Visual and optical performance and quality of life after implantation of posterior chamber phakic intraocular lens

Purpose To evaluate visual, optical, and quality of life (QoL) outcomes and intercorrelations after bilateral implantation of posterior chamber phakic intraocular lenses. Methods Twenty eyes with high to moderate myopia of 10 patients that underwent PRL implantation (Phakic Refractive Lens, Carl Zeiss Meditec AG) were examined. Refraction, visual acuity, photopic and low mesopic contrast sensitivity (CS) with and without glare, ocular aberrations, as well as QoL outcomes (National Eye Institute Refractive Error Quality of Life Instrument-42, NEI RQL-42) were evaluated at 12 months postoperatively. Results Significant improvement in uncorrected (UDVA) and best-corrected distance (CDVA) visual acuities were found postoperatively (p < 0.01), with significant reduction in spherical equivalent (p < 0.01). Low mesopic CS without glare was significantly better than measurements with glare for 1.5, 3, and 6 cycles/degree (p < 0.01). No significant correlations between higher order root mean square (RMS) with CDVA (r = −0.26, p = 0.27) and CS (r ≤ 0.45, p ≥ 0.05) were found. Postoperative binocular photopic CS for 12 cycles/degree and 18 cycles/degree correlated significantly with several RQL-42 scales. Glare index correlated significantly with CS measures and scotopic pupil size (r = −0.551, p = 0.04), but not with higher order RMS (r = −0.02, p = 0.94). Postoperative higher order RMS, postoperative primary coma and postoperative spherical aberration was significant higher for 5-mm pupil diameter (p < 0.01) compared with controls. Conclusions Correction of moderate to high myopia by means of PRL implantation had a positive impact on CS and QoL. The aberrometric increase induced by the surgery does not seem to limit CS and QoL. However, perception of glare is still a relevant disturbance in some cases possibly related to the limitation of the optical zone of the PRL.

How to measure healthiness in buildings: Experiences in teaching with BIM tools

Introducing teaching about healthy solutions in buildings and BIM has been a challenge for the University of Alicante. Teaching attached to very tighten study plans conditioned the types of methods that could be used in the past. The worldwide situation of crisis that especially reached Spain and the bursting of the housing bubble generated a lack of employment that reached universities where careers related to construction, Architecture and Architectural Technologist, suffered a huge reduction in the number of students enrolled. In the case of the University of Alicante, students’ enrolment for Architectural Technology reached an 80% reduction. The necessity of a reaction against this situation made the teachers be innovative and use the new Bologna adapted study plans to develop new teaching experiences introducing new concepts: people wellbeing in buildings and BIM. Working with healthy solutions in buildings provided new approaches for building design and construction as an alternative to sustainability. For many years sustainability was the concept that applied to housing gave buildings an added value and the possibility of having viability in a very complex scenario. But after lots of experiences, the approved methodologies for obtaining sustainable housing were ambiguous and at the end, investors, designers, constructors and purchasers cannot find real and validated criteria for obtaining an effective sustainable house. It was the moment to work with new ideas and concepts and start facing buildings from the users’ point of view. At the same time the development of new tools, BIM, has opened a wide range of opportunities, innovative and suggestive, that allows simulation and evaluation of many building factors. This paper describes the research in teaching developed by the University of Alicante to adapt the current study plans, introducing work with healthy solutions in buildings and the use of BIM, with the aim of attracting students by improving their future employability. Pilot experiences have been carried out in different subjects based on the work with projects and case studies under an international frame with the cooperation of different European partner universities. The use of BIM tools, introduced in 2014, solved the problems that appeared in some subjects, mainly building construction, and helped with the evaluation of some healthy concepts that presented difficulties until this moment as knowledge acquired by the students was hard to be evaluated. The introduction of BIM tools: Vasari, FormIt, Revit and Light Control among others, allowed the study of precise healthy concepts and provided the students a real understand of how these different parameters can condition a healthy architectural space. The analysis of the results showed a clear acceptance by the students and gave teachers the possibility of opening new research lines. At the same time, working with BIM tools to obtain healthy solutions in building has been a good option to improve students’ employability as building market in Spain is increasing the number of specialists in BIM with a wider knowledge.