Toric implantable collamer lens for moderate to high myopic astigmatism: 3-year follow-up

Background To evaluate the 3-year clinical outcomes after toric implantable collamer lens (ICL) implantation for the management of moderate to high myopic astigmatism. Methods Thirty-four eyes of 20 patients who underwent toric ICL implantation were reviewed. All eyes completed 3-year follow-up. Uncorrected (UDVA) and corrected (CDVA) distance LogMAR visual acuities, refraction, endothelial cell density (ECD), and surgical complications were evaluated. Vectorial analysis of astigmatic correction was also done. Results A significant improvement in UDVA, CDVA, manifest spherical and cylindrical refraction was observed at 1 week and remained stable after 3 years. Twenty-six eyes (76.5 %) gained lines of CDVA, and two eyes (5.9 %) showed a loss of 1 line of CDVA. The spherical equivalent (SE) was within ±0.50 D of emmetropia in 18 eyes (52.9 %) and within ±1.00 D in 28 eyes (82.4 %). Differences between target-induced astigmatism (TIA) and surgically-induced astigmatism (SIA) were statistically significant (p < 0.01), and a trend to undercorrection of the refractive astigmatism was present after 3 years. The magnitude of flattening effect (FE) was found to be significantly lower than the magnitude of TIA (p < 0.01). The magnitude of the torque vector was always positive, with a value below 0.50 D in all cases. No vision-threatening complications were observed during the follow-up. Conclusion Toric ICL implantation is an effective and safe surgical option that provides a relatively predictable and stable refractive correction of myopic astigmatism. Further improvements are needed to minimize the degree of undercorrection.

Twenty-year advanced DInSAR analysis of severe land subsidence: The Alto Guadalentín Basin (Spain) case study

A twenty-year period of severe land subsidence evolution in the Alto Guadalentín Basin (southeast Spain) is monitored using multi-sensor SAR images, processed by advanced differential interferometric synthetic aperture radar (DInSAR) techniques. The SAR images used in this study consist of four datasets acquired by ERS-1/2, ENVISAT, ALOS and COSMO-SkyMed satellites between 1992 and 2012. The integration of ground surface displacement maps retrieved for different time periods allows us to quantify up to 2.50 m of cumulated displacements that occurred between 1992 and 2012 in the Alto Guadalentín Basin. DInSAR results were locally compared with global positioning system (GPS) data available for two continuous stations located in the study area, demonstrating the high consistency of local vertical motion measurements between the two different surveying techniques. An average absolute error of 4.6 ± 4 mm for the ALOS data and of 4.8 ± 3.5 mm for the COSMO-SkyMed data confirmed the reliability of the analysis. The spatial analysis of DInSAR ground surface displacement reveals a direct correlation with the thickness of the compressible alluvial deposits. Detected ground subsidence in the past 20 years is most likely a consequence of a 100–200 m groundwater level drop that has persisted since the 1970s due to the overexploitation of the Alto Guadalentín aquifer system. The negative gradient of the pore pressure is responsible for the extremely slow consolidation of a very thick (> 100 m) layer of fine-grained silt and clay layers with low vertical hydraulic permeability (approximately 50 mm/h) wherein the maximum settlement has still not been reached.

Implantation of a diffractive trifocal intraocular lens: One-year follow-up

Purpose: To evaluate the visual, refractive, contrast-sensitivity, and aberrometric outcomes during a 1-year follow-up after implantation of a trifocal intraocular lens (IOL). Setting: Premium Clinic, Teplice, Czech Republic. Design: Prospective case series. Methods: This study included eyes of patients having cataract surgery with implantation of the trifocal IOL model AT Lisa tri 839MP. Distance, intermediate (66 and 80 cm), and near (33 and 40 cm) vision; contrast sensitivity; aberrometric outcomes; and the defocus curve were evaluated during a 12-month follow-up. The level of posterior capsule opacification (PCO) was also evaluated. Results: In 120 eyes (60 patients), 1 month postoperatively, an improvement was observed in all visual parameters (P ≤ .03) except corrected near and intermediate visual acuities (both P ≥ .05). From 1 month to 12 months postoperatively, small but statistically significant changes were observed in uncorrected and corrected distance and near visual acuities (all P ≤ .03) and in uncorrected intermediate visual acuity (P = .01). In the defocus curve, no significant differences were found between visual acuities corresponding to defocus levels of −1.0 diopter (D) and −2.0 D (P = .22). The level of ocular spherical aberration decreased statistically significantly at 6 months (P < .001). Ocular and internal higher-order aberrations increased minimally but significantly from 6 to 12 months postoperatively (P < .001). The mean 12-month PCO score was 0.32 ± 0.44 (SD). Four eyes (3.3%) required neodymium:YAG capsulotomy. Conclusion: The trifocal IOL provided complete and stable visual restoration after cataract surgery during a 12-month follow-up, with good levels of visual quality.