Long-term incidence of dry eyes and visual aberrations after corneal refractive surgery

INTRODUCTION/PURPOSE: Billions of people world wide suffer from refractive errors requiring glasses, contact lenses, or other means of correction to enable them to see better. Many people seeking permanent means to correct their vision consider undergoing corneal refractive laser surgeries (CRLS), photorefractive keratectomy (PRK), laser-assisted subepithelial keratectomy (LASEK), or laser in situ keratomileusis (LASIK). These surgeries have been shown to improve vision, but are not without risks for complications intra-operatively and postoperatively. Few studies have looked at the long-term incidence of postoperative complications such as dry eyes and visual aberrations and the associated preoperative risk factors. It is the aim of this study to examine the long-term incidence of dry eyes and visual aberrations (starbursts, halos, glare) after CRLS, and assess for preoperative risk factors associated with the persistence of these symptoms after surgery. METHODS: This study consisted of 319 patients identified for undergoing PRK, LASEK, or LASIK, at Boston Laser between December 2009 and January 2014. The participants in this study completed a novel online questionnaire consisting of questions to assess dry eye and visual aberration symptoms, and included questions adapted from the Ocular Surface Disease Index (OSDI). Postoperative dry eye symptoms were measured based on the OSDI score and a new dry eye measurement score created for this study's questionnaire. Presence or absence of visual aberration symptoms postoperatively were measured based on a score created for this study and derived from the calculation of the OSDI score. Additionally, a retrospective chart review was conducted of the 319 participants' medical charts to gather and assess for preoperative risk factors related to the long-term incidence of both dry eye and visual aberration symptoms. RESULTS: Our data found a significant association (p 0.05) was found between the novel dry eye score and the preoperative factors, but it did approach significance with two variables, necessitating further investigation: gender and actual ablation. No significance (p >0.05) was found in the association between the preoperative dry eye risk assessment and severity of postoperative symptoms as gathered using the OSDI score. Our data found a significant association (p 0.05) when comparing the difference between mean OSDI, dry eye, and visual aberration scores between participants grouped by years since surgery. DISCUSSION/CONCLUSION: Our data found a significant relationship between long-term dry eye risk after CRLS and preoperative pupil size, flap thickness, and dry eye risk assessment. Similarly the data also displayed a significant association between long-term visual aberration risk after CRLS and greater preoperative cylindrical manifest refraction, flat K, and flap thickness. These findings contribute to the risk factors identified in similar short-term follow-up studies, and support the need for increased research into the risk factors and long-term incidence of dry eyes and visual aberrations after CRLS. While the data showed no significance between participants grouped by years since surgery and reported postoperative symptoms, the OSDI mean scores did approach significance (p = 0.088), suggesting that further research with a greater survey population is required

Discriminants, symmetrized graph monomials, and sums of squares

Motivated by the necessities of the invariant theory of binary forms J. J. Sylvester constructed in 1878 for each graph with possible multiple edges but without loops its symmetrized graph monomial which is a polynomial in the vertex labels of the original graph. In the 20-th century this construction was studied by several authors. We pose the question for which graphs this polynomial is a non-negative resp. a sum of squares. This problem is motivated by a recent conjecture of F. Sottile and E. Mukhin on discriminant of the derivative of a univariate polynomial, and an interesting example of P. and A. Lax of a graph with 4 edges whose symmetrized graph monomial is non-negative but not a sum of squares. We present detailed information about symmetrized graph monomials for graphs with four and six edges, obtained by computer calculations

Tools in the orbit space approach to the study of invariant functions: rational parametrization of strata

Functions which are equivariant or invariant under the transformations of a compact linear group $G$ acting in an euclidean space $\real^n$, can profitably be studied as functions defined in the orbit space of the group. The orbit space is the union of a finite set of strata, which are semialgebraic manifolds formed by the $G$-orbits with the same orbit-type. In this paper we provide a simple recipe to obtain rational parametrizations of the strata. Our results can be easily exploited, in many physical contexts where the study of equivariant or invariant functions is important, for instance in the determination of patterns of spontaneous symmetry breaking, in the analysis of phase spaces and structural phase transitions (Landau theory), in equivariant bifurcation theory, in crystal field theory and in most areas where use is made of symmetry adapted functions. A physically significant example of utilization of the recipe is given, related to spontaneous polarization in chiral biaxial liquid crystals, where the advantages with respect to previous heuristic approaches are shown.Comment: Figures generated through texdraw package; revised version appearing in J. Phys. A: Math. Ge

Der Gesundheitsstandort Haushalt: Mit Telematik in eine neue Zukunft?

Der Haushalt ist bereits heute ein wichtiger Ort der Krankheitsbewältigung und Gesunderhaltung, neben Krankenhäusern und Arztpraxen. Aktivitäten zur Krankheitsbewältigung und Gesunderhaltung werden in Zukunft verstärkt im Haushalt stattfinden. Intelligent eingesetzte Gesundheitstelematik kann die Möglichkeiten des dritten Gesundheitsstandorts vergrößern. Der Erfolg von Anwendungen der Gesundheitstelematik im Haushalt ist abhängig von der Berücksichtigung der Perspektiven aller Beteiligten

Wide area detection system: Conceptual design study

An integrated sensor for traffic surveillance on mainline sections of urban freeways is described. Applicable imaging and processor technology is surveyed and the functional requirements for the sensors and the conceptual design of the breadboard sensors are given. Parameters measured by the sensors include lane density, speed, and volume. The freeway image is also used for incident diagnosis

On the algebraic invariant curves of plane polynomial differential systems

We consider a plane polynomial vector field $P(x,y)dx+Q(x,y)dy$ of degree $m>1$. To each algebraic invariant curve of such a field we associate a compact Riemann surface with the meromorphic differential $\omega=dx/P=dy/Q$. The asymptotic estimate of the degree of an arbitrary algebraic invariant curve is found. In the smooth case this estimate was already found by D. Cerveau and A. Lins Neto [Ann. Inst. Fourier Grenoble 41, 883-903] in a different way.Comment: 10 pages, Latex, to appear in J.Phys.A:Math.Ge

Semantics and Proof Theory of the Epsilon Calculus

The epsilon operator is a term-forming operator which replaces quantifiers in ordinary predicate logic. The application of this undervalued formalism has been hampered by the absence of well-behaved proof systems on the one hand, and accessible presentations of its theory on the other. One significant early result for the original axiomatic proof system for the epsilon-calculus is the first epsilon theorem, for which a proof is sketched. The system itself is discussed, also relative to possible semantic interpretations. The problems facing the development of proof-theoretically well-behaved systems are outlined.Comment: arXiv admin note: substantial text overlap with arXiv:1411.362

Invariants of Artinian Gorenstein Algebras and Isolated Hypersurface Singularities

We survey our recently proposed method for constructing biholomorphic invariants of quasihomogeneous isolated hypersurface singularities and, more generally, invariants of graded Artinian Gorenstein algebras. The method utilizes certain polynomials associated to such algebras, called nil-polynomials, and we compare them with two other classes of polynomials that have also been used to produce invariants.Comment: 13 page