Objective To analyze the accuracy of the new generation intraocular lens(IOL)formula and the Wang-Koch(WK)adjustment in individuals with severe myopia undergoing combined anterior-posterior surgery.Methods A total of 100 patients(100 eyes)with axial length(AL)＞26 mm undergoing combined anterior and posterior segment surgery in our department from June 2015 to June 2021 were enrolled in this study.Totally 13 IOL calculation formulas,such as Barrett Universal Ⅱ(BU Ⅱ),Emmetropia Verifying Optical(EVO),Kane,Haigis,Hoffer Q,Holladay,and SRK/T as well as the first generation linear WK eye axis optimization formula(Haigis-WK1,SRK/T-WK1,Hoffer Q-WK1,Holladay 1-WK1)and the second generation linear WK eye axis optimization formula(SRK/T-WK2,Holladay 1-WK2),were utilized to determine IOL diopter.The mean prediction error(ME),mean absolute error(MAE),median absolute error(MedAE),and percentage of prediction error within different refractive thresholds were calculated to assess the accuracy of each formula.In order to investigate the impact of AL on accuracy of IOL calculation,the patients were categorized into group A(38 eyes,26.00 mm＜AL≤28.00 mm),group B(28 eyes,28.00 mm＜AL≤30.00 mm),and group C(34 eyes,AL＞30.00 mm).Additionally,the patients were also divided into silicone oil(63 eyes)and non-silicone oil(37 eyes)groups based on preoperative intraocular filling to determine the effect of intraocular filling on IOL calculation.Results The MedAE values of the new-generation IOL formulas(BU Ⅱ,EVO,and Kane)were significantly lower(0.34D,0.31D,0.35D)than those of traditional formulas(P＜0.05).Additionally,the percentage of prediction errors within±0.25 D,±0.50 D,±0.75 D,and±1.00 D were significantly higher with the new formulas when compared to traditional ones(P＜0.05).Traditional formulas exhibited a hyperopic deviation(0.35D～0.65 D),which could be corrected using the WK eye axis adjustment.WK2 was effective in improving the accuracy of calculation in SRK/T and Holladay 1 formulas,and there was no statistical difference in the MedAE values of SRK/T-WK2 and Holladay 1-WK2 formulas with the new-generation IOL formulas.When comparing the formulas across different axial eye length groups in terms of MedAE,the new IOL formulas(BU Ⅱ,kane and EVO)and WK-corrected formulas(Haigis-WK1,SRK/T-WK 1,SRK/T-WK2,Hoffer Q-WK1,Holladay 1-WK1,Holladay 1-WK2)showed no significant differences among the different AL groups.However,there were significant differences in the MedAE values of traditional formulas among the different AL groups(P＜0.01),with group C displaying the largest MedAE values(Haigis:0.84D,SRK/T:1.10D,Hoffer Q:1.23D,Holladay 1:1.20D).Comparing the MedAE values of different formulas in various preoperative intraocular filling groups,it was observed that the MedAE values of the new-generation IOL formulas(BU Ⅱ,kane and EVO),Haigis,and SRK/T formulas were significantly higher in the silicone oil-filled eye group than the non-silicone oil-filled eye group(P＜0.05).Conclusion In patients with high myopia undergoing combined anterior and posterior segment surgery,the precision and consistency of the new-generation IOL formulas and the second-generation linear WK axis correction formula exhibit significant improvements when compared to traditional formulas.

Objective:To explore the effects of conditioned medium of human bone marrow mesenchymal stem cells (BMSCs) on the proliferation, adhesion and differentiation of immortalized human Müller cell line (MIO-M1).Methods:The differentiation was induced in the third-passage BMSCs with osteogenic, chondrogenic and adipogenic medium and identified by alizarin red, alcian blue and oil red O staining, respectively.The expression levels of mesenchymal stem cell markers CD73, CD90 and CD105 and hematopoietic cell markers CD34, CD45 and human leukocyte antigen-DR (HLA-DR) were assayed by flow cytometry.The expressions levels of Müller cell markers SOX9, glutamine synthetase (GS), vimentin and cellular retinaldehyde-binding protein (CRALBP), retinal stem cell markers SOX2, nestin and CHX10, and cell proliferation marker cyclin D3 (CCND3) in MIO-M1 cells were detected by immunofluorescence staining.The MIO-M1 cells were divided into standard medium group, 293T conditioned medium group, and BMSC conditioned medium group and were incubated in the medium according to grouping.The cellular area, circularity, elongation factor and perimeter were analyzed quantitatively.The cell cycle was detected by flow cytometry, and the cell proliferation was determined by neurospora experiment and 5-ethynyl-2'-deoxyuridine (EdU) staining.The expression of vascular cell adhesion molecule 1 (VCAM-1) at protein and mRNA levels in the culture supernatant was detected by enzyme linked immunosorbent assay (ELISA) and quantitative real-time PCR (qRT-PCR), respectively.The expression of retinal neuron markers protein kinase C (PKCα), Rhodopsin, microtubule-associated protein 2 (MAP2) and β-tubulin (Tuj1) was detected by immunofluorescence staining and qRT-PCR.Results:CD73, CD90, CD105 showed an enhanced expression, and CD34, CD45 and HLA-DR showed weakened expression in the BMSCs.The BMSCs differentiated into osteoblasts, chondrocytes and adipocytes.Expression of SOX9, GS, vimentin and CRALBP, SOX2, CHX10, nestin and CCND3 was found in the MIO-M1 cells.Compared with standard medium group and 293T conditioned medium group, MIO-M1 cells cultured in BMSC conditioned medium group changed into an elongated spindle-shaped or multipolar morphology with reduced cell area, increased elongation index and decreased circularity, showing statistically significant differences among them ( F=6.973, 12.370, 6.311; all at P<0.01). There were increased neurospheres formed by MIO-M1 cells in BMSC conditioned medium group compared with standard medium group and 293T conditioned medium group at different time points ( Fgroup=134.300, P<0.001; Ftime=82.910, P<0.001). Compared with the standard medium group and 293T conditioned medium group, the EdU-positive rate and proliferation index of MIO-M1 cells in BMSC conditioned medium group were significantly increased, with statistically significant differences ( F=6.973, 74.110; all at P<0.05); the VCAM-1 protein expression in cell supernatant and the relative expression level of VCAM-1 mRNA in BMSC conditioed medium group were significantly increased ( F=13.720, 7.896; all at P<0.05); the mRNA expression levels of PKCα, Rhodopsin, Tuj1 and MAP2 were higher in MIO-M1 cells of BMSC conditioned medium group under the condition of differentiation ( F=14.490, 5.424, 14.330, 7.405; all at P<0.05). Conclusions:BMSCs conditioned medium can change the morphology of MIO-M1 cells and promote their proliferation, adhesion and differentiation into retinal neurons.