Comparison of astigmatism correction and visual outcomes in mix-and-match implantations of trifocal intraocular lenses with femtosecond laser-assisted arcuate keratotomy and contralateral bifocal Toric intraocular lenses

IntroductionAstigmatism reduces the postoperative visual performance after non-toric intraocular lenses (IOLs) implantation, and limits the use of refractive IOLs in cataract surgery. The purpose of this study was to compare the efficacy in astigmatism correction and the postoperative visual outcomes between the implantation of a trifocal IOL with femtosecond laser-assisted arcuate keratotomy (FSAK) in one eye and a bifocal toric IOL (TIOL) in the other, in patients with cataract and moderate astigmatism.MethodsThis prospective observational paired-eye study enrolled patients with cataract and corneal astigmatism (CA) between 0.75 and 2.25 D in both eyes. The patients underwent a mix-and-match treatment comprising trifocal IOL implantation with FSAK and bifocal TIOL implantation. We compared the visual acuity (VA) at all distances, defocus curve, postoperative refractive astigmatism (RfA), CA, high-order aberrations, modulation transfer function (MTF) curve, and Strehl ratio between the two eye groups.ResultsIn total, 41 patients (82 eyes) were enrolled and completed a 6-month follow-up. The 1- and 3-month uncorrected distance VA and 3-month uncorrected near VA were greater in eyes with bifocal TIOLs than with trifocal IOLs and FSAK (p = 0.036, 0.010, and 0.030, respectively), whereas the latter had greater uncorrected intermediate VA at every visit and greater VA in the intermediate range of defocus curve (at −1.50 and − 2.00 D) than the eyes with bifocal TIOLs. The postoperative RA of the eyes with trifocal IOL and FSAK was significantly higher than that of the bifocal TIOL-implanted eyes at the 3- and 6-month follow-ups.DiscussionBoth FSAK and TIOL implantation effectively reduce pre-existing moderate astigmatism in patients with cataract. The eyes with bifocal TIOLs had more stable long-term astigmatism correction, whereas those with trifocal IOLs and FSAK had better intermediate VA. Therefore, a mix-and-match implantation of trifocal IOL with FSAK and contralateral bifocal TIOL could achieve effective astigmatism correction and provide an overall optimal VA

Effect of astigmatism on visual outcomes after multifocal intraocular lens implantation: a systematic review and meta-analysis

PurposeTo investigate the effects of postoperative astigmatism on the visual outcomes following presbyopia-correcting surgery with multifocal intraocular lens implantation.MethodsA comprehensive literature search was conducted using PubMed, Embase, and Web of Science for articles published until January 2023. Additionally, we included retrospective case series and prospective comparative studies. The combined mean difference (MD) with 95% confidence intervals (CI) and odds ratio (OR) with 95% CI were used to express continuous and categorical outcomes, respectively. All statistical analyses were performed using Review Manager (version 5.4.1).ResultsWe included nine eligible studies that analyzed 3,088 eyes. The proportion of eyes with useful postoperative visual acuity (logMAR ≤ 0.20) and residual astigmatism significantly differed with respect to the magnitude of astigmatism and presence/absence of blurred vision (p < 0.001 for both). Additionally, the mean uncorrected distance visual acuity (MD, 0.14; 95% CI, 0.06 to 0.21; p = 0.0003) and uncorrected intermediate visual acuity (MD, 0.07; 95% CI, 0.00 to 0.13; p = 0.04), but not the uncorrected near visual acuity (MD, 0.02; 95%CI-0.01 to 0.05; p = 0.17), significantly differed according to the magnitude of astigmatism.ConclusionAstigmatism, even at low levels (≥ 0.5D), has a significant effect on visual outcomes, especially on UDVA and UIVA, following multifocal intraocular lens implantation. Accurate preoperative and postoperative evaluation of astigmatism is important

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

A Gradient-Assisted Energy-Efficient Backpressure Scheduling Algorithm for Wireless Sensor Networks

Backpressure based scheduling has revealed remarkable performance in wireless multihop networks as reported in a lot of previous work. However, its lack of consideration on energy use efficiency is still an obstacle for backpressure based algorithms to be deployed in resource-constrained wireless sensor networks (WSNs). In this paper, we focus on studying the design of energy efficient backpressure based algorithm. For this purpose, we propose a gradient-assisted energy-efficient backpressure scheduling algorithm (GRAPE) for WSNs. GRAPE introduces a new link-weight calculation method, based on which gradient information and nodal residual energy are taken into account when making decisions on backpressure based transmission scheduling. According to the decisions made by this new method, packets are encouraged to be forwarded to nodes with more residual energy. We theoretically prove the throughput-optimality of GRAPE. Simulation results demonstrate that GRAPE can achieve significant performance improvements in terms of energy use efficiency, network throughput, and packet delivery ratio as compared with existing work

raps: a precision-adaptive protocol towards improved data fidelity in wireless sensor networks

Achieving high data quality and efficient network resource utilization is two major design objectives of wireless sensor networks (WSNs). However, these two objectives are often conflictive. By allowing sensors to report sampled data at high rates, fine-grained data quality can be obtained. However, the limited resources of a WSN make it difficult to support very high traffic rate. Therefore, the capability of adaptively adjusting sensor nodes' traffic-generating rates on the basis of the availability of network resources and application requirements is critical. This issue has attracted much attention recently, and some work has been carried out. To achieve high data quality and improved utilization of network resources, in this paper, we propose rate-based adaptive precision setting (RAPS) protocol, which works in a way that each sensor can adaptively adjust its traffic-generating rate on the basis of the current network resources availability and application requirements. RAPS introduces the following two key factors into its design: application's precision requirement and packet arrival rate. Analytical and simulation results show that RAPS can achieve improved data quality while reducing packet delivery latency. © 2012 John Wiley & Sons, Ltd.Achieving high data quality and efficient network resource utilization is two major design objectives of wireless sensor networks (WSNs). However, these two objectives are often conflictive. By allowing sensors to report sampled data at high rates, fine-grained data quality can be obtained. However, the limited resources of a WSN make it difficult to support very high traffic rate. Therefore, the capability of adaptively adjusting sensor nodes' traffic-generating rates on the basis of the availability of network resources and application requirements is critical. This issue has attracted much attention recently, and some work has been carried out. To achieve high data quality and improved utilization of network resources, in this paper, we propose rate-based adaptive precision setting (RAPS) protocol, which works in a way that each sensor can adaptively adjust its traffic-generating rate on the basis of the current network resources availability and application requirements. RAPS introduces the following two key factors into its design: application's precision requirement and packet arrival rate. Analytical and simulation results show that RAPS can achieve improved data quality while reducing packet delivery latency. © 2012 John Wiley & Sons, Ltd