Cost-effectiveness of internal limiting membrane peeling versus no peeling for patients with an idiopathic full-thickness macular hole:Results from a randomised controlled trial

Aim: To determine whether internal limiting membrane (ILM) peeling is cost-effective compared with no peeling for patients with an idiopathic stage 2 or 3 full-thickness macular hole. Methods: A cost-effectiveness analysis was performed alongside a randomised controlled trial. 141 participants were randomly allocated to receive macular-hole surgery, with either ILM peeling or no peeling. Health-service resource use, costs and quality of life were calculated for each participant. The incremental cost per quality-adjusted life year (QALY) gained was calculated at 6 months. Results: At 6 months, the total costs were on average higher (£424, 95% CI -182 to 1045) in the No Peel arm, primarily owing to the higher reoperation rate in the No Peel arm. The mean additional QALYs from ILM peel at 6 months were 0.002 (95% CI 0.01 to 0.013), adjusting for baseline EQ-5D and other minimisation factors. A mean incremental cost per QALY was not computed, as Peeling was on average less costly and slightly more effective. A stochastic analysis suggested that there was more than a 90% probability that Peeling would be cost-effective at a willingness-to-pay threshold of £20 000 per QALY. Conclusion: Although there is no evidence of a statistically significant difference in either costs or QALYs between macular hole surgery with or without ILM peeling, the balance of probabilities is that ILM Peeling is likely to be a cost-effective option for the treatment of macular holes. Further long-term follow-up data are needed to confirm these findings.

You have free access to this content 5.8 GHz full duplex amplitude shift keying retrodirective interrogator array

This article describes a practical demonstration of a complete full-duplex “amplitude shift keying (ASK)” retrodirective radio frequency identification (RFID) transceiver array.The interrogator incorporates a “retrodirective array (RDA)” with a dual-conversion phase conjugating architecture in order to achieve better performance than is possible with conventional RFID solutions. Here mixers phase conjugate the incoming signal and a carrier recovery circuit recovers incoming angle of arrival phase information of an encoded amplitude shift keyed signal. The resulting interrogator provides a receiver sensitivity level of -109 dBm. A four element square patch RDA gives a 3 dB automatic beam steering angle of acceptance of ±45°. When compared to an RFID system operating by conventional (non-retrodirective) means retrodirective action leads to improved range extension of up to 16 times at ±45°. Operator pointing accuracy requirements are also reduced due to automatic retrodirective self-pointing. These features significantly enhance deployment opportunities requiring long range low equivalent isotropic radiation power (EIRP) and/or RFID tagging of moving platforms. © 2012 Wiley Periodicals, Inc. Microwave Opt Technol Lett 55:160–164, 2013; View this article online at wileyonlinelibrary.com. DOI 10.1002/mop.27258

Full duplex reflection amplifier tag

The authors describe a reflection amplifier adapted to have both a reflection and a transmission port. The amplifier uses a single silicon bipolar transistor and demonstrates a reflection gain of 13 dB, transmission gain of 10 dB and 3.4 dB noise figure at 5.25 GHz. The added feature of transmission gain in the reflection amplifier permits practical implementation of full duplex microwave radiofrequency indentification (RFID) tag operation. By using a simple subcarrier modulation scheme full duplex RFID operation utilising this amplifier is demonstrated. These results indicate that for 27 dBm (0.5 W) effective isotropic radiated power (EIRP) transmit power it should be possible to obtain approximately 8 m downlink range and 25 m uplink range

Vitrectomy with internal limiting membrane (ILM) peeling versus vitrectomy with no peeling for idiopathic full-thickness macular hole (FTMH)

Several observational studies have suggested the potential benefit of internal limiting membrane (ILM) peeling to treat idiopathic full-thickness macular hole (FTMH). However, no strong evidence is available on the potential benefit(s) of this surgical manoeuvre and uncertainty remains among vitreoretinal surgeons about the indication for peeling the ILM, whether to use it in all cases or in long-standing and/or larger holes.