Comparative analysis of constructive solutions for thermal insulation by using computer applications in building rehabilitation in Mediterranean climate. The Spanish case

The new Spanish legislation in Energy Saving, similar to European regulation, provides new technical requirements to adequate technical solutions used in integral rehabilitation of existing buildings. The aim of this paper is to present, analyze and discuss the main thermal insulation constructive solutions best suited to a Mediterranean climate, and conclude on their suitability under the legislation in Energy Saving. The proposed methodology is based on the most usual constructive solutions in integral rehabilitation of buildings by analyzing their outstanding design features, by studying its construction details and then by applying the software provided by the Spanish legislation of energy efficiency in buildings. The results of the study evaluate and classify several solutions for façade rehabilitation according to energy efficiency criteria and their suitability for this type of weather, verifying the necessity of using software applications in energy saving for the proper design of constructive solutions in building rehabilitation.

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.