Considerations on the Castrop formula for calculation of intraocular lens power

Background: To explain the concept of the Castrop lens power calculation formula and show the application and results from a large dataset compared to classical formulae. Methods: The Castrop vergence formula is based on a pseudophakic model eye with 4 refractive surfaces. This was compared against the SRKT, Hoffer-Q, Holladay1, simplified Haigis with 1 optimized constant and Haigis formula with 3 optimized constants. A large dataset of preoperative biometric values, lens power data and postoperative refraction data was split into training and test sets. The training data were used for formula constant optimization, and the test data for cross-validation. Constant optimization was performed for all formulae using nonlinear optimization, minimising root mean squared prediction error. Results: The constants for all formulae were derived with the Levenberg-Marquardt algorithm. Applying these constants to the test data, the Castrop formula showed a slightly better performance compared to the classical formulae in terms of prediction error and absolute prediction error. Using the Castrop formula, the standard deviation of the prediction error was lowest at 0.45 dpt, and 95% of all eyes in the test data were within the limit of 0.9 dpt of prediction error. Conclusion: The calculation concept of the Castrop formula and one potential option for optimization of the 3 Castrop formula constants (C, H, and R) are presented. In a large dataset of 1452 data points the performance of the Castrop formula was slightly superior to the respective results of the classical formulae such as SRKT, Hoffer-Q, Holladay1 or Haigis

Successful toric intraocular lens implantation in a patient with induced cataract and astigmatism after posterior chamber toric phakic intraocular lens implantation: a case report

<p>Abstract</p> <p>Introduction</p> <p>We report the case of a patient in whom simultaneous toric phakic intraocular lens removal and phacoemulsification with toric intraocular lens implantation were beneficial for reducing pre-existing astigmatism and acquiring good visual outcomes in eyes with implantable collamer lens-induced cataract and astigmatism.</p> <p>Case presentation</p> <p>A 53-year-old woman had undergone toric implantable collamer lens implantation three years earlier. After informed consent was obtained, we performed simultaneous toric implantable collamer lens removal and phacoemulsification with toric intraocular lens implantation. Preoperatively, the manifest refraction was 0, -0.5 × 15, with an uncorrected visual acuity of 0.7 and a best spectacle-corrected visual acuity of 0.8. Postoperatively, the manifest refraction was improved to 0, -0.5 × 180, with an uncorrected visual acuity of 1.2 and a best spectacle-corrected visual acuity of 1.5. No vision-threatening complications were observed.</p> <p>Conclusion</p> <p>Toric intraocular lens implantation may be a good surgical option for the correction of spherical and cylindrical errors in eyes with implantable collamer lens-induced cataract and astigmatism.</p

Monte Carlo simulation of expected outcomes with the AcrySof® toric intraocular lens

<p>Abstract</p> <p>Background</p> <p>To use a Monte Carlo simulation to predict postoperative results with the AcrySof^®Toric lens, evaluating the likelihood of over- or under-correction using various toric lens selection criteria.</p> <p>Methods</p> <p>Keratometric data were obtained from a large patient population with preoperative corneal astigmatism <= 2.50D (2,000 eyes). The probability distributions for toric marking accuracy, surgically induced astigmatism and lens rotation were estimated using available data. Anticipated residual astigmatism was calculated using a Monte Carlo simulation under two different lens selection scenarios.</p> <p>Results</p> <p>This simulation demonstrated that random errors in alignment, surgically induced astigmatism and lens rotation slightly reduced the overall effect of the toric lens. Residual astigmatism was statistically significantly higher under the simulation of surgery relative to an exact calculation (p < 0.05). The simulation also demonstrated that more aggressive lens selection criteria could produce clinically significant reductions in residual astigmatism in a high percentage of patients.</p> <p>Conclusion</p> <p>Monte Carlo simulation suggests that surgical variability and lens orientation/rotation variability may combine to produce small reductions in the correction achieved with the AcrySof^®Toric^®IOL. Adopting more aggressive lens selection criteria may yield significantly lower residual astigmatism values for many patients, with negligible overcorrections. Surgeons are encouraged to evaluate their AcrySof^®Toric^®outcomes to determine if they should modify their individual lens selection criteria, or their default surgically induced astigmatism value, to benefit their patients.</p

Memory in Microbes: Quantifying History-Dependent Behavior in a Bacterium

Memory is usually associated with higher organisms rather than bacteria. However, evidence is mounting that many regulatory networks within bacteria are capable of complex dynamics and multi-stable behaviors that have been linked to memory in other systems. Moreover, it is recognized that bacteria that have experienced different environmental histories may respond differently to current conditions. These “memory” effects may be more than incidental to the regulatory mechanisms controlling acclimation or to the status of the metabolic stores. Rather, they may be regulated by the cell and confer fitness to the organism in the evolutionary game it participates in. Here, we propose that history-dependent behavior is a potentially important manifestation of memory, worth classifying and quantifying. To this end, we develop an information-theory based conceptual framework for measuring both the persistence of memory in microbes and the amount of information about the past encoded in history-dependent dynamics. This method produces a phenomenological measure of cellular memory without regard to the specific cellular mechanisms encoding it. We then apply this framework to a strain of Bacillus subtilis engineered to report on commitment to sporulation and degradative enzyme (AprE) synthesis and estimate the capacity of these systems and growth dynamics to ‘remember’ 10 distinct cell histories prior to application of a common stressor. The analysis suggests that B. subtilis remembers, both in short and long term, aspects of its cell history, and that this memory is distributed differently among the observables. While this study does not examine the mechanistic bases for memory, it presents a framework for quantifying memory in cellular behaviors and is thus a starting point for studying new questions about cellular regulation and evolutionary strategy

Effectiveness of manual therapies: the UK evidence report

<p>Abstract</p> <p>Background</p> <p>The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions.</p> <p>Methods</p> <p>The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs.</p> <p>Results</p> <p>By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines.</p> <p>Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments.</p> <p>Conclusions</p> <p>Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation, or for Stage 1 hypertension when added to an antihypertensive diet. In children, the evidence is inconclusive regarding the effectiveness for otitis media and enuresis, and it is not effective for infantile colic and asthma when compared to sham manipulation.</p> <p>Massage is effective in adults for chronic low back pain and chronic neck pain. The evidence is inconclusive for knee osteoarthritis, fibromyalgia, myofascial pain syndrome, migraine headache, and premenstrual syndrome. In children, the evidence is inconclusive for asthma and infantile colic.</p