 0.05). The rates of the refractive correction methods after long-time discontinuation were 36.7%, 22.4%, 22.4%, 12.4%, and 6.1% for spectacles, rigid gas permeable contact lenses, soft contact lenses, either spectacles or soft contact lenses, and refractive operations, respectively. CONCLUSION: The corneal morphology and central corneal thickness returned to the original after three months of discontinuation of orthokeratology. The myopia had no significant growth after discontinuation, and there was no significant difference between low to moderate and relatively high myopia.

[The long-term clinical effects of orthokeratology in high myopia children].

OBJECTIVE: To investigate the long-term clinical effects of orthokeratology (ortho-k) in high myopia children with 5 years of follow-ups. METHODS: Prospective study. We chose 30 high myopia patients to wear ortho-k contact lenses (CLs) for controlling or delaying myopia progression from 2003. Among them, there were 10 boys and 20 girls whose average age was (15 ± 2) years, spherical diopters were (-7.34 ± 0.91) D, corneal astigmatism diopters were (-1.06 ± 0.62) D, uncorrected visual acuity was LogMAR 0.89 ± 0.29, corneal flattened curvature was (43.54 ± 1.16) D, and axial length was (26.38 ± 0.94) mm. All patients, with informed consent before fitting of ortho-k CLs, had conventional refraction and ocular tests. We compared the values of spherical diopters, visual acuity, corneal flattened curvature and axial length before and 6 months, 1 year, 2 years, 3 years, 4 years and 5 years after wearing CLs, respectively. The results were analyzed by SPSS 16.0 software. RESULTS: During the five years of observation periods, all patients' visual acuity and corneal flattened curvature were different from the pre-fitting (P < 0.05). Compared to the pre-fitting, the naked visual acuity was some degree improved, it was LogMAR 0.45 ± 0.31, 0.49 ± 0.32, 0.43 ± 0.30, 0.47 ± 0.31, 0.58 ± 0.35, 0.53 ± 0.27, respectively. F = 10.725, P = 0.000. Corneal flatten curvature was tend to be flatter, such was 41.14 ± 1.54, 41.75 ± 1.88, 41.54 ± 2.10, 41.73 ± 1.89, 41.94 ± 1.61, 40.70 ± 1.67. F = 10.161, P = 0.000 (All P < 0.05). The spherical diopters during the first two years after wearing ortho-k CLs were significantly reduced, compared with the previous values (it was -5.23 ± 1.81, -5.59 ± 2.75, -6.29 ± 2.12, -6.63 ± 2.31, -6.83 ± 2.33, -7.01 ± 1.81, respectively, F = 4.929, P = 0.000), and kept stable in the long-term observation. The axial length checked at 5 years was slightly elongated (it was 26.41 ± 0.90, 26.68 ± 0.93, 26.69 ± 1.06, 26.75 ± 0.94, 26.81 ± 1.04, 27.04 ± 1.01. F = 1.831, P = 0.094). The axial elongation was retarded by using ortho-k CLs in high myopia children. All patients were not subjected to severe complications which may lead to quitting the enrollments. CONCLUSIONS: Orthokeratology used in controlling or delaying high myopia progression is definitely outstanding in 5 years observations. Standard lens wearing and regular lens check improve safety of lens use in high myopia.

[Further enhance the long-term myopia control efficacy and safety of orthokeratology].

Strategies and methods of myopia prevention and control has been more and more. In recent years optical correction method is focusing on promoting the retinal mid-peripheral myopic defocus, improving the visual quality and promoting the accommodative function. Among the all, orthokeratology is the most notable optometry technology. This article will combine research progress both local and international achievements, the present situation of the domestic popularized the technique, and the existing problems. From the realistic approach, keep improving, the pursuit of stability, the pursuit of harmony and eliminate the false five aspects, to discuss how to promote orthokeratology for the myopia control with long-term stably efficacy and safety. How to promote the harmony and cooperation between doctors, patients and manufactures. And how to correctly guide the orthokeratology Having both specification and continued development.

[Corneal thickness and endothelial observation for youth myopia patients fitted with ortho-k lens for seven years].

OBJECTIVE: To observe the changes of the corneal thickness and endothelial cell for youth myopia patients fitted with long-term orthokeratology (Ortho-K, OK). METHODS: Retrospective case series study. During 2000 to 2005, 30 patients with OK lens wearing more than seven years in the Bei Yi Optometry & Ophthalmology Center had been chose in this study, and all the right eye of each person was selected for retrospective case statistics (30 eyes). the measure instruments, including A scan pachymeter and endothelium microscope, were used to the long-term continuous supervise, which involved the central and para-peripheral corneal thickness, corneal endothelium and corneal conjunctival complications rate. Then the 30 patients were divided into two groups: the moderate-low myopia group is less than -4.00 D with 12 patients (24 eyes), and the high myopia group is more than -5.00 D with 10 patients (20 eyes). And the difference between two groups was involved in this research. The one-way analysis of variance was used to compare before, after six months, after one year, after three years, after five years and after seven years OK lens wearing for the patients. And the variance analysis was used to compare between moderate-low and high myopia groups. RESULTS: Corneal thickness analysis during these seven years: the average central corneal thickness before and after seven-years wearing are (549.45 ± 33.72) and (538.97 ± 34.28) µm, respectively, and the central corneal thickness had no significant changes (F = 1.749, P = 0.076); The corneal thickness of nasal, superior, temporal and inferior also had no significant changes (P > 0.05). The average corneal endothelial cell densities before and after seven-years wearing are (3188.53 ± 272.25) and (3186.64 ± 278.69) num/mm(2), respectively, and the corneal endothelial cell density had no significant changes during seven years wearing (F = 2.204, P = 0.088). The average hexagonal cell ratio before and after seven-years wearing are 66.18% ± 6.42% and 64.65% ± 8.03%, respectively, and the hexagonal cell ratio had no significant changes during seven-years wearing (F = 2.097, P = 0.085). The average cell area and coefficient of variation also had no significant change during seven-years wearing (F = 2.143, 2.114; P > 0.05). There was also no statistics significance between moderate-low and high myopia of the endothelial cell and the corneal thickness change with long-term OK lens wearing. The slight corneal conjunctival complication was occurred during seven-year wearing, such as corneal fluorescence stain (less than 7%), and no serious complication was happened during seven-year wearing. CONCLUSIONS: In generally, it is safety for youth with long-term scientific and standardized wearing high Dk material orthokeratology contact lens.

Impact assessment of construction waste policy intensity on environmental efficiency based on system generalized method of moments.

With the acceleration of urbanization in recent years, China has witnessed large-scale construction across its provinces, generating massive amounts of construction waste that pose challenges to environmental protection and sustainable development. This study evaluated the impact of construction waste policy intensity on its environmental efficiency. Firstly, the content analysis method was used to analyze the construction waste policy text quantitatively. Second, this study constructed a slack-based measure (SBM) model based on data envelopment analysis (DEA), considering resource input and construction waste output to measure environmental efficiency. Finally, we built and tested an econometric model of how policies affect environmental efficiency using the system generalized method of moments (SYS-GMM). The findings indicate a non-linear U-shaped link between policy intensity and environmental efficiency. Among all five control variables, population density, urbanization level, and technological innovation enhance environmental efficiency, while economic development and highway density will lower it. This study advances the research on construction waste policies and offers some insights for the construction industry to pursue sustainable development.

Altering optical zone diameter, reverse curve width, and compression factor: impacts on visual performance and axial elongation in orthokeratology.

PURPOSE: To investigate the effects of modifications in back optical zone diameter (BOZD), reverse curve width (RCW), and compression factor (CF) on refractive error changes and axial elongation in myopic children undergoing orthokeratology (ortho-k) over a 12-month period. METHOD: In this retrospective study, data from 126 myopic children undergoing ortho-k fitting were analyzed. Subjects were categorized into four distinct groups based on lens design parameters: Group A (BOZD 6.0 mm, RCW 0.6 mm, CF 0.75 D); Group B (BOZD 6.0 mm, RCW 0.6 mm, CF 1.25 D); Group C (BOZD 5.4 mm, RCW 0.9 mm, CF 1.25 D); and Group D (BOZD 5.0 mm, RCW 1.1 mm, CF 1.25 D). The study evaluated uncorrected visual acuity (UCVA), corneal topography, and axial length (AL) at intervals, using Linear Mixed Models (LMMs) for time-based changes, and ANOVA or Kruskal-Wallis tests for group differences in AL elongation. A multivariable regression analysis identified factors independently associated with AL elongation. RESULTS: Within the first day and week, all four groups displayed significant improvements in UCVA and alterations in corneal curvature, which subsequently stabilized. Although UCVA variations between groups were subtle, Group D had less corneal curvature change than Groups A and B initially and exhibited significantly less AL elongation after one year. No significant difference in corneal curvature change or AL elongation was observed between Group C and the other groups. Multiple regression analysis indicated that older baseline age, greater baseline spherical equivalent refractive error, and smaller BOZD were associated with less AL elongation. CONCLUSION: The study reveals a positive correlation between BOZD and axial length growth over the 12-month period. A pure 0.5 D CF increment demonstrates a nonsignificant impact. This study provides new ideas into optimizing the parameters of ortho-k lenses.

[Clinical study on treatment of secondary keratoconus with special designed rigid gas permeable contact lens].

OBJECTIVE: To investigate the clinical effects of special designed rigid gas permeable contact lens (RGPCL) in the treatment of secondary keratoconus. METHODS: Retrospective study. The results of correction of secondary keratoconus by the RGPCL in 89 cases (102 eyes) at the Optometry & Ophthalmology Center were analyzed, including history, slit lamp microscope, computer assisted corneal topography, phoropter, corneal endothelial cell examinations and A-scan corneal thickness measurements. We selected and designed the contact lens with different materials for refractive correction according to different corneal deformations. Visual stability and corneal changes were regularly observed. We compared corrected vision, corneal curvature and corneal topography before and after wearing spectacles and RGPCL by using a paired-t test. RESULT: Secondary keratoconus after keratorefractive operation in 56 cases (67 eyes), including post-LASIK in 53 eyes, post-PRK in 4 eyes and post-RK in 10 eyes were observed. The cornea thickness in the lesion region was less than 0.4 mm, with nebula or macula. Corneal topography showed different local protrusions, Steep K ranged 47.56 D to 69.72 D, corneal astigmatism ranged 4.00 D to 14.00 D, with irregular deformations, visible different degrees matrix strips pattern changes and Fleischer ring. Secondary keratoconus in 31 cases (31 eyes) was developed after corneal injury. The lesions included opaque scar, decrease of corneal endothelial density, multi-deformations and aphakia in 15 eyes. In addition, there were different degrees of damage in pupil, iris, vitreous and retina. Secondary keratoconus in one case (2 eyes) was developed after anti-glaucoma and pediatric cataract extraction operations (with intraocular lens implantation). Another case was secondary to repeated bilateral keratitis episodes, with large macula, mild thinning of cornea, neovascularization and roughness of corneal surface. The uncorrected visual acuity in these eyes was poor. After wearing the aspherical, Rose K, Piggyback and other special design of RGPCL made by high oxygen permeability materials, visual acuity could be raised to 4.9 or more in 90% cases. Corrected visual acuity remained stable and increased in some cases. Corneal topography showed that the corneal astigmatism, SRI and SAI values were reduced after wearing RGPCL, and the differences were statistically significant (t = 2.389, 2.645, 2.255, P < 0.05). CONCLUSION: By using special designed RGPCL in secondary keratoconus after corneal refractive surgery or trauma, satisfactory corrected vision, flattened cornea and regular corneal shapes could be obtained.

Tracing the Trends of General Construction and Demolition Waste Research Using LDA Modeling Combined With Topic Intensity.

The study of construction and demolition waste (CDW) has attracted more and more attentions with the increasing CDW pollution caused by the large-scale infrastructure construction. This study used the Latent Dirichlet Allocation (LDA) combined with topic intensity to discover hot topics and development trends in the study area of CDW. First, the LDA was used for topic modeling to extract the existing topics from textual data. Second, the topic intensity was calculated for the extracted topics and the numerical values of the topic intensity represented the popularity of the topics. In this study, 4 topics were extracted from 1,849 relevant articles through the LDA modeling and topic intensity calculation. The results showed that the topic of "CDW management" had an upward trend. Topics such as "recycled aggregate," "environmental impact," and "study of CDW on soil" all showed a downward trend. The methods of this study can dig into the topics of CDW study and help scholars to engage in this field for better understanding the prevalence and evolution trends of these topics.

A resilient and lightweight cellulose/graphene oxide/polymer-derived multifunctional carbon aerogel generated from Pickering emulsion toward a wearable pressure sensor.

In the new era of competitive smart electronics, the development of compressible multifunctional carbon aerogels is highly needed, but still faces enormous challenges. Here we demonstrate a robust strategy to fabricate multifunctional carbon aerogel via freeze-drying of cellulose nanofibers (CNF) and graphene oxide (GO) co-stabilized Pickering emulsion gel followed by high-temperature annealing. The resulting carbon aerogel exhibits tunable mechanical, hydrophilic and hydrophobic properties due to varying the elemental composition and the pyrolysis of introduced polymers. The carbon aerogel is resilient against high compression strain up to 99 % and has ultralow density (1.82 mg/cm3). The CNF/GO/acrylonitrile butadiene styrene-derived carbon aerogel (CRA)-based sensor has shown desirable sensitivity (17.65 kPa-1), ultralow detection limit of pressure (60 Pa), and fast responsive time (130 ms), which is capable of detecting human activity, identifying spatial pressure distribution, and communicating with smartphones via Wi-Fi. Moreover, the carbon aerogel reveals effective thermal insulation and photothermal conversion performance. These results suggest the great potentials for developing lightweight and compressible carbon aerogels with multiple functions to meet various applications.

[Advantage of higher oxygen transmissibility material Piggyback lens for keratoconus correction].

OBJECTIVE: To evaluate the oxygen transmissibility of new material Piggyback lens combined with silicone hydrogel lens and higher Dk RGPCL. To investigate the improving of visual acuity, ocular shape and comfortable, also orthokeratology results and safety of this new system for keratoconus correction. METHODS: Calculating the oxygen transmission (Dk/t) of the new Piggyback system involves Ohm's Law. Compare the changes of ocular surface curves and astigmatism with or without Si-SCL fitting, RGPCL vision and Piggyback lens vision. Investigate the comfortable improving and ocular complications, and changes of corneal shape after fitted with Piggyback lens by using corneal topography. RESULTS: Selected silicone hydrogel lens was pure vision (B&L PV, 36% water, Dk/t 110) lens, RGPCL material was Menicon Z, Dk/t 95.9 and Boston XO, Dk/t 58.8. It was calculated to 44.4 Dk/t and 34.4 Dk/t with these two combinations. Twenty two moderate and severe keratoconus patients (28 eyes) fitted with the Piggyback lens successfully. Corneal K reading and astigmatism decreased significantly after wore the Si-SCL. Compared with RGPCL vision(4.82 ± 0.11), Piggyback lens vision (4.93 ± 0.08) was significant increased (t = -10.395, P < 0.01) 90% cases improved comfort vs prior RGPCL wear alone. Only few cases appeared slight conjunctival hyperemia and corneal staining. Corneal topography showed corneal flatter, spherical and regular reshaping results after 6 months wore the Piggyback lens. CONCLUSIONS: By fitting Piggyback systems using new Si-SCL and higher Dk RGPCL materials may help problematic keratoconic patients improve visual acuity, comfort and safety, increase wearing time and orthokeratology results further.

[Promote sound development of domestic modern orthokeratology].

Introduced the history of orthokeratology briefly. Give a definition of modern orthokeratology. Evaluated the effects and safety of orthokeratology for the myopia reduction and myopia control based on the studies from authoritative units domestic and abroad. Compared to international advanced level, approached any misunderstanding from different angles in domestic utility, such as unrealistic spread in the early, commercial operate, overstate the danger, and problems of applicable groups, wearing method and period also be discussed. Furthermore indicated that the further development of new material, new individual design and wavefront aberration guided technology should improve visual quality of orthokeratology, should make more longer effect, more safety and more comfortable results. It could promote sound development of domestic modern orthokeratology then.

[Effects of wearing long-term Ortho-K contact lens on corneal thickness and corneal endothelium].

OBJECTIVE: The current study evaluated the response of the cornea to more than 3 years of Ortho-K CL wearing by investigating the changes of corneal thickness and corneal endothelium. METHODS: One hundred and thirty-two subjects were fitted with Ortho-K CL (Dk 100), which were worn overnight or daily for more than 3 years. Central and para-peripheral corneal thickness and corneal endothelium were measured before and during this period by using A scan pachymeter and non contact specular microscope. RESULTS: There were no significant changes in corneal thickness (P < 0.05) and corneal endothelial polymegathism and pleomorphism could not be found after long-term wearing of Ortho-K CL (overnight or daily wear). CONCLUSIONS: This study shows that high Dk Ortho-K CL used for scientific reshaping treatment only induces mild corneal response. Therefore, the Ortho-K CL can be worn safely for long-term control of myopia.

[The analysis of corneal topography for keratoconus].

OBJECTIVE: To investigate the refraction and videokeratographic characteristics of keratoconus. METHODS: 262 eyes of 147 patients with keratoconus were examined using autorefractor and computerized corneal topography, which generated the quantitative descriptors including refraction, keratometry, corneal astigmatism, the surface regularity index (SRI), the surface asymmetry index (SAI), and morphologic description. RESULTS: All patients were classified into four groups: suspect, mild, moderate and advanced group. The topographical configurations of the lesions were divided into bow-tie pattern subdivided into symmetric and asymmetric pattern, and non-bow-tie pattern including nipple, oval, global and anomalistic pattern. The bow-tie pattern mostly appeared symmetrical and occurred in suspect and mild cases. The nipple and oval pattern mostly occurred in mild and moderate ones located in the central or inferior paracentral cornea. The global pattern mostly occurred in moderate and advanced ones located in the central cornea. The anomalistic pattern occurred in advanced ones. Bilateral topography showed symmetrical in majority of patients with bilateral keratoconus. There was no correlation between the diameter of lesion and the refraction power of corneal apex (r = 0.208, P = 0.092). There was negative correlation between the distance from corneal center to the apex of lesion and the refraction power of corneal apex (r = -0.400, P = 0.001). CONCLUSIONS: Corneal topography is a sensitive method to detect the keratoconus earlier, which helps eye doctors to take appropriate measures to improve patients vision and avoid patients from undergoing excimer laser keratorefractive surgery. In addition, it can show the configuration of the lesion, which guide the fitting of hard contact lens.

Novel mutation (V505D) of the TGFBI gene found in a Chinese family with lattice corneal dystrophy, type I.

PURPOSE: To report a novel V505D mutation of the human transforming growth factor beta-induced (TGFBI) gene found in a Chinese family with lattice corneal dystrophy, type I (LCDI). METHODS: Genomic DNA was extracted from peripheral leukocytes from eight affected and four unaffected members of a Chinese family with LCDI. Exons of the TGFBI gene were amplified by polymerase chain reaction and directly sequenced. Fifty normal Chinese individuals were also analysed as controls. Histopathological examination of a corneal button was performed after keratoplasty of the proband. RESULTS: A heterozygous single-base-pair transversion (GTC to GAC, valine to aspartic acid) at codon 505 in exon 11 of the TGFBI gene (V505D) was detected in all of the affected members. No mutation was found in the unaffected members or in the 50 normal controls. The mutation cosegregated with the disease phenotype throughout three generations. Although a slit-lamp examination showed features of LCDI in most cases, the age at onset of the symptoms was several years later than that in cases of LCDI with an R124C mutation. By histopathological examination, numerous amyloid deposits were observed in the stroma, including beneath Bowman's membrane. CONCLUSION: A novel V505D mutation in the TGFBI gene causes LCDI in this Chinese family. It is the fourth reported mutation of the TGFBI gene associated with LCDI.

[The evaluation of visual quality in keratoconus eyes corrected by rigid gas-permeable contact lens].

OBJECTIVE: To evaluate the visual quality in keratoconus eyes corrected by rigid gas-permeable contact lens (RGPCL) and spectacles. METHODS: Corrected visual acuity, corneal topography, wavefront aberration and contrast sensitivity were measured in 27 keratoconus patients (54 eyes) before and after the fitting of RGPCL. RESULTS: The inclusive keratoconus eyes were divided mild 30 eyes, moderate 13 eyes and sever 11 eyes. The average myopia and average astigmatism were (6.92 +/- 3.66) D and (5.75 +/- 1.85) D respectively. Uncorrected visual acuity (VA) in 96.3% keratoconus eyes was or= 0.6, while 100% by RGPCL. The VA in 20.4% of eyes corrected by spectacles were >or= 1.0, while 66.7% by RGPCL. Corneal topography study showed corneal toricity decreased to