Determining which factors influence the optimum multifocal contact lens correction for presbyopia

Presbyopia is a consequence of ageing and is therefore increasing inprevalence due to an increase in the ageing population. Of the many methods available to manage presbyopia, the use of contact lenses is indeed a tried and tested reversible option for those wishing to be spectacle free. Contact lens options to correct presbyopia include multifocal contact lenses and monovision.Several options have been available for many years with available guides to help choose multifocal contact lenses. However there is no comprehensive way to help the practitioner selecting the best option for an individual. An examination of the simplest way of predicting the most suitable multifocal lens for a patient will only enhance and add to the current evidence available. The purpose of the study was to determine the current use of presbyopic correction modalities in an optometric practice population in the UK and to evaluate and compare the optical performance of four silicone hydrogel soft multifocal contact lenses and to compare multifocal performance with contact lens monovision. The presbyopic practice cohort principal forms of refractive correction were distance spectacles (with near and intermediate vision providedby a variety of other forms of correction), varifocal spectacles and unaided distance with reading spectacles, with few patients wearing contact lenses as their primary correction modality. The results of the multifocal contact lens randomised controlled trial showed that there were only minor differences in corneal physiology between the lens options. Visual acuity differences were observed for distance targets, but only for low contrast letters and under mesopic lighting conditions. At closer distances between 20cm and 67cm, the defocus curves demonstrated that there were significant differences in acuity between lens designs (p < 0.001) and there was an interaction between the lens design and the level of defocus (p < 0.001). None of the lenses showed a clear near addition, perhaps due to their more aspheric rather than zoned design. As expected, stereoacuity was reduced with monovision compared with the multifocal contact lens designs, although there were some differences between the multifocal lens designs (p < 0.05). Reading speed did not differ between lens designs (F = 1.082, p = 0.368), whereas there was a significant difference in critical print size (F = 7.543, p < 0.001). Glare was quantified with a novel halometer and halo size was found to significantly differ between lenses(F = 4.101, p = 0.004). The rating of iPhone image clarity was significantly different between presbyopic corrections (p = 0.002) as was the Near Acuity Visual Questionnaire (NAVQ) rating of near performance (F = 3.730, p = 0.007).The pupil size did not alter with contact lens design (F = 1.614, p = 0.175), but was larger in the dominant eye (F = 5.489, p = 0.025). Pupil decentration relative to the optical axis did not alter with contact lens design (F = 0.777, p =0.542), but was also greater in the dominant eye (F = 9.917, p = 0.003). It was interesting to note that there was no difference in spherical aberrations induced between the contact lens designs (p > 0.05), with eye dominance (p > 0.05) oroptical component (ocular, corneal or internal: p > 0.05). In terms of subjective patient lens preference, 10 patients preferred monovision,12 Biofinity multifocal lens, 7 Purevision 2 for Presbyopia, 4 AirOptix multifocal and 2 Oasys multifocal contact lenses. However, there were no differences in demographic factors relating to lifestyle or personality, or physiological characteristics such as pupil size or ocular aberrations as measured at baseline,which would allow a practitioner to identify which lens modality the patient would prefer. In terms of the performance of patients with their preferred lens, it emerged that Biofinity multifocal lens preferring patients had a better high contrast acuity under photopic conditions, maintained their reading speed at smaller print sizes and subjectively rated iPhone clarity as better with this lens compared with the other lens designs trialled. Patients who preferred monovision had a lower acuity across a range of distances and a larger area of glare than those patients preferring other lens designs that was unexplained by the clinical metrics measured. However, it seemed that a complex interaction of aberrations may drive lens preference. New clinical tests or more diverse lens designs which may allow practitioners to prescribe patients the presbyopic contact lens option that will work best for them first time remains a hope for the future.

Nonlinear pulse distortion in few-mode fiber

Nonlinear pulse propagation in a few mode fiber is experimentally investigated, by measuring temporal and phase responses of the output pulses by use of a frequency discriminator technique, showing that self-phase modulation, dispersion and linear mode-coupling are the dominant effects.

Influence of QT correction on temporal and amplitude features for human identification via ECG

Identification of humans via ECG is being increasingly studied because it can have several advantages over the traditional biometric identification techniques. However, difficulties arise because of the heartrate variability. In this study we analysed the influence of QT interval correction on the performance of an identification system based on temporal and amplitude features of ECG. In particular we tested MLP, Naive Bayes and 3-NN classifiers on the Fantasia database. Results indicate that QT correction can significantly improve the overall system performance. © 2013 IEEE.

Prediction of welding distortion in butt joint of thin plates

This paper investigates distortions and residual stresses induced in butt joint of thin plates using Metal Inert Gas welding. A moving distributed heat source model based on Goldak's double-ellipsoid heat flux distribution is implemented in Finite Element (FE) simulation of the welding process. Thermo-elastic-plastic FE methods are applied to modelling thermal and mechanical behaviour of the welded plate during the welding process. Prediction of temperature variations, fusion zone and heat affected zone as well as longitudinal and transverse shrinkage, angular distortion, and residual stress is obtained. FE analysis results of welding distortions are compared with existing experimental and empirical predictions. The welding speed and plate thickness are shown to have considerable effects on welding distortions and residual stresses. © 2009 Elsevier Ltd. All rights reserved.

Advantages of strong mode coupling for suppression of nonlinear distortion in few-mode fibers

Nonlinear distortion in few-mode fibers for intermediate coupling is studied for the first time. Coupling strengths beyond -20 dB/100m give suppression of nonlinear distortion below the isolated mode without mode coupling.

Trapping and unlimited delay of light pulses at microscale without distortion

A tunable bottle microresonator can trap an optical pulse of the given spectral width, hold it as long as the material losses permit, and release without distortion.

Study of effect on tensile stress test from distortion of fibre laser welded Ti6Al4V using FEA

Distortion is one type of defect in the weld, which is troublesome for some reasons, especially in thin plate welding. Distortion was found in fibre laser welding processing for 0.7mm thickness Ti6Al4V plate. The purpose of this paper is to understand and evaluate the effect of distortion on stress level by FEA and tensile test. A group of 0.7mm Ti6Al4V plates welded using continuous wave fibre laser. FEA models were established for fibre laser welded Ti6Al4V in abaqus 6.7. © (2011) Trans Tech Publications.

Investigating the utility of clinical assessments to predict success with presbyopic contact lens correction

PURPOSE: To determine the utility of a range of clinical and non-clinical indicators to aid the initial selection of the optimum presbyopic contact lens. In addition, to assess whether lens preference was influenced by the visual performance compared to the other designs trialled (intra-subject) or compared to participants who preferred other designs (inter-subject). METHODS: A double-masked randomised crossover trial of Air Optix Aqua multifocal, PureVision 2 for Presbyopia, Acuvue OASYS for Presbyopia, Biofinity multifocal and monovision was conducted on 35 presbyopes (54.3±6.2years). Participant lifestyle, personality, pupil characteristics and aberrometry were assessed prior to lens fitting. After 4 weeks of wear, high and low contrast visual acuity (VA) under photopic and mesopic conditions, reading speed, Near Activity Visual Questionnaire (NAVQ) rating, subjective quality-of-vision scoring, defocus curves, stereopsis, halometry, aberrometry and ocular physiology were quantified. RESULTS: After trialling all the lenses, preference was mixed (n=12 Biofinity, n=10 monovision, n=7 Purevision, n=4 Air Optix Aqua, n=2 Oasys). Lens preference was not dependent on personality (F=1.182, p=0.323) or the hours spent working at near (p=0.535) or intermediate (p=0.759) distances. No intersubject or strong intrasubject relationships emerged between lens preference and reading speed, NAVQ rating, halo size, aberrometry or ocular physiology (p>0.05). CONCLUSIONS: Participant lifestyle and personality, ocular optics, contact lens visual performance and ocular physiology provided poor indicators of the preferred lens type after 4 weeks of wear. This is confounded by the wide range of task visual demands of presbyopes and the limited optical differences between current multifocal contact lens designs.

DC-link voltage control strategy for reducing capacitance and total harmonic distortion in single-phase grid-connected photovoltaic inverters

High-volume capacitance is required to buffer the power difference between the input and output ports in single-phase grid-connected photovoltaic inverters, which become an obstacle to high system efficiency and long device lifetime. Furthermore, total harmonic distortion becomes serious when the system runs into low power level. In this study, a comprehensive analysis is introduced for two-stage topology with the consideration of active power, DC-link (DCL) voltage, ripple and capacitance. This study proposed a comprehensive DCL voltage control strategy to minimise the DCL capacitance while maintaining a normal system operation. Furthermore, the proposed control strategy is flexible to be integrated with the pulse-skipping control that significantly improves the power quality at light power conditions. Since the proposed control strategy needs to vary DCL voltage, an active protection scheme is also introduced to prevent any voltage violation across the DCL. The proposed control strategy is evaluated by both simulation and experiments, whose results confirm the system effectiveness.

Suppression of nonlinear distortion in few-mode fibres using strong mode coupling

In this paper, we investigate the impact of linear mode coupling on the efficiency of intermodal four-wave mixing and on the group delay statistics in few-mode fibres. The investigation will include not only the weak or strong linear coupling regimes, but also the transition region between them, the intermediate coupling regime. This analysis will allow to assess the level of coupling strength require to suppress the nonlinear distortion in a few-mode fibre below the level of distortion for single-mode propagation without mode coupling.

Nonlinear distortion in mode delay compensated few-mode fibre spans with intermediate coupling

Nonlinear distortion in delay-compensated spans for intermediate coupling is studied for the first time. Coupling strengths under -30dB/100m allow distortion reduction using shorter compensation lengths and higher delays. For higher coupling strengths no significant penalty results from shorter compensation lengths.