Fifteen years follow-up of photorefractive keratectomy up to 10 D of myopia: outcomes and analysis of the refractive regression

PURPOSE: To evaluate outcomes of photorefractive keratectomy up to -10.00 D of myopia and -4.50 of astigmatism and to develop a predictive model for the refractive changes in the long term. SETTING: Vissum Corporation and Miguel Hernandez University (Alicante, Spain). DESIGN: Retrospective-prospective observational series of cases. METHODS: This study included 33 eyes of 33 patients aged 46.79±7.04 years (range 40-57) operated with the VISX 20/20 excimer laser with optical zones of 6 mm. No mitomycin C was used in any of these cases. The minimum follow-up was 15 years. The main outcome measures were: uncorrected and corrected distance visual acuity, manifest refraction and corneal topography. Linear regression models were developed from the observed refractive changes over time. RESULTS: Safety and efficacy indexes at 15 years were 1.18 and 0.83, respectively. No statistically significant differences were detected for any keratometric variable during the follow-up (p≥0.103). 15 years after the surgery 54.55% of the eyes were within ±1.00 D of spherical equivalent and 84.85% within ±2.00 D. The uncorrected distance visual acuity at 15 years was 20/25 or better in 60.6% of the eyes and 20/40 or better in 72.73% of the eyes. The correlation between the attempted and the achieved refractions was r=0.948 (p<0.001) at 1 year, and r=0.821 (p<0.001) at 15 years. No corneal ectasia was detected in any case during the follow-up. CONCLUSIONS: Photorefractive keratectomy is a safe refractive procedure in the long term within the range of myopia currently considered suitable for its use, although its efficacy decreases with time, especially, in high myopia. The model developed predicts a myopic regression of 2.00 D at 15 years for an ablation depth of 130 µm

Pengaruh Model Pembelajaran Pendekatan Saintifik terhadap Hasil Belajar Siswa pada Materi Kelarutan dan Hasil Kali Kelarutan

Tujuan penelitian ini adalah untuk mengetahui pengaruh model pembelajaran pendekatan saintifik terhadap hasil belajar siswa pada materi kelarutan dan hasil kali kelarutan. Sampel berjumlah 61 siswa yang tersebar didua kelas, yaitu kelas eksperimen berjumlah 29 siswa dan kelas kontrol berjumlah 32 siswa. Pengumpulan data menggunakan tes. Analisis data menggunakan uji t. Hasil analisis data menunjukkan bahwa dalam taraf signifikan 0,05 dengan dk = 59 diperoleh nilai thitung &gt; ttabel atau 4,880 &gt; 2,003 maka tolak H0. Kesimpulan terdapat pengaruh model pembelajaran pendekatan saintifik terhadap hasil belajar siswa pada materi kelarutan dan hasil kali kelarutan

Procedimiento de reconstrucción de la topografía corneal a partir de datos altímetros o de curvatura

Número de publicación: ES2392619 A1 (12.12.2012) También publicado como: ES2392619 B1 (22.10.2013) Número de Solicitud: Consulta de Expedientes OEPM (C.E.O.) P201000842(08.06.2010)Procedimiento de reconstrucción de la topografía corneal a partir de datos altimétricos o de curvatura. La invención consiste en un método de reconstrucción de la superficie de la cara anterior de la córnea, a partir de los datos medidos en un conjunto discreto de puntos por medio de un topógrafo corneal o equipo equivalente. Se trata de un procedimiento que obtiene una expresión analítica de la superficie, combinando un ajuste por polinomios de Zernike o con esfera de mejor ajuste, con una reconstrucción por funciones de base radial gaussianas. Se logra obtener una descripción detallada de la superficie corneal, permitiendo un diagnóstico más fiable de patologías, o la implementación de tratamientos customizados. Este procedimiento es fácilmente implementable en cualquier topógrafo corneal, tomógrafo de coherencia óptica, equipos de lámpara de hendidura y equivalentes, de los existentes en el mercado, como sustituto del método estándar basado en polinomios de Zernike.Universidad de Almerí

An adaptive algorithm for the cornea modeling from keratometric data

In this paper we describe an adaptive and multi-scale algorithm for the parsimonious t of the corneal surface data that allows to adapt the number of functions used in the reconstruction to the conditions of each cornea. The method implements also a dynamical selection of the parameters and the management of noise. It can be used for the real-time reconstruction of both altimetric data and corneal power maps from the data collected by keratoscopes, such as the Placido rings based topographers, decisive for an early detection of corneal diseases such as keratoconus. Numerical experiments show that the algorithm exhibits a steady exponential error decay, independently of the level of aberration of the cornea. The complexity of each anisotropic gaussian basis functions in the functional representation is the same, but their parameters vary to fit the current scale. This scale is determined only by the residual errors and not by the number of the iteration. Finally, the position and clustering of their centers, as well as the size of the shape parameters, provides an additional spatial information about the regions of higher irregularity. These results are compared with the standard approximation procedures based on the Zernike polynomials expansions

Comparative Analysis of Some Modal Reconstruction Methods of the Shape of the Cornea from Corneal Elevation Data

Purpose: A comparative study of the ability of some modal schemes to reproduce corneal shapes of varying complexity was performed, by using both standard radial polynomials and radial basis functions (RBFs). The hypothesis was that the correct approach in the case of highly irregular corneas should combine several bases. Methods: Standard approaches of reconstruction by Zernike and other types of radial polynomials were compared with the discrete least-squares fit (LSF) by the RBF in three theoretical surfaces, synthetically generated by computer algorithms in the absence of measurement noise. For the reconstruction by polynomials, the maximal radial order 6 was chosen, which corresponds to the first 28 Zernike polynomials or the first 49 Bhatia-Wolf polynomials. The fit with the RBF was performed by using a regular grid of centers. Results: The quality of fit was assessed by computing for each surface the mean square errors (MSEs) of the reconstruction by LSF, measured at the same nodes where the heights were collected. Another criterion of the fit quality used was the accuracy in recovery of the Zernike coefficients, especially in the case of incomplete data. Conclusions: The Zernike (and especially, the Bhatia-Wolf) polynomials constitute a reliable reconstruction method of a nonseverely aberrated surface with a small surface regularity index (SRI). However, they fail to capture small deformations of the anterior surface of a synthetic cornea. The most promising approach is a combined one that balances the robustness of the Zernike fit with the localization of the RBF

Occurrence and antimicrobial resistance of arcobacter spp. Recovered from aquatic environments

Arcobacter spp. are emerging waterborne and foodborne zoonotic pathogens responsible for gastroenteritis in humans. In this work, we evaluated the occurrence and the antimicrobial resistance profile of Arcobacter isolates recovered from different aquatic sources. Besides, we searched for Arcobacter spp. in seaweeds and the corresponding seawater samples. Bacteriological and molecular methods applied to 100 samples led to the isolation of 28 Arcobacter isolates from 27 samples. The highest prevalence was detected in rivers followed by artificial ponds, streams, well waters, and spring waters. Seaweeds contained a higher percentage of Arcobacter than the corresponding sea-water samples. The isolates were identified as Arcobacter butzleri (96.4%) and Arcobacter cryaerophilus (3.6%). All the isolates showed a multi-drug resistance profile, being resistant to at least three different classes of antibiotics. Molecular analysis of genetic determinants responsible for tetracycline resistance in nine randomly chosen isolates revealed the presence of tetO and/or tetW. This work confirms the occurrence and the continuous emergence of antibiotic-resistant Arcobacter strains in environmental samples; also, the presence of quinolone-resistant Arcobacter spp. in aquatic sources used for water supply and irrigation represents a potential risk for human health

Morphogeometric analysis for characterization of keratoconus considering the spatial localization and projection of apex and minimum corneal thickness point

This work evaluates changes in new morphogeometric indices developed considering the position of anterior and posterior corneal apex and minimum corneal thickness (MCT) point in keratoconus. This prospective comparative study included 440 eyes of 440 patients (age, 7–99 years): control (124 eyes) and keratoconus (KC) groups (316 eyes). Tomographic information (Sirius®, Costruzione Strumenti Oftalmici, Italy) was treated with SolidWorks v2013, creating the following morphogeometric parameters: geometric axis–apex line angle (GA–AP), geometric axis–MCT line angle (GA–MCT, apex line–MCT line angle (AP–MCT), and distances between apex and MCT points on the anterior (anterior AP–MCTd) and posterior corneal surface (posterior AP–MCTd). Statistically significant higher values of GA–AP, GA–MCT, AP–MCT and anterior AP–MCTd were found in the keratoconus group (p ≤ 0.001). Moderate significant correlations of corneal aberrations (r ≥ 0.587, p < 0.001) and corneal thickness parameters (r ≤ −0.414, p < 0.001) with GA–AP and AP–MCT were found. Anterior asphericity was found to be significantly correlated with anterior and posterior AP–MCTd (r ≥ 0.430, p < 0.001). Likewise, GA–AP and AP–MCT showed a good diagnostic ability for the detection of keratoconus, with optimal cutoff values of 9.61° (sensitivity 85.5%, specificity 80.3%) and 18.08° (sensitivity 80.5%, specificity 78.7%), respectively. These new morphogeometric indices allow a clinical characterization of the 3-D structural alteration occurring in keratoconus, with less coincidence in the spatial projection of the apex and MCT points of both corneal surfaces. Future studies should confirm the potential impact on the precision of these indices of the variability of posterior corneal surface measurements obtained with Scheimpflug imaging technology.This publication has been carried out in the framework of the Thematic Network for Co-Operative Research in Health (RETICS), reference number RD16/0008/0012, financed by the Carlos III Health Institute–General Subdirection of Networks and Cooperative Investigation Centers (R&D&I National Plan 2013–2016) and the European Regional Development Fund (FEDER). The author David P. Piñero has been supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal, RYC-2016-20471