Journal of cataract and refractive surgery最新文献

{"title":"Comment on: Enhancing patient education in cataract surgery using a conversational artificial intelligence chatbot: pilot randomized controlled trial.","authors":"Henry Bair","doi":"10.1097/j.jcrs.0000000000002019","DOIUrl":"10.1097/j.jcrs.0000000000002019","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"949"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes and in vivo wavefront analysis of a toric transcleral plug-fixated intraocular lens using a pyramidal sensor aberrometer.","authors":"Lorenzo de Angelis, Vito Romano, Fabrizio Giansanti, Gianni Virgili, Marianna Della Porta, Stanislao Rizzo, Francesco Barca","doi":"10.1097/j.jcrs.0000000000001930","DOIUrl":"10.1097/j.jcrs.0000000000001930","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the visual, refractive, and aberrometric outcomes of a toric (T) FIL-SSF intraocular lens (IOL) implanted in aphakic eyes lacking capsular support.</p><p><strong>Setting: </strong>Ospedale Piero Palagi and Azienda Ospedaliera Universitaria Careggi, Florence, Italy.</p><p><strong>Design: </strong>Multicenter prospective observational case series.</p><p><strong>Methods: </strong>Aphakic eyes with regular corneal astigmatism >1 diopter (D) underwent sutureless transscleral fixation of a T FIL-SSF IOL. Preoperative assessment included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, corneal tomography, and biometry. Postoperative visits occurred at 1 day; 7 days; and 1 month, 3 months, and 6 months. At 6 months, vector astigmatism analysis, wavefront aberrometry, and IOL alignment were performed.</p><p><strong>Results: </strong>15 eyes from 12 patients completed the 6-month follow-up. Mean UDVA improved from 0.96 ± 0.25 to 0.19 ± 0.10 logMAR and CDVA from 0.41 ± 0.32 to 0.04 ± 0.05 logMAR (both P < .01). Mean postoperative spherical equivalent prediction error was -0.12 ± 0.54 D. Mean absolute corneal astigmatism decreased from 2.15 ± 0.54 D to a mean refractive astigmatism of 0.73 ± 0.48 D. Wavefront aberrometry showed total astigmatism of 0.36 ± 0.28 µm, with mean total higher-order aberrations of 0.24 ± 0.08 µm. Mean IOL misalignment was 3.33 ± 3.42 degrees, significantly correlated with residual refractive astigmatism (ρ = 0.71 P < .01).</p><p><strong>Conclusions: </strong>T FIL-SSF IOL implantation provided substantial improvements in visual acuity, predictable refractive outcomes, and significant cylinder reduction in aphakic eyes with corneal astigmatism lacking capsular support.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"859-864"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of corneal crosslinking for keratoconus across pediatric, adolescent, and adult populations in a diverse U.S. population.","authors":"Karen M Chen, Thitima Wungcharoen, Cindy Zhao, David Myung, Edward E Manche","doi":"10.1097/j.jcrs.0000000000001932","DOIUrl":"10.1097/j.jcrs.0000000000001932","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate long-term outcomes of epithelium-off corneal crosslinking (CXL) on keratoconus progression and visual function across pediatric, adolescent, and adult cohorts in a diverse U.S. population over a 5-year follow-up period.</p><p><strong>Setting: </strong>Tertiary care ophthalmology center in the United States.</p><p><strong>Design: </strong>Retrospective cohort study conducted between January 2017 and October 2025 of patients treated between January 2017 and May 2023. Inclusion criteria required a diagnosis of progressive keratoconus and ≥12 months of follow-up.</p><p><strong>Methods: </strong>243 eyes from 193 patients were analyzed, including 80 eyes from pediatric patients (32.9%) younger than 18 years of age. All eyes underwent standard epithelium-off CXL for progressive keratoconus. Clinical parameters, including corrected distance visual acuity (CDVA), maximum keratometry (Kmax), minimum central corneal thickness (CCTmin), and wavefront aberrations (root mean square error), were recorded preoperatively and at 12-month postoperative intervals through 60 months.</p><p><strong>Results: </strong>CXL was associated with significant and sustained visual and structural improvements. Mean CDVA improved significantly from baseline and remained improved through 60 months ( P < .05). The greatest mean corneal flattening (Kmax) occurred within the first 2 years, with stability maintained through 48 months ( P < .05). Postoperative CCTmin overall declined from preoperative baseline, demonstrating a trend of gradual rethickening consistent with stromal remodeling after 24 months, while remaining below baseline ( P < .05). Wavefront aberrations remained stable, and adverse events were minimal.</p><p><strong>Conclusions: </strong>CXL is associated with long-term safety and sustained improvements in visual and tomographic outcomes across pediatric, adolescent, and adult patients in a diverse U.S. cohort, supporting timely intervention in progressive keratoconus.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"872-878"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization of crystalline lens refractive index to improve the accuracy of intraocular lens power calculation in patients with dense cataract.","authors":"Tsuyoshi Nogami, Takashi Kojima, Akeno Tamaoki, Ayako Sawaki, Asato Hasegawa, Tatsushi Kaga","doi":"10.1097/j.jcrs.0000000000001941","DOIUrl":"10.1097/j.jcrs.0000000000001941","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate effects of crystalline lens refractive index (LRI) on prediction error (PE) and suggest the optimal LRI in cases of dense cataract.</p><p><strong>Setting: </strong>Chukyo Hospital, Aichi, Japan.</p><p><strong>Design: </strong>Retrospective consecutive case series study.</p><p><strong>Methods: </strong>Patients who underwent cataract surgery were enrolled and allocated into Group A (nuclear hardness ≤III) and B (nuclear hardness ≥IV) based on the Emery-Little classification. The swept-source optical biometer was used for biometric measurements. Assuming the postoperative axial length (AL) to be the valid value, a corrected LRI (CLRI) was calculated to make the preoperative AL equivalent to the postoperative one. In the validation group, the PE of the SRK/T formula and Barrett Universal II (BUII) were evaluated using the precorrection and postcorrection refractive indices.</p><p><strong>Results: </strong>Of the 5196 enrolled eyes, 1084 were evaluated. In Group A, there was no significant difference between the preoperative and postoperative ALs ( P = .07). In Group B, the mean postoperative AL (24.09 ± 2.05 mm) was significantly shorter than the mean preoperative AL (24.12 ± 2.06 mm) ( P < .001). The average CLRI in Group A and B were 1.41 and 1.42, respectively. In the validation group, the PEs using CLRI (SRK/T, 0.10 ± 0.48 diopters [D]; BUII, 0.03 ± 0.35 D) were significantly smaller than those using LRI (SRK/T, 0.18 ± 0.49 D; BUII, 0.12 ± 0.36 D) ( P < .001).</p><p><strong>Conclusions: </strong>In cases of high lens nucleus hardness, the use of proposed CLRI demonstrated potentials for reducing PE.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"890-896"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual performance and patient-reported outcomes of an EDF intraocular lens compared with a monofocal intraocular lens: randomized trial.","authors":"Stefan Palkovits, Manuel Ruiss, Caroline Pilwachs, Johannes Zeilinger, Stefan Georgiev, Oliver Findl","doi":"10.1097/j.jcrs.0000000000001942","DOIUrl":"10.1097/j.jcrs.0000000000001942","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate clinical performance and visual outcomes of the Acunex Vario AN6V in comparison with the monofocal version, the Acunex AN6.</p><p><strong>Setting: </strong>Department of Ophthalmology, Hanusch Hospital, Vienna, Austria.</p><p><strong>Design: </strong>Prospective, randomized, monocenter trial.</p><p><strong>Methods: </strong>Patients undergoing bilateral cataract surgery were randomized to receive extended depth of field (EDF) intraocular lens (IOL), the Acunex Vario AN6V (EDF group) or the monofocal IOL Acunex AN6 (monofocal group). Primary outcome was spectacle independence 6 months postoperatively. Furthermore, uncorrected and corrected distance, intermediate and near visual acuity, stereo vision, defocus curves, and rate of photopic phenomena were assessed.</p><p><strong>Results: </strong>50 patients were included in the study, of whom 42 completed the 2 months and 35 the 6-month visit. 2 months after the procedure, a significantly higher proportion of patients in the EDF were spectacle-free during near tasks than in the monofocal group (37.5% vs 5.3%). Uncorrected and corrected distance intermediate (UIVA and DCIVA) as well as near (UNVA and DCNVA) visual acuities were significantly better in the EDF group (UIVA: 0.09 ± 0.12 vs 0.16 ± 0.07; P = .035; DCIVA: 0.12 ± 0.10 vs 0.16 ± 0.08; P = .03; UIVA: 0.24 ± 0.12 vs 0.37 ± 0.11; P = .001; DCNVA: 0.24 ± 0.12 vs 0.37 ± 0.11; P = .001) Furthermore, the EDF group had a larger range of defocus. Stereo vision and the occurrence of photopic phenomena were comparable between both groups.</p><p><strong>Conclusions: </strong>In comparison with the monofocal version, the EDF IOL AN6V demonstrated greater spectacle independence and significant enhancement in both intermediate and near visual acuities. Notably, the incidence, severity, and degree of perceived dysphotopsia were similar in both groups.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"897-903"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal nerve regeneration:where we are today.","authors":"Sathish Srinivasan","doi":"10.1097/j.jcrs.0000000000002024","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000002024","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":"52 9","pages":"841-842"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply : Accuracy of new-generation and traditional intraocular lens power calculation formulas in pediatric primary implantation.","authors":"Jiaxin Jin, Yanyu Shen, Yiwen Qu, Hui Chen, Xiaohang Wu, Ling Jin, Yizhi Liu, Haotian Lin, Zhenzhen Liu","doi":"10.1097/j.jcrs.0000000000002004","DOIUrl":"10.1097/j.jcrs.0000000000002004","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"953-954"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interexpert agreement on epithelial thickness mapping for refractive surgery screening: variability highlights need for standardization.","authors":"Niklas Mohr, Jorge L Alio Del Barrio, Martin Dirisamer, Alain Saad, Stefan Kassumeh, Wolfgang J Mayer, Siegfried G Priglinger, Nikolaus Luft","doi":"10.1097/j.jcrs.0000000000001928","DOIUrl":"10.1097/j.jcrs.0000000000001928","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate interexpert agreement on epithelial thickness map interpretation and its influence on eligibility decisions for keratorefractive surgery candidates.</p><p><strong>Setting: </strong>Multicenter international collaboration involving 4 experienced refractive surgeons.</p><p><strong>Design: </strong>Retrospective, masked case review study.</p><p><strong>Methods: </strong>A total of 103 cases were retrospectively evaluated, including patients with normal (n = 44), borderline (n = 44), and keratoconic (n = 15) corneal tomography, as defined by the Belin-Ambrosio display (BAD). 4 independent experts (M.D., J.L.A.d.B., A.S., and N.L.) first assessed surgical eligibility based on Scheimpflug tomography and subsequently re-evaluated the same cases with the addition of anterior segment optical coherence tomography-based epithelial thickness maps. To ensure comparability, a standardized questionnaire with 9 predefined epithelial thickness characteristics was used. Interrater agreement was quantified with Fleiss κ, and the relative impact of each imaging modality on decision-making was ranked.</p><p><strong>Results: </strong>Incorporating epithelial mapping changed the eligibility decision in 19% (77/412) of cases. Specifically, 9% (16/176) of normal, 20% (35/176) of borderline, and 3% (2/60) of keratoconic cases were reclassified as eligible, while 2% (3/176), 6% (10/176), and 3% (2/60), respectively, were deemed ineligible. Interrater agreement on eligibility was moderate before (κ = 0.46) and after (κ = 0.43) adding epithelial maps but remained poor in borderline cases (κ = 0.14 and 0.12, respectively). Agreement on epithelial profile features ranged from poor to fair (κ = -0.78 to 0.35). Corneal topography and BAD were ranked as most influential, followed by epithelial mapping.</p><p><strong>Conclusions: </strong>Epithelial mapping frequently shifted decisions toward eligibility. However, poor interexpert agreement highlights the need for standardized, safety-oriented interpretation to ensure consistent ectasia risk assessment before refractive surgery.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"865-871"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147306193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual and refractive outcomes with intrascleral haptic fixation of the light adjustable lens.","authors":"Allison J Chen, Emily Grace Rodgers, Li Wang, Douglas D Koch, Christina Y Weng, Zaina N Al-Mohtaseb","doi":"10.1097/j.jcrs.0000000000001936","DOIUrl":"10.1097/j.jcrs.0000000000001936","url":null,"abstract":"<p><strong>Purpose: </strong>To describe refractive outcomes with intrascleral haptic fixation (ISHF) of the light adjustable lens (LAL).</p><p><strong>Setting: </strong>Baylor College of Medicine and 1 private practice in the United States.</p><p><strong>Design: </strong>Retrospective sequential cohort.</p><p><strong>Methods: </strong>All patients undergoing double-needle ISHF of the LAL were included in the study. Pretreatment and post-lock-in uncorrected distance visual acuity (UDVA) were recorded. Mean numerical errors, refractive prediction errors, and astigmatism outcomes were measured.</p><p><strong>Results: </strong>10 eyes were included. Initial pretreatment UDVA after surgery ranged from 20/25 to 20/150, and post-lock-in UDVA ranged from 20/12.5 to 20/40 (median UDVA 20/20; mean 0.01 logMAR [spherical equivalent 0.04]). Mean magnitude of refractive astigmatism was 0.70 diopters (D) (range 0.00 to 1.50 D) pretreatment and 0.25 D (range 0.0 to 0.75 D) after final lock-in. Pretreatment mean numerical error was +1.00 D (SD 0.94 D) and was reduced to -0.022 D (SD 0.28) after treatments and lock-in sessions. All eyes (10/10) achieved their full visual potential in UDVA.</p><p><strong>Conclusions: </strong>This study illustrates that with careful planning and patience, patients with poor or absent capsular support who previously did not have a customizable option can potentially achieve personalized visual outcomes with excellent refractive accuracy with scleral fixation of the LAL.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"885-889"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroprotective and anti-inflammatory strategies for corneal nerve regeneration and ocular surface stability after corneal refractive surgeries: systematic review.","authors":"Anas Alamoudi, Abdulaziz Khalid Aldahlawi, Ahmed Alnabihi, Rozan Abdulaziz AlGhamdi, Hind Mohammed Aljabri, Naif Almufarriji, Rahaf Khder Sharif, Danah Albreiki, Bader AlQahtani","doi":"10.1097/j.jcrs.0000000000001933","DOIUrl":"10.1097/j.jcrs.0000000000001933","url":null,"abstract":"<p><strong>Topic: </strong>This study aimed to systematically synthesize and critically appraise all controlled trials evaluating neuroprotective and anti-inflammatory pharmacotherapies for enhancing corneal nerve regeneration and ocular surface stability after corneal refractive surgeries.</p><p><strong>Clinical relevance: </strong>Postrefractive surgery dry eye and hypoesthesia are common and often persistent, underscoring the need for evidence-based pharmacologic strategies to promote corneal nerve recovery and tear film stability.</p><p><strong>Methods: </strong>The authors registered a PROSPERO-guided protocol (CRD42024610462) and systematically searched Clinicaltrials.gov, CENTRAL, Google scholar, Medline from inception to March 2025 for randomized controlled trials (RCTs) evaluating neuroprotective or anti-inflammatory pharmacotherapies after laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), laser-assisted subepithelial keratectomy, or femto-LASIK. 2 independent reviewers screened records, extracted data, and assessed risk of bias using the Cochrane Risk of Bias 2 tool.</p><p><strong>Results: </strong>7 trials (n = 484 participants/eyes, 6 countries) met eligibility. Topical cyclosporine 0.05% (2 RCTs) consistently hastened flap sensitivity recovery (Δ + 4 cm at 3 months) and improved 6-month ocular surface metrics (ocular surface disease index -5 points; tear breakup time [TBUT] +4 seconds; Schirmer +5.5 mm; P < .001). Topical chloroquine 0.03% produced similar but smaller gains. Topical diclofenac 0.1% reduced PRK pain by ∼50% within 24 hours without delaying epithelial closure. Topical citicoline 1% accelerated sensory normalization by 2 weeks and transiently enhanced Schirmer/TBUT, whereas autologous platelet-rich plasma reduced epithelial staining but did not affect nerve density. Oral pregabalin (150 mg 2 times a day) and oral gabapentin (300 mg perioperatively) reduced first-week pain after surface ablation yet had no measurable impact on nerve metrics or dry eye indices through 6 months.</p><p><strong>Conclusions: </strong>Among tested strategies, topical cyclosporine provides the strongest evidence for enhancing corneal nerve function and long-term tear film stability after refractive surgery. However, overall evidence remains limited. Larger, double-masked trials with extended follow-up are needed to further elucidate the roles of these interventions.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"936-942"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}