Clinical utility of the KAMRA corneal inlay

The treatment of presbyopia has been the focus of much scientific and clinical research over recent years, not least due to an increasingly aging population but also the desire for spectacle independence. Many lens and nonlens-based approaches have been investigated, and with advances in biomaterials and improved surgical methods, removable corneal inlays have been developed. One such development is the KAMRA™ inlay where a small entrance pupil is exploited to create a pinhole-type effect that increases the depth of focus and enables improvement in near visual acuity. Short- and long-term clinical studies have all reported significant improvement in near and intermediate vision compared to preoperative measures following monocular implantation (nondominant eye), with a large proportion of patients achieving Jaeger (J) 2 to J1 (~0.00 logMAR to ~0.10 logMAR) at the final follow-up. Although distance acuity is reduced slightly in the treated eye, binocular visual acuity and function remain very good (mean 0.10 logMAR or better). The safety of the inlay is well established and easily removable, and although some patients have developed corneal changes, these are clinically insignificant and the incidence appears to reduce markedly with advancements in KAMRA design, implantation technique, and femtosecond laser technology. This review aims to summarize the currently published peer-reviewed studies on the safety and efficacy of the KAMRA inlay and discusses the surgical and clinical outcomes with respect to the patient’s visual function.

Case-based reasoning enabling database mining for cryo-preserving algae applications

Case-based Reasoning's (CBR) origins were stimulated by a desire to understand how people remember information and are in turn reminded of information, and that subsequently it was recognized that people commonly solve problems by remembering how they solved similar problems in the past. Thus CBR became an appropriate way to find out the most suitable solution method for a new problem based on the old methods for the same or even similar problems. The research highlights how to use CBR to aid biologists in finding the best method to cryo preserve algae. The study found CBR could be used successfully to find the similarity percentage between the new algae and old cases in the case base. The prediction result showed approximately 93.75% accuracy, which proves the CBR system can offer appropriate recommendations for most situations. © 2011 IEEE.

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.

Analyzing evacuation decisions using multi-attribute utility theory (MAUT)

Emergency managers are faced with critical evacuation decisions. These decisions must balance conflicting objectives as well as high levels of uncertainty. Multi-Attribute Utility Theory (MAUT) provides a framework through which objective trade-offs can be analyzed to make optimal evacuation decisions. This paper is the result of data gathered during the European Commission Project, Evacuation Responsiveness by Government Organizations (ERGO) and outlines a preliminary decision model for the evacuation decision. The illustrative model identifies levels of risk at which point evacuation actions should be taken by emergency managers in a storm surge scenario with forecasts at 12 and 9 hour intervals. The results illustrate how differences in forecast precision affect the optimal evacuation decision. Additional uses for this decision model are also discussed along with improvements to the model through future ERGO data-gathering.