Journal of refractive surgery最新文献

{"title":"Reply: Clarification Regarding Astigmatism Inclusion Criteria in a Study Comparing TG-LASIK and KLEx.","authors":"Trevor D Annis, Charisma B Evangelista, Samantha B Rodgers, Quan V V Bui, Paul D Kohler, José E Capó-Aponte","doi":"10.3928/1081597X-20260313-01","DOIUrl":"https://doi.org/10.3928/1081597X-20260313-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e387"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633748","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":"The Use of Digital Integrated Manifest Refraction in Pseudophakic Eyes.","authors":"Pablo A Barragán-Castillo, Felix Piloto-Reyes, Erik Navas-Villar, Paula González-Palomo, Salomon Merikansky, Nora Robledo-Silva, Ivonne Curiel-Arce, Juan Mario García-Coronado, Diego Melo-Orta, Arturo Chayet","doi":"10.3928/1081597X-20260214-02","DOIUrl":"https://doi.org/10.3928/1081597X-20260214-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the accuracy and efficiency of a digital integrated manifest refraction system compared with standard manifest refraction in pseudophakic eyes.</p><p><strong>Methods: </strong>This prospective, double-blind study analyzed 100 eyes from 100 pseudophakic patients; 35 eyes received monofocal intraocular lenses MA60AC (AcrySof three-piece IOL; Alcon Laboratories, Inc], MX60 (enVista; Bausch & Lomb, Inc), CNA00 (Clareon Monofocal, Alcon Laboratories, Inc), and SN60AT (AcrySof IQ Monofocal; Alcon Laboratories, Inc) and 65 eyes received trifocal IOLs TFNT00 (AcrySof IQ PanOptix; Alcon Laboratories, Inc) and ZFR00V (Synergy; Johnson & Johnson Surgical Vision, Inc). All patients underwent objective refraction with the Nidek ARK-530A autorefractor, followed by manifest refraction performed with the Topcon VT-100 (Std-MR group) and the digital integrated manifest refraction unit TS-610 (Nidek Co, Ltd) (DI-MR group). Outcomes assessed included manifest spherical equivalent, refractive cylinder, time, correlation, and agreement between methods.</p><p><strong>Results: </strong>The mean manifest spherical equivalent was -0.15 ± 0.38 diopters (D) with the TS-610 and -0.14 ± 0.38 D with standard refraction (<i>P</i> = .31). Linear regression demonstrated a strong correlation between methods (<i>R</i> = 0.914, <i>R</i>² = 0.835, <i>P</i> < .001). The mean cylinder was -0.66 ± 0.52 D (TS-610) versus -0.62 ± 0.57 D (Std-MR), with a mean difference of -0.11 ± 0.17 D and a centroid of 0.01 ± 0.20 D in vector analysis. DI-MR significantly reduced testing time (3.1 ± 1.8 minutes) compared with Std-MR (7.1 ± 7.4 minutes, <i>P</i> = .001).</p><p><strong>Conclusions: </strong>The automated TS-610 manifest refraction system demonstrated excellent agreement with Std-MR refraction in pseudophakic eyes, while significantly reducing testing time. DI-MR provides a reliable and efficient alternative for postoperative evaluation and may enhance workflow efficiency in cataract and refractive practices.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e354-e358"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633697","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":"Clarification Regarding Astigmatism Inclusion Criteria in a Study Comparing TG-LASIK and KLEx.","authors":"Yasar Sakarya, Rabia Sakarya, Hasan Koyu","doi":"10.3928/1081597X-20260305-03","DOIUrl":"https://doi.org/10.3928/1081597X-20260305-03","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e387"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633719","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":"The Look That You Choose.","authors":"Naia Amat","doi":"10.3928/1081597X-20260305-02","DOIUrl":"https://doi.org/10.3928/1081597X-20260305-02","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e288"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633750","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":"Subjective and Objective Visual Quality Outcomes After KLEx vs KLEx Xtra: A 2-Year Prospective Randomized Trial.","authors":"Jing Cong, Xueqi Lin, Xinran Li, Jiayue Yuan, Wangyuan Liu, Xiuyu Mao, Shichu Liu, Qianhong Feng, Xianglian Li, Yingying Hu, Chenli Feng, Jinhui Dai","doi":"10.3928/1081597X-20260112-09","DOIUrl":"https://doi.org/10.3928/1081597X-20260112-09","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the 2-year refractive correction outcomes and subjective and objective visual quality between keratorefractive lenticule extraction (KLEx) and KLEx combined with corneal cross-linking (KLEx Xtra).</p><p><strong>Methods: </strong>Patients with myopia were recruited for KLEx or KLEx Xtra surgeries. Only the right eyes were selected. The cross-linking energy was 2.4 J/cm². Visual acuity and optical quality (objective and subjective) were assessed preoperatively and at 1, 6, 12, and 24 months postoperatively.</p><p><strong>Results: </strong>A total of 150 participants were enrolled, divided into two groups: the KLEx group (75 eyes) and the KLEx Xtra group (75 eyes). At 24 months, the KLEx Xtra group showed significantly superior refractive stability (manifest refraction spherical equivalent -0.02 ± 0.33 diopters [D]) compared to the KLEx group (-0.18 ± 0.34 diopters; <i>P</i> < .05). A transient increase in higher order aberrations (HOAs) in the KLEx Xtra group was observed during early postoperative recovery, which gradually subsided without long-term adverse visual impact. The KLEx Xtra group demonstrated significantly poorer Optical Quality Analysis System II parameters at the early postoperative period compared to the KLEx group (<i>P</i> < .05), but all metrics became comparable between the groups by 12 to 24 months, Early postoperative increases in HOAs in the KLEx Xtra group resolved by 6 months postoperatively. Subjective quality of vision scores showed no significant intergroup differences at 24 months, except for glare.</p><p><strong>Conclusions: </strong>KLEx Xtra enhances long-term refractive stability without detriment to visual quality, making it a viable option for patients with borderline risk profiles.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e307-e317"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633754","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 Outcomes and the Impact of Intermediate Segment Orientation on the Performance of an Asymmetric Multifocal Intraocular Lens.","authors":"Cameron McLintock, Samir Uprety, James McKelvie, Henry B Wallace","doi":"10.3928/1081597X-20260212-04","DOIUrl":"https://doi.org/10.3928/1081597X-20260212-04","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the visual outcomes and the impact of intermediate segment orientation on the performance of an asymmetric multifocal intraocular lens (IOL) in patients who have cataract.</p><p><strong>Methods: </strong>In this retrospective single-center study, 251 eyes of 251 patients who underwent phacoemulsification with the Lentis Comfort LS-313 MF15 IOL (Oculentis BV) implantation were analyzed. Patients' data were divided into four groups: one non-toric and three toric IOL groups based on astigmatic type (with-the-rule [WTR], against-the-rule [ATR], and oblique astigmatism). Visual outcomes including uncorrected distance visual acuity (UDVA), intermediate visual acuity (UIVA), and near visual acuity (UNVA) were compared between the groups. Regression analysis was used to evaluate the relationship between visual outcomes and angle alpha, derived from Purkinje images from the ANTERION biometer (Heidelberg Engineering).</p><p><strong>Results: </strong>This study found no significant difference in uncorrected visual outcomes (UDVA, UIVA, UNVA) among the four groups: non-toric (60 eyes) and toric IOL groups comprising WTR (63 eyes), ATR (64 eyes), and oblique (64 eyes) across different intermediate segment orientations. Uncorrected visual acuity was comparable across all groups, with 90% of eyes or more achieving 20/25 UDVA, 90% or more achieving 20/40 UIVA, and 70% or more achieving 20/70 UNVA. The majority of eyes (80% or more) achieved refractive outcomes within ±0.50 and 0.50 diopters (D) or less residual cylinder. Regression analysis showed no significant relationship between angle alpha and visual outcomes.</p><p><strong>Conclusions: </strong>The Lentis MF IOL demonstrated good visual outcomes in both the non-toric and toric groups, with no significant impact of intermediate segment orientation or angle alpha on postoperative visual and refractive parameters.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e377-e386"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633695","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":"Comparison of Visual Performance Among Two Multifocal-Extended Depth-of-Focus Intraocular Lens Types and a Trifocal Intraocular Lens.","authors":"Ken Hayashi, Koichi Uno, Shunsuke Hayashi, Motoaki Yoshida","doi":"10.3928/1081597X-20260212-01","DOIUrl":"https://doi.org/10.3928/1081597X-20260212-01","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the visual performance of a new multifocal-extended depth-of-focus (EDOF) intraocular lens (IOL) (TECNIS Odyssey, Johnson & Johnson) with that of an earlier multifocal-EDOF IOL (TECNIS Synergy; Johnson & Johnson) and a trifocal IOL (PanOptix; Alcon Laboratories, Inc).</p><p><strong>Methods: </strong>Ninety eyes of 90 patients who received one of two types of multifocal-EDOF IOLs or a trifocal IOL were enrolled. Uncorrected and corrected distance visual acuity at various distances, photopic and mesopic contrast visual acuity, and degree of photic symptoms were evaluated at 3 months postoperatively and compared among groups.</p><p><strong>Results: </strong>Mean uncorrected far and intermediate visual acuities from infinity to 1 m were generally better in the Odyssey group than in the other groups (<i>P</i> ⩽ .046), but uncorrected near visual acuity at 0.3 m and intermediate visual acuity at 0.5 m were worse (<i>P</i> ⩽ .028). However, mean distance-corrected far and intermediate visual acuities from infinity to 1 m, did not differ significantly among groups, and near visual acuity and intermediate visual acuity at 0.5 and 0.7 m were significantly worse, in the Odyssey group than in the other groups (<i>P</i> ⩽ .018). Mean mesopic contrast visual acuity at 10% contrast and glare size were significantly better in the Odyssey group than in the other groups (<i>P</i> ⩽ .040).</p><p><strong>Conclusions: </strong>The Odyssey provided better uncorrected far and intermediate visual acuities from infinity to 1 m than the other IOLs despite no significant difference in distance-corrected visual acuity. However, it showed worse uncorrected and distance-corrected near visual acuity and intermediate visual acuities at 0.5 m, suggesting that the Odyssey has far-dominant properties and greater tolerance to refractive errors.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e327-e334"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633729","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":"Rotational Stability and Vault Outcomes of the EVO ICL Using Oblique Implanting Orientation Compared to Horizontal/Vertical Implanting Orientation.","authors":"Zishuo Li, Hongyu Kong, Ye Yao, Zhen Li, Tian Tian, Shihao Chang, Yan Yan, Xingtao Zhou, Lingling Niu, Peijun Yao","doi":"10.3928/1081597X-20260212-02","DOIUrl":"https://doi.org/10.3928/1081597X-20260212-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the outcomes of Implantable Collamer Lens (EVO ICL; STAAR Surgical) implantation using customized oblique implanting orientation, focusing on rotational stability, vault predictability, and refractive efficacy compared to horizontal and vertical implanting orientations.</p><p><strong>Methods: </strong>In this prospective case series, 219 eyes of 110 patients underwent customized EVO ICL implantation guided by ultrasound biomicroscopy (UBM) measurements of sulcus-tosulcus (STS) diameters, ciliary sulcus morphology (MCS), and routine measurement of anterior segment including anterior chamber depth (ACD). Eyes were stratified into horizontal (n = 95), vertical (n = 41), and oblique (n = 83) groups based on implanting orientation. Postoperative assessments at 1 day, 1 week, 1 month, 3 months, and 1 year included refractive outcomes, vault measurements, and rotational degree analysis using slit-lamp photography and Mediview software.</p><p><strong>Results: </strong>At 1 year, all groups maintained ideal vault ranging from 118 to 1,053 µm, with 93.8% of eyes achieving 250 to 1,000 µm. The oblique group exhibited comparable vault (562.0 ± 189.2 µm) to the horizontal (571.2 ± 206.9 µm) and vertical (533.1 ± 185.4 µm) groups, with no significant intergroup differences (<i>P</i> = .64). Rotational stability showed no statistical differences among groups (oblique: 3.56 ± 2.78°, horizontal: 3.42 ± 2.49°, vertical: 3.24 ± 2.74°; <i>P</i> = .86). The most significant ICL rotation occurred within the initial postoperative week in all groups, with subsequent stabilization observed thereafter. Haptic positioning behind the ciliary processes correlated with reduced rotation (<i>r</i> = -0.37, <i>P</i> = .004) in the oblique group. Refractive outcomes were consistent across groups, with uncorrected distance visual acuity in 96.7% of eyes achieving preoperative corrected distance visual acuity and 85.5% of eyes having astigmatism of -0.50 diopters or less.</p><p><strong>Conclusions: </strong>UBM-guided customized oblique implantation of an ICL achieved safety, efficacy, and vault predictability comparable to traditional implanting orientations, with good rotational stability, offering an alternative design to achieve optimal vault. Long-term rotational stability requires further observation.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e367-e376"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633708","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":"Corneal Endothelium and Tear Film Metrics Enhance the Accuracy of Machine Learning Prediction in Implantable Collamer Lens Surgery Outcomes.","authors":"Zeyu Meng, Jinze Zhang, Sutong Li, Mengyun Zhou, Yushuang Liu, Shang Huang, Jin Yuan, Naiyang Li, Peng Xiao","doi":"10.3928/1081597X-20260112-06","DOIUrl":"https://doi.org/10.3928/1081597X-20260112-06","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and evaluate a machine learning (ML) model to predict postoperative vault and residual refractive error following Implantable Collamer Lens (ICL) implantation by incorporating corneal functional parameters, and to investigate their influence on prediction accuracy.</p><p><strong>Methods: </strong>This study included 282 eyes implanted with ICLs from 142 patients. A Marine Predators Algorithm combined with a support vector machine (MPA-SVM) for feature selection and optimal modeling was trained to predict postoperative vault residual refractive error using preoperative ocular parameters, with and without corneal functional parameters, including tear film quality and corneal endothelium metrics. Model performance was compared using mean absolute error (MAE), median absolute error (MedAE), R-squared (<i>R</i>²), and Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>Corneal endothelium metrics significantly improved MPA-SVM performance in vault prediction (<i>P</i> < .05), achieving lower MAE (138.55) and MedAE (110.41) and higher <i>R</i>² (0.26) and prediction accuracy. For refractive error prediction, combining tear film quality, endothelium metrics, and other ocular parameters yielded the best results for cylinder (MAE = 0.38; MedAE = 0.32; <i>R</i>² = 0.19), significantly outperforming models using only ocular parameters (<i>P</i> < .05). Endothelium metrics also improved sphere prediction, with numerically lower MedAE and a higher percentage of prediction errors within ±0.25, ±0.50, and ±0.75 diopters.</p><p><strong>Conclusions: </strong>In the MPA-SVM ICL prediction model, corneal endothelium metrics significantly improves vault prediction and, when combined with tear film quality parameters, enhances cylinder prediction after ICL implantation. This enhanced model offers ophthalmologists a valuable tool for improving the safety and planning of ICL procedures.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e289-e298"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633716","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":"Asymptomatic Meibomian Gland Dysfunction in Refractive Surgery Candidates.","authors":"Shawn Sapir, Michael Mimouni, Tzahi Sela, Gur Munzer, Igor Kaiserman","doi":"10.3928/1081597X-20260112-08","DOIUrl":"https://doi.org/10.3928/1081597X-20260112-08","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association between asymptomatic meibomian gland dysfunction (MGD) and preoperative clinical parameters in candidates for refractive surgery.</p><p><strong>Methods: </strong>This retrospective case-control study was conducted at Care Vision Laser Center, Tel Aviv, Israel. A total of 3,472 eyes that underwent evaluation and subsequently proceeded to keratorefractive surgery between January 2019 and December 2024 were included. All eyes had normal tear break-up time (TBUT) and no dry eye symptoms. MGD severity was graded clinically (0 to 3) by a single examiner and categorized as low (grades 0 to 1) or high (grades 2 to 3). Preoperative parameters were compared using univariate analyses, and variables reaching significance were evaluated using multivariate logistic regression to identify independent associations with high MGD. A subgroup analysis of eyes with available low-contrast acuity (CA6%) measurements was performed to assess functional visual differences.</p><p><strong>Results: </strong>High MGD was identified in 1,731 eyes (49.9%), whereas 1,741 eyes (50.1%) were classified as low MGD. High MGD eyes were significantly older (<i>P</i> < .001), more likely to wear contact lenses (<i>P</i> < .001), and demonstrated higher myopia (<i>P</i> < .001), thinner pachymetry (<i>P</i> < .001), steeper keratometry (<i>P</i> ⩽ .001), and worse preoperative UDVA and CDVA (both <i>P</i> < .001). In the CA6% subgroup (n = 1,602), contrast acuity was significantly reduced in the high MGD group (<i>P</i> = .007). Multivariate analysis identified independent associations between high MGD severity and older age (odds ratio [OR]: 1.063; <i>P</i> < .001), contact lens wear (OR: 1.424; <i>P</i> < .001), thinner corneas (OR: 0.995/µm; <i>P</i> < .001), higher myopia (OR: 0.851/diopter; <i>P</i> < .001), and reduced CDVA (OR: 25.933; <i>P</i> = .022).</p><p><strong>Conclusions: </strong>Asymptomatic MGD in refractive surgery candidates is independently associated with older age, contact lens wear, higher myopia, thinner corneas, and reduced visual performance. Routine MGD screening is recommended even in asymptomatic patients undergoing preoperative refractive evaluation.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e299-e306"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633722","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}