Fitting an MSD (Mini Scleral Design) rigid contact lens in advanced keratoconus with INTACS

Keratoconus is a bilateral degenerative disease characterized by a non-inflammatory, progressive central corneal ectasia (typically asymmetric) and decreased vision. In its early stages it may be managed with spectacles and soft contact lenses but more commonly it is managed with rigid contact lenses. In advanced stages, when contact lenses can no longer be fit, have become intolerable, or corneal damage is severe, a penetrating keratoplasty is commonly performed. Alternative surgical techniques, such as the use of intra-stromal corneal ring segments (INTACS) have been developed to try and improve the fit of rigid contact lenses in keratoconic patients and avoid penetrating keratoplasties. This case report follows through the fitting of rigid contact lenses in an advanced keratoconic cornea after an INTACS procedure and discusses clinical findings, treatment options, and the use of mini-scleral and scleral lens designs as they relate to the challenges encountered in managing such a patient. Mini-scleral and scleral lenses are relatively easy to fit, and can be of benefit to many patients, including advanced keratoconic patients, post-INTAC patients and post-penetrating keratoplasty patients. © 2011 British Contact Lens Association.

Energy scaling of Kerr-lens mode-locked thin-disk oscillators

Geometric scaling of a Kerr-lens mode-locked Yb:YAG thin-disk oscillator yields femtosecond pulses with an average output power of 270 W. The scaled system delivers femtosecond (210-330 fs) pulses with a peak power of 38 MW. These values of average and peak power surpass the performance of any previously reported femtosecond laser oscillator operated in atmospheric air.

Quantum-dot saturable absorber and Kerr lens mode-locked Yb:KGW laser with >300 kW of peak power

Dual action of quantum-dot saturable absorber and Kerr lens mode locking of a diode-pumped Yb:KGW laser was demonstrated. The laser delivered 105 fs pulses with 2.5 W of average power and >300 kW of peak power.

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.

Quantum-dot saturable absorber and Kerr-lens mode-locked Yb:KGW laser with >450 kW of peak power

The hybrid action of quantum-dot saturable absorber and Kerr-lens mode locking in a diode-pumped Yb:KGW laser was demonstrated. Using a quantum-dot saturable absorber with a 0.7% (0.5%) modulation depth, the mode-locked laser delivered 90 fs (93 fs) pulses with 3.2 W (2.9 W) of average power at the repetition rate of 77 MHz, corresponding to 462 kW (406 kW) of peak power and 41 nJ (38 nJ) of pulse energy. To the best of our knowledge, this represents the highest average and peak powers generated to date from quantum-dot saturable absorber-based mode-locked lasers.

Ocular biotribology and the contact lens:Surface interactions and ocular response

Biotribology is essentially the study of friction, lubrication and wear in biological systems. The area has been widely studied in relation to the behaviour of synovial joints and the design and behaviour of hip joint prostheses, but only in the last decade have serious studies been extended to the eye. In the ocular environment - as distinct from articular joints - wear is not a major factor. Both lubrication and friction are extremely important, however; this is particularly the case in the presence of the contact lens, which is a medical device important not only in vision correction but also as a therapeutic bandage for the compromised cornea. This chapter describes the difficulty in replicating experimental conditions that accurately reflect the complex nature of the ocular environment together with the factors such as load and rate of travel of the eyelid, which is the principal moving surface in the eye. Results obtained across a range of laboratories are compared.

The development of biomaterials for contact lens applications:effects of wear modality on materials design

The successful design of polymers for contact lens applications depends on the ability to provide a balance of properties appropriate to the ocular environment. Principal relevant aspects of the anterior eye are the tear film, eyelid and cornea, which govern the requirements for surface properties, modulus and oxygen permeability, respectively. Permeability requirements and the developing view of the needs of the cornea, in terms of oxygen consumption and the particular roles of fluorine and silicon in the design of silicone hydrogels, which have proved to be the most successful family of materials for this demanding application, are discussed. The contact lens field is complicated by the fact that contact lenses are used in a range of wear modalities, the extremes of which can conveniently be classified as lenses that are disposed of at the end of a single period of daily wear and those used for 30. days of successive day-and-night periods, frequently referred to as extended or continuous wear. As silicone hydrogels developed, in the decade following their launch there has been a progressive trend in properties taking both modulus and water content closer to those of conventional hydrogels. This is particularly evident in the family of daily disposable contact lenses that have appeared since 2008.

Development of an instrument to measure high school students' global awareness and attitudes: Looking through the lens of social sciences

The purpose of this study was to develop an instrument to measure high school students’ perspectives on global awareness and attitudes toward social issues. The research questions that guided this study were: (a) Can acceptable validity and reliability estimates be established for an instrument developed to measure high schools students' global awareness? (b) Can acceptable validity and reliability estimates be established for an instrument developed to measure high schools students' attitudes towards global social issues? (c) What is the relationship between high school students’ GPA, race/ethnicity, gender, socio-economic status, parents’ education, getting the news, reading and listening habits, the number of classes taken in the social sciences, whether they speak a second language, and have experienced living in or visiting other countries, and their perception of global awareness and attitudes toward global social issues. ^ An ex post facto research design was used and the data were collected using a 4-part Likert-type survey. It was administered to 14 schools in the Miami-Dade County, Florida area to 704 students. A factor analysis with an orthogonal varimax rotation was vii used to select the factors that best represented the three constructs – global education, global citizenship, and global workforce. This was done to establish construct validity. Cronbach’s alpha was used to determine the reliability of the instrument. Descriptive statistics and a hierarchical multiple regression were used for the demographics to establish their relationship, if any, to the findings. ^ Key findings of the study were that reliable and valid estimates can be developed for the instrument. The multiple regression analysis for model 1 and 2 accounted for a variance of 3% and 5% for self-perceptions of global awareness (factor 1). The regression model also accounted for a 5% and 13% variance in the two models for attitudes toward global social issues (factor 2). The demographics that were statistically significant were: ethnicity, gender, SES, parents’ education, listening to music, getting the news, speaking a second language, GPA, classes taken in the social sciences, and visiting other countries. An important finding for the study was those attending public schools (as opposed to private schools) had more positive attitudes towards global social issues (factor 2) The statistics indicated that these students had taken history, economics, and social studies – a curriculum infused with global perspectives.^

Critical Race Theory: Focusing the Lens on Human Resource Development

The challenge that continues to face HRD is how to integrate real concerns for diversity into programs, practices, and research. Critical race theory was used as a lens to examine work on diversity published in Human Resource Development Quarterly (HRDQ). Eight publications were selected and analyzed.

Discourse Analysis of Frank McCourt’s Teacher Man Through a Feminist Educational Lens

This qualitative study used critical discourse analysis to highlight how educational stakeholders can examine discourses and react to power in texts using a feminist lens to problematize identity.

A View of Faculty Library Use and Perception From an Organizational Culture Lens

This study investigated faculty library demand from an organizational culture perspective at one college where annual requests for library instruction are received from a mere six percent of faculty. Analysis of survey data revealed a statistically significant difference in academic discipline assignment of library research, with the English-Humanities faculty group far exceeding all other faculty groups including the Social Sciences.

Cross-Cultural Mentoring: Exploration through the Lens of African American Students

Culture, trust and prejudice may impact cross-cultural mentoring relationships among African American students attending colleges in the United States. By recognizing the cultural perceptions and differences that exist, mentors and protégés may develop a better understanding of each other’s culture so as to enhance mentoring outcomes and student success.

Looking At Residents’ Attitudes towards Spring Break Tourism in Texas through the Lens of Community Attachment

The growth of spring break tourism in many destinations has become problematic, predominantly due to the excessive behaviour of college students. This paper examines residents’ attitudes toward spring break tourism in South Padre Island (located in Texas, USA) through the lens of community attachment. By understanding the attitudes of residents of the host communities, tourism planners and policy-makers can create policies to shape the character of tourism according to the residents’ needs. The findings suggest that, at this point in time, community residents perceive that the benefits of spring break tourism benefits exceed its’ costs. Also, the short and intense season of spring break tourism allows residents to better deal with social costs.

The effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma : a randomized controlled trial (EAGLE)

Medical Research Council (ref G0701604) and administered by the NIHR-EME (ref 09-800-26)