Estimation of the Central Corneal Power in Keratoconus: Theoretical and Clinical Assessment of the Error of the Keratometric Approach

Purpose: The aim of this study was to analyze theoretically the errors in the central corneal power calculation in eyes with keratoconus when a keratometric index (nk) is used and to clinically confirm the errors induced by this approach. Methods: Differences (DPc) between central corneal power estimation with the classical nk (Pk) and with the Gaussian equation (PGauss c ) in eyes with keratoconus were simulated and evaluated theoretically, considering the potential range of variation of the central radius of curvature of the anterior (r1c) and posterior (r2c) corneal surfaces. Further, these differences were also studied in a clinical sample including 44 keratoconic eyes (27 patients, age range: 14–73 years). The clinical agreement between Pk and PGauss c (true net power) obtained with a Scheimpflug photography–based topographer was evaluated in such eyes. Results: For nk = 1.3375, an overestimation was observed in most cases in the theoretical simulations, with DPc ranging from an underestimation of 20.1 diopters (D) (r1c = 7.9 mm and r2c = 8.2 mm) to an overestimation of 4.3 D (r1c = 4.7 mm and r2c = 3.1 mm). Clinically, Pk always overestimated the PGauss c given by the topography system in a range between 0.5 and 2.5 D (P , 0.01). The mean clinical DPc was 1.48 D, with limits of agreement of 0.71 and 2.25 D. A very strong statistically significant correlation was found between DPc and r2c (r = 20.93, P , 0.01). Conclusions: The use of a single value for nk for the calculation of corneal power is imprecise in keratoconus and can lead to significant clinical errors.

The relevance of harmonising the technical level of social housing with the urban level of the neighbourhood through the example of the 500 dwellings in Albacete

The Architecture and Household Trade Union built nearly 2,000 subsidized dwellings in Albacete from 1941 to 1971. It was the responsible entity from the end of the Civil War until the beginning of Democracy of the social policy programs in Spain. Later on, and together with the National Housing Institute, were responsible for the construction activity. Its limited budget, scarcity of technical and human resources and an urgent need for new housing developments, constituted the basis for producing a vast housing market of low construction qualities. However, thanks to the true architectonic expertise of some of the professionals, some of the developments were designed with a clear urban strategy and in direct relation with the city, which characterizes them to be studied and conserved. This is the case for the selected development for the analysis, the urban complex of the 500 dwellings in Albacete, the Hermanos Falcó Neighborhood. Designed and built between 1963, Alfonso Crespo and Adolfo Gil architects, and 1977 second reformed project by the architect Fernando Rodríguez. It is characterized by its layout on the territory, its controlled relation with the city and its different types of open blocks. Above all, its spatial and human scale strengths, directly related to the European post-war proposals, have to be emphasized; although its technical deficiencies affect the interior quality of the houses. This paper examines its virtues and failures and proposes, using current tools, its renovation. This proposal main aims are to extend its lifetime and develop the particular and urban sustainability levels.

La nueva Estadística de Migraciones: una buena elección por parte del INE

El Instituto Nacional de Estadística ha decidido elaborar una nueva Estadística de Migraciones utilizando como base la Estadística de Variaciones Residenciales. En este artículo se aportan algunos argumentos que apoyan esta decisión, ante la persistente falta de coherencia entre las fuentes del sistema estadístico español para captar la movilidad. En particular, se profundiza en los problemas de subestimación e inconsistencia interna de la Encuesta de Población Activa para medir la inmigración, a la vista de las diferencias entre las tres series de flujos de inmigración internacional que es posible estimar a partir de la misma.

Technical efficiency in the retail food industry: the influence of inventory investment, wage levels, and age of the firm

The objective of this paper is to estimate technical efficiency in retailing; and the influence of inventory investment, wage levels, and firm age on this efficiency. We use the output supermarket chains’ sales volume, calculated isolating the retailer price effect on its sales revenue. This output allows us to estimate a strictly technical concept of efficiency. The methodology is based on the estimation of a stochastic parametric function. The empirical analyses applied to panel data on a sample of 42 supermarket chains between 2000 and 2002 show that inventory investment and wage level have an impact on technical efficiency. In comparison, the effect of these factors on efficiency calculated through a monetary output (sales revenue) shows some differences that could be due to aspects related to product prices.

Spectral BRDF-based determination of proper measurement geometries to characterize color shift of special effect coatings

A reduced set of measurement geometries allows the spectral reflectance of special effect coatings to be predicted for any other geometry. A physical model based on flake-related parameters has been used to determine nonredundant measurement geometries for the complete description of the spectral bidirectional reflectance distribution function (BRDF). The analysis of experimental spectral BRDF was carried out by means of principal component analysis. From this analysis, a set of nine measurement geometries was proposed to characterize special effect coatings. It was shown that, for two different special effect coatings, these geometries provide a good prediction of their complete color shift.

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.