Analysis of internal astigmatism and higher order aberrations in eyes implanted with a new diffractive multifocal toric intraocular lens

Background To evaluate the intraocular lens (IOL) position by analyzing the postoperative axis of internal astigmatism as well as the higher-order aberration (HOA) profile after cataract surgery following the implantation of a diffractive multifocal toric IOL. Methods Prospective study including 51 eyes with corneal astigmatism of 1.25D or higher of 29 patients with ages ranging between 20 and 61 years old. All cases underwent uneventful cataract surgery with implantation of the AT LISA 909 M toric IOL (Zeiss). Visual, refractive and corneal topograpy changes were evaluated during a 12-month follow-up. In addition, the axis of internal astigmatism as well as ocular, corneal, and internal HOA (5-mm pupil) were evaluated postoperatively by means of an integrated aberrometer (OPD Scan II, Nidek). Results A significant improvement in uncorrected distance and near visual acuities (p < 0.01) was found, which was consistent with a significant correction of manifest astigmatism (p < 0.01). No significant changes were observed in corneal astigmatism (p = 0.32). With regard to IOL alignment, the difference between the axes of postoperative internal and preoperative corneal astigmatisms was close to perpendicularity (12 months, 87.16° ± 7.14), without significant changes during the first 6 months (p ≥ 0.46). Small but significant changes were detected afterwards (p = 0.01). Additionally, this angular difference correlated with the postoperative magnitude of manifest cylinder (r = 0.31, p = 0.03). Minimal contribution of intraocular optics to the global magnitude of HOA was observed. Conclusions The diffractive multifocal toric IOL evaluated is able to provide a predictable astigmatic correction with apparent excellent levels of optical quality during the first year after implantation.

Conformational changes of dissolved humic and fulvic superstructures with progressive iron complexation

Conformational changes of a humic acid (HA) and a fulvic acid (FA) induced by iron complexation were followed by high-performance size exclusion chromatography (HPSEC) with both UV–vis and refractive index (RI) detectors. Molecular size distribution was reduced for HA and increased for FA with progressive iron complexation. Since interactions of Fe with humic components are electrostatic, it is likely that the triple-charged Fe ions formed stronger complexes with the more acidic hydrophilic and hydrated FA than with the less acidic and more hydrophobic HA. The large content of ionized carboxyl groups in FA, thus favored the formation of intra- or intermolecular bridges between the negatively charged fulvic acid molecules, and led to more compact and larger size network than for HA. Conversely, iron complexation with HA disrupted the humic conformational arrangements stabilized by only weak hydrophobic bonds into smaller-size aggregates of greater conformational stability due to formation of strong metal complexes. These results confirmed that humic molecules in solution were organized in supramolecular associations of relatively small molecules loosely bound together by dispersive interactions and hydrogen bonds, and they specifically responded to chemical changes brought about by metal additions. The present study revealed the molecular changes occurring in superstructures of natural organic matter when in metal complexes and contributed to understand and predict the environmental behavior in waters and soil of metal complexes with natural organic matter.

Error induced by the estimation of the corneal power and the effective lens position with a rotationally asymmetric refractive multifocal intraocular lens

AIM: To evaluate the prediction error in intraocular lens (IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position (ELP). METHODS: Retrospective study including a total of 25 eyes of 13 patients (age, 50 to 83y) with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL (Oculentis GmbH, Germany). In all cases, an adjusted IOL power (PIOLadj) was calculated based on Gaussian optics using a variable keratometric index value (nkadj) for the estimation of the corneal power (Pkadj) and on a new value for ELP (ELPadj) obtained by multiple regression analysis. This PIOLadj was compared with the IOL power implanted (PIOLReal) and the value proposed by three conventional formulas (Haigis, Hoffer Q and Holladay). RESULTS: PIOLReal was not significantly different than PIOLadj and Holladay IOL power (P>0.05). In the Bland and Altman analysis, PIOLadj showed lower mean difference (-0.07 D) and limits of agreement (of 1.47 and -1.61 D) when compared to PIOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELPadj was significantly lower than ELP calculated with other conventional formulas (P<0.01) and was found to be dependent on axial length, anterior chamber depth and Pkadj. CONCLUSION: Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing the keratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors.

Comparative analysis of the visual performance and aberrometric outcomes with a new hybrid and two silicone hydrogel multifocal contact lenses: a pilot study

Background: The aim was to evaluate the visual performance achieved with a new multifocal hybrid contact lens and to compare it with that obtained with two other currently available multifocal soft contact lenses. Methods: This pilot prospective comparative study comprised a total of 16 presbyopic eyes of eight patients ranging in age from 43 to 58 years. All patients were fitted with three different models of multifocal contact lens: Duette multifocal (SynergEyes), Air Optix AQUA multifocal (Alcon) and Biofinity multifocal (CooperVision). Fittings were performed randomly in each patient according to a random number sequence, with a wash-out period between fittings of seven days. At two weeks post-fitting, visual, photopic contrast sensitivity and ocular aberrometry were evaluated. Results: No statistically significant differences were found in distance and near visual acuity achieved with the three different types of multifocal contact lens (p ≥ 0.05). Likewise, no significant differences between lenses were found in the monocular and binocular defocus curve (p ≥ 0.10). Concerning contrast sensitivity, better monocular contrast sensitivities for 6, 12 and 18 cycles per degree were found with the Duette and Air Optix multifocal compared to Biofinity (p = 0.02). Binocularly, differences between lenses were not significant (p ≥ 0.27). Furthermore, trefoil aberration was significantly higher with Biofinity multifocal (p < 0.01) and Air Optix (p = 0.01) multifocal compared to Duette. Conclusions: The Duette multifocal hybrid contact lens seems to provide similar visual quality outcomes in presbyopic patients with low corneal astigmatism, when compared with other soft multifocal contact lenses. This preliminary result should be confirmed in studies with larger samples.

Ultrasonic and X-ray computed tomography characterization of progressive fracture damage in low-porous carbonate rocks

This paper studies the fracturing process in low-porous rocks during uniaxial compressive tests considering the original defects and the new mechanical cracks in the material. For this purpose, five different kinds of rocks have been chosen with carbonate mineralogy and low porosity (lower than 2%). The characterization of the fracture damage is carried out using three different techniques: ultrasounds, mercury porosimetry and X-ray computed tomography. The proposed methodology allows quantifying the evolution of the porous system as well as studying the location of new cracks in the rock samples. Intercrystalline porosity (the smallest pores with pore radius < 1 μm) shows a limited development during loading, disappearing rapidly from the porosimetry curves and it is directly related to the initial plastic behaviour in the stress–strain patterns. However, the biggest pores (corresponding to the cracks) suffer a continuous enlargement until the unstable propagation of fractures. The measured crack initiation stress varies between 0.25 σp and 0.50 σp for marbles and between 0.50 σp and 0.85 σp for micrite limestone. The unstable propagation of cracks is assumed to occur very close to the peak strength. Crack propagation through the sample is completely independent of pre-existing defects (porous bands, stylolites, fractures and veins). The ultrasonic response in the time-domain is less sensitive to the fracture damage than the frequency-domain. P-wave velocity increases during loading test until the beginning of the unstable crack propagation. This increase is higher for marbles (between 15% and 30% from initial vp values) and lower for micrite limestones (between 5% and 10%). When the mechanical cracks propagate unstably, the velocity stops to increase and decreases only when rock damage is very high. Frequency analysis of the ultrasonic signals shows clear changes during the loading process. The spectrum of treated waveforms shows two main frequency peaks centred at low (~ 20 kHz) and high (~ 35 kHz) values. When new fractures appear and grow the amplitude of the high-frequency peak decreases, while that of the low-frequency peak increases. Besides, a slight frequency shift is observed towards higher frequencies.