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.

New-Generation Hybrid Contact Lens for the Management of Extreme Irregularity in a Thin Cornea After Unsuccessful Excimer Laser Refractive Surgery

Purpose: To report a very successful outcome obtained with the fitting of a new-generation hybrid contact lens of reverse geometry in a thin cornea with extreme irregularity due to the presence of a central island after unsuccessful myopic excimer laser refractive surgery. Methods: A 32-year-old man attended to our clinic complaining of very poor vision in his right eye after bilateral laser in situ keratomileusis (treatment or surgery) for myopia correction and some additional retreatments afterward. After a comprehensive ocular evaluation, contact lens fitting with a reverse geometry hybrid contact lens (SynergEyes PS, SynergEyes, Carlsbad, CA) was proposed as a solution for this case. Visual, refractive, and ocular aberrometric outcomes with the contact lens were evaluated. Results: Distance visual acuity improved from a prefitting uncorrected value of 20/200 to a postfitting corrected value of 20/16. Prefitting manifest refraction was +6.00 sphere and −3.00 cylinder at 70°, with a corrected distance visual acuity of 20/40. Higher order root mean square for a 5-mm pupil changed from a prefitting value of 1.45 to 0.34 µm with the contact lens. The contact lens wearing was reported as comfortable, and the patient was very satisfied with this solution. Conclusions: The SynergEyes PS contact lens seems to be an excellent option for the visual rehabilitation of corneas with extreme irregularity after myopic excimer laser surgery, minimizing the level of higher order aberrations and providing an excellent visual outcome.

The X-ray outburst of the Galactic Centre magnetar SGR J1745−2900 during the first 1.5 year

In 2013 April a new magnetar, SGR 1745−2900, was discovered as it entered an outburst, at only 2.4 arcsec angular distance from the supermassive black hole at the centre of the Milky Way, Sagittarius A*. SGR 1745−2900 has a surface dipolar magnetic field of ∼2 × 1014 G, and it is the neutron star closest to a black hole ever observed. The new source was detected both in the radio and X-ray bands, with a peak X-ray luminosity LX ∼ 5 × 1035 erg s−1. Here we report on the long-term Chandra (25 observations) and XMM–Newton (eight observations) X-ray monitoring campaign of SGR 1745−2900 from the onset of the outburst in 2013 April until 2014 September. This unprecedented data set allows us to refine the timing properties of the source, as well as to study the outburst spectral evolution as a function of time and rotational phase. Our timing analysis confirms the increase in the spin period derivative by a factor of ∼2 around 2013 June, and reveals that a further increase occurred between 2013 October 30 and 2014 February 21. We find that the period derivative changed from 6.6 × 10−12 to 3.3 × 10−11 s s−1 in 1.5 yr. On the other hand, this magnetar shows a slow flux decay compared to other magnetars and a rather inefficient surface cooling. In particular, starquake-induced crustal cooling models alone have difficulty in explaining the high luminosity of the source for the first ∼200 d of its outburst, and additional heating of the star surface from currents flowing in a twisted magnetic bundle is probably playing an important role in the outburst evolution.

Information Search Habits of First Year College Students

New technologies have transformed teaching processes and enabled new ways of study and learning. In these activities, it is suspected that the students don't make good use of new available technologies or, in the best case, they are underused. The analysis of this issue with the design of strategies to correct any defects found is the motivation that supports the development of this work and the main purpose of it. Evaluate information search habits used by the student and analyse their deduct synthesis and processing capabilities of the results found. The researchers of this study are university teachers of first year subjects, which allows them to know the information search performances by students.

Fitting of a New Design of Full Scleral Contact Lens in Advanced Keratoconus with Previous Implantation of Intracorneal Ring Segments

This case report reports the visual rehabilitation obtained with the fitting of a new design of full scleral contact lens (ICD 16.5 contact lens, Paragon Vision Sciences, distributed by Lenticon, Madrid, Spain) in a cornea with advanced keratoconus and previous implantation of intracorneal ring segment with a very limited effect. This eye had a refraction of –3.00 × 55° cylinder, providing a visual acuity of 0.5 LogMAR. The topographic pattern was very irregular with the presence of a significant central protrusion and a significant central corneal thinning. Some previous unsuccessful fittings have been performed with corneal and corneal-scleral lenses. A comfortable wearing was achieved with a fully scleral contact lens of 4600 μm of sagittal height, optical power of –11.25 D, and providing an apical clearance of 196 μm. A visual acuity of 0.0 LogMAR combined with a relevant aberrometric improvement was achieved with this contact lens. The patient was completely satisfied with the fitting. The result was maintained during 1 year after the fitting. Full scleral lenses are then able to provide comfortable wear and a significant increase in visual acuity combined with a significant improvement in the visual quality in eyes with advanced keratoconus.