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Gender differences in all grades were evaluated in regard to subjective and objective refractive error (RE), axial length (AL), corneal keratometry, higher-order aberrations (HOAs), and a questionnaire regarding environmental factors of myopia progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the girls in all grades, corneal keratometry was steeper and AL was shorter (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.05), coma-like and total aberration (in 6mm) corneal HOAs, coma-like, spherical-like, and total aberration (in 6mm) ocular HOAs were larger (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.05), in addition, only spherical aberration (in 4mm) corneal HOAs were smaller. In all grades, no gender-related differences were found in myopia prevalence (Grade 1: boys = 6.1%; girls = 6.5%, Grade 9: boys = 60.4%; girls = 65.4%) as well as RE. The questionnaire findings revealed that in all grades the girls spent more time reading and less time playing mobile-phone-app games (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Japanese school children, AL was shorter in the girls than in the boys, although, no gender-related differences were observed in myopia prevalence. The steeper cornea in girls might be associated with that discrepancy, and partially with gender differences of HOAs. Gender-specific differences of AL and HOAs should be considered in the analysis of myopia progression in school-aged children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10384-025-01272-6","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T06:11:38Z","timestamp":1756793498000},"page":"245-253","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Gender differences in higher-order aberrations and refractive error in Japanese school children: the Kyoto Childhood Refractive Error Study (KRES)"],"prefix":"10.1007","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1156-9732","authenticated-orcid":false,"given":"Yo","family":"Nakamura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Hieda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Nakai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuko","family":"Nakata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chie","family":"Sotozono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeru","family":"Kinoshita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"key":"1272_CR1","doi-asserted-by":"publisher","first-page":"1739","DOI":"10.1016\/S0140-6736(12)60272-4","volume":"379","author":"IG Morgan","year":"2012","unstructured":"Morgan IG, Ohno-Matsui K, Saw SM. 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