Error induced by the estimation of the corneal power and the effective lens position with a rotationally asymmetric refractive multifocal intraocular lens

AIM: To evaluate the prediction error in intraocular lens (IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position (ELP). METHODS: Retrospective study including a total of 25 eyes of 13 patients (age, 50 to 83y) with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL (Oculentis GmbH, Germany). In all cases, an adjusted IOL power (PIOLadj) was calculated based on Gaussian optics using a variable keratometric index value (nkadj) for the estimation of the corneal power (Pkadj) and on a new value for ELP (ELPadj) obtained by multiple regression analysis. This PIOLadj was compared with the IOL power implanted (PIOLReal) and the value proposed by three conventional formulas (Haigis, Hoffer Q and Holladay). RESULTS: PIOLReal was not significantly different than PIOLadj and Holladay IOL power (P>0.05). In the Bland and Altman analysis, PIOLadj showed lower mean difference (-0.07 D) and limits of agreement (of 1.47 and -1.61 D) when compared to PIOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELPadj was significantly lower than ELP calculated with other conventional formulas (P<0.01) and was found to be dependent on axial length, anterior chamber depth and Pkadj. CONCLUSION: Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing the keratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors.

Positional accommodative intraocular lens power error induced by the estimation of the corneal power and the effective lens position

Purpose: To evaluate the predictability of the refractive correction achieved with a positional accommodating intraocular lenses (IOL) and to develop a potential optimization of it by minimizing the error associated with the keratometric estimation of the corneal power and by developing a predictive formula for the effective lens position (ELP). Materials and Methods: Clinical data from 25 eyes of 14 patients (age range, 52–77 years) and undergoing cataract surgery with implantation of the accommodating IOL Crystalens HD (Bausch and Lomb) were retrospectively reviewed. In all cases, the calculation of an adjusted IOL power (PIOLadj) based on Gaussian optics considering the residual refractive error was done using a variable keratometric index value (nkadj) for corneal power estimation with and without using an estimation algorithm for ELP obtained by multiple regression analysis (ELPadj). PIOLadj was compared to the real IOL power implanted (PIOLReal, calculated with the SRK-T formula) and also to the values estimated by the Haigis, HofferQ, and Holladay I formulas. Results: No statistically significant differences were found between PIOLReal and PIOLadj when ELPadj was used (P = 0.10), with a range of agreement between calculations of 1.23 D. In contrast, PIOLReal was significantly higher when compared to PIOLadj without using ELPadj and also compared to the values estimated by the other formulas. Conclusions: Predictable refractive outcomes can be obtained with the accommodating IOL Crystalens HD using a variable keratometric index for corneal power estimation and by estimating ELP with an algorithm dependent on anatomical factors and age.

Minimizing the IOL Power Error Induced by Keratometric Power

Purpose. To evaluate theoretically in normal eyes the influence on IOL power (PIOL) calculation of the use of a keratometric index (nk) and to analyze and validate preliminarily the use of an adjusted keratometric index (nkadj) in the IOL power calculation (PIOLadj). Methods. A model of variable keratometric index (nkadj) for corneal power calculation (Pc) was used for IOL power calculation (named PIOLadj). Theoretical differences ($PIOL) between the new proposed formula (PIOLadj) and which is obtained through Gaussian optics (PIOL Gauss) were determined using Gullstrand and Le Grand eye models. The proposed new formula for IOL power calculation (PIOLadj) was prevalidated clinically in 81 eyes of 81 candidates for corneal refractive surgery and compared with Haigis, HofferQ, Holladay, and SRK/T formulas. Results. A theoretical PIOL underestimation greater than 0.5 diopters was present in most of the cases when nk = 1.3375 was used. If nkadj was used for Pc calculation, a maximal calculated error in $PIOL of T0.5 diopters at corneal vertex in most cases was observed independently from the eye model, r1c, and the desired postoperative refraction. The use of nkadj in IOL power calculation (PIOLadj) could be valid with effective lens position optimization nondependent of the corneal power. Conclusions. The use of a single value of nk for Pc calculation can lead to significant errors in PIOL calculation that may explain some IOL power overestimations with conventional formulas. These inaccuracies can be minimized by using the new PIOLadj based on the algorithm of nkadj.

Ocular refractive and biometric characteristics in patients with tilted disc syndrome

Purpose: To evaluate the ocular refractive and biometric characteristics in patients with tilted disc syndrome (TDS). Methods: This case-control study comprised 41 eyes of 25 patients with established TDS and forty eyes of 20 age- and sex-matched healthy control subjects. All had a complete ocular examination including refraction and analysis using Fourier transformation, slit lamp biomicroscopy, pachymetry keratometry, and ocular biometry. Corneal topography examinations were performed in the syndrome group only. Results: There were no significant differences in spherical equivalent (p = 0.334) and total astigmatism (p= 0.246) between groups. However, mean best spectacular corrected visual acuity was significantly worse in TDS patients (P < 0.001). The lenticular astigmatism was significantly greater in the syndrome group, while the corneal component was greater in the controls (p = 0.004 and p = 0.002, respectively). The measured biometric features were the same in both groups, except for the lens thickness, relative lens position, and lens-axial length factor which were greater in the TDS group (p = 0.002, p = 0.015, and p = 0.025, respectively). Conclusions: Clinically significant lenticular astigmatism, more oblique corneal astigmatism, and thicker lens were characteristic findings in patients with TDS.

A study of capacitance-voltage characteristics of lead zirconate titanate ferroelectric thin films and their usage to investigate polarization and coercive field.

Capacitance-voltage (C-V) characteristics of lead zirconate titanate (PZT) thin films with a thickness of 130 nm were measured between 300 and 533 K. The transition between ferroelectric and paraelectric phases was revealed to be of second order in our case, with a Curie temperature at around 450 K. A linear relationship was found between the measured capacitance and the inverse square root of the applied voltage. It was shown that such a relationship could be fitted well by a universal expression of C/A = k(V+V(0))(-1/2) and that this expression could be derived by expanding the Landau-Devonshire free energy at an effective equilibrium position of the Ti/Zr ion in a PZT unit cell. By using the derived equations in this work, the free energy parameters for an individual material can be obtained solely from the corresponding C-V data, and the temperature dependences of both remnant polarization and coercive voltage are shown to be in quantitative agreement with the experimental data.

A Local Superlens

Superlenses enable near-field imaging beyond the diffraction limit. However, their widespread implementation in optical imaging technology so far has been limited by large-scale fabrication, fixed lens position and specific object materials. Here, we demonstrate that a dielectric lamella of sub-wavelength size in all three spatial dimensions behaves as a compact superlens that operates at infrared wavelengths and can be positioned to image any local microscopic area of interest on the sample. In particular, the lamella superlens may be placed in contact with any type of object and therefore enables examination of hard-to-scan samples e.g. with high topography or in liquids, without altering the specimen design. This lamella-based local superlens design is directly applicable to sub-wavelength light-based technology such as integrated optics.

Fusion of fundus images and MRI data of the human eye

Purpose Ophthalmologists are confronted with a set of different image modalities to diagnose eye tumors e.g., fundus photography, CT and MRI. However, these images are often complementary and represent pathologies differently. Some aspects of tumors can only be seen in a particular modality. A fusion of modalities would improve the contextual information for diagnosis. The presented work attempts to register color fundus photography with MRI volumes. This would complement the low resolution 3D information in the MRI with high resolution 2D fundus images. Methods MRI volumes were acquired from 12 infants under the age of 5 with unilateral retinoblastoma. The contrast-enhanced T1-FLAIR sequence was performed with an isotropic resolution of less than 0.5mm. Fundus images were acquired with a RetCam camera. For healthy eyes, two landmarks were used: the optic disk and the fovea. The eyes were detected and extracted from the MRI volume using a 3D adaption of the Fast Radial Symmetry Transform (FRST). The cropped volume was automatically segmented using the Split Bregman algorithm. The optic nerve was enhanced by a Frangi vessel filter. By intersection the nerve with the retina the optic disk was found. The fovea position was estimated by constraining the position with the angle between the optic and the visual axis as well as the distance from the optic disk. The optical axis was detected automatically by fitting a parable on to the lens surface. On the fundus, the optic disk and the fovea were detected by using the method of Budai et al. Finally, the image was projected on to the segmented surface using the lens position as the camera center. In tumor affected eyes, the manually segmented tumors were used instead of the optic disk and macula for the registration. Results In all of the 12 MRI volumes that were tested the 24 eyes were found correctly, including healthy and pathological cases. In healthy eyes the optic nerve head was found in all of the tested eyes with an error of 1.08 +/- 0.37mm. A successful registration can be seen in figure 1. Conclusions The presented method is a step toward automatic fusion of modalities in ophthalmology. The combination enhances the MRI volume with higher resolution from the color fundus on the retina. Tumor treatment planning is improved by avoiding critical structures and disease progression monitoring is made easier.

Packet voice/data in local broadcast networks

A local area network that can support both voice and data packets offers economic advantages due to the use of only a single network for both types of traffic, greater flexibility to changing user demands, and it also enables efficient use to be made of the transmission capacity. The latter aspect is very important in local broadcast networks where the capacity is a scarce resource, for example mobile radio. This research has examined two types of local broadcast network, these being the Ethernet-type bus local area network and a mobile radio network with a central base station. With such contention networks, medium access control (MAC) protocols are required to gain access to the channel. MAC protocols must provide efficient scheduling on the channel between the distributed population of stations who want to transmit. No access scheme can exceed the performance of a single server queue, due to the spatial distribution of the stations. Stations cannot in general form a queue without using part of the channel capacity to exchange protocol information. In this research, several medium access protocols have been examined and developed in order to increase the channel throughput compared to existing protocols. However, the established performance measures of average packet time delay and throughput cannot adequately characterise protocol performance for packet voice. Rather, the percentage of bits delivered within a given time bound becomes the relevant performance measure. Performance evaluation of the protocols has been examined using discrete event simulation and in some cases also by mathematical modelling. All the protocols use either implicit or explicit reservation schemes, with their efficiency dependent on the fact that many voice packets are generated periodically within a talkspurt. Two of the protocols are based on the existing 'Reservation Virtual Time CSMA/CD' protocol, which forms a distributed queue through implicit reservations. This protocol has been improved firstly by utilising two channels, a packet transmission channel and a packet contention channel. Packet contention is then performed in parallel with a packet transmission to increase throughput. The second protocol uses variable length packets to reduce the contention time between transmissions on a single channel. A third protocol developed, is based on contention for explicit reservations. Once a station has achieved a reservation, it maintains this effective queue position for the remainder of the talkspurt and transmits after it has sensed the transmission from the preceeding station within the queue. In the mobile radio environment, adaptions to the protocols were necessary in order that their operation was robust to signal fading. This was achieved through centralised control at a base station, unlike the local area network versions where the control was distributed at the stations. The results show an improvement in throughput compared to some previous protocols. Further work includes subjective testing to validate the protocols' effectiveness.

Anterior ophthalmic imaging

Improvements in imaging chips and computer processing power have brought major advances in imaging of the anterior eye. Digitally captured images can be visualised immediately and can be stored and retrieved easily. Anterior ocular imaging techniques using slitlamp biomicroscopy, corneal topography, confocal microscopy, optical coherence tomography (OCT), ultrasonic biomicroscopy, computerised tomography (CT) and magnetic resonance imaging (MRI) are reviewed. Conventional photographic imaging can be used to quantify corneal topography, corneal thickness and transparency, anterior chamber depth and lateral angle and crystalline lens position, curvature, thickness and transparency. Additionally, the effects of tumours, foreign bodies and trauma can be localised, the corneal layers can be examined and the tear film thickness assessed. © 2006 The Authors.

Position-dependent velocity of an effective temperature point for the estimation of the thermal diffusivity of solids

A new approach is proposed to estimate the thermal diffusivity of optically transparent solids at ambient temperature based on the velocity of an effective temperature point (ETP), and by using a two-beam interferometer the proposed concept is corroborated. 1D unsteady heat flow via step-temperature excitation is interpreted as a `micro-scale rectilinear translatory motion' of an ETP. The velocity dependent function is extracted by revisiting the Fourier heat diffusion equation. The relationship between the velocity of the ETP with thermal diffusivity is modeled using a standard solution. Under optimized thermal excitation, the product of the `velocity of the ETP' and the distance is a new constitutive equation for the thermal diffusivity of the solid. The experimental approach involves the establishment of a 1D unsteady heat flow inside the sample through step-temperature excitation. In the moving isothermal surfaces, the ETP is identified using a two-beam interferometer. The arrival-time of the ETP to reach a fixed distance away from heat source is measured, and its velocity is calculated. The velocity of the ETP and a given distance is sufficient to estimate the thermal diffusivity of a solid. The proposed method is experimentally verified for BK7 glass samples and the measured results are found to match closely with the reported value.

Plasmonic graded-index planar lens based on subwavelength features in the effective index regime

We experimentally demonstrate the planar focusing of Surface Plasmon Polaritons using space variant PMMA subwavelength features on top of a metallic film. Focusing is obtained by creating an effective graded refractive index profile. © 2012 OSA.

Plasmonic graded-index planar lens based on subwavelength features in the effective index regime

We experimentally demonstrate the planar focusing of Surface Plasmon Polaritons using space variant PMMA subwavelength features on top of a metallic film. Focusing is obtained by creating an effective graded refractive index profile. © OSA 2012.

Evaluation of effective groundwater recharge of freshwater lens in small islands by the combined modeling of geoelectrical data and water heads

In small islands, a freshwater lens can develop due to the recharge induced by rain. Magnitude and spatial distribution of this recharge control the elevation of freshwater and the depth of its interface with salt water. Therefore, the study of lens morphology gives useful information on both the recharge and water uptake due to evapotranspiration by vegetation. Electrical resistivity tomography was applied on a small coral reef island, giving relevant information on the lens structure. Variable density groundwater flow models were then applied to simulate freshwater behavior. Cross validation of the geoelectrical model and the groundwater model showed that recharge exceeds water uptake in dunes with little vegetation, allowing the lens to develop. Conversely, in the low-lying and densely vegetated sectors, where water uptake exceeds recharge, the lens cannot develop and seawater intrusion occurs. This combined modeling method constitutes an original approach to evaluate effective groundwater recharge in such environments.
[Comte, J.-C., O. Banton, J.-L. Join, and G. Cabioch (2010), Evaluation of effective groundwater recharge of freshwater lens in small islands by the combined modeling of geoelectrical data and water heads, Water Resour. Res., 46, W06601, doi:10.1029/2009WR008058.]

Effect of position of near addition in an asymmetric refractive multifocal intraocular lens on quality of vision

Purpose
To evaluate the impact of the position of an asymmetric multifocal near segment on visual quality.

Setting
Cathedral Eye Clinic, Belfast, United Kingdom.

Design
Retrospective comparative case series.

Methods
Data from consecutive patients who had bilateral implantation of the Lentis Mplus LS-312 multifocal intraocular lens were divided into 2 groups. One group received inferonasal near-segment placement and the other, superotemporal near-segment placement. A +3.00 diopter (D) reading addition (add) was used in all eyes. The main outcome measures included uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), contrast sensitivity, and quality of vision. Follow-up was 3 months.

Results
Patients ranged in age from 43 to 76 years. The inferonasal group comprised 80 eyes (40 patients) and the superotemporal group, 76 eyes (38 patients). The mean 3-month spherical equivalent was −0.11 D ± 0.49 (SD) in the inferonasal group and −0.18 ± 0.46 D in the superotemporal group. The mean postoperative UDVA was 0.14 ± 0.10 logMAR and 0.18 ± 0.15 logMAR, respectively. The mean monocular UNVA was 0.21 ± 0.14 logRAD and 0.24 ± 0.13 logRAD, respectively. No significant differences were observed in the higher-order aberrations, total Strehl ratio (point-spread function), or modulation transfer function between the groups. Dysphotopic symptoms measured with a validated quality-of-vision questionnaire were not significantly different between groups.

Conclusion
Positioning of the near add did not significantly affect objective or subjective visual function parameters.