Lentes intraoculares trifocales: revisión bibliográfica

El objetivo del presente estudio ha sido evaluar y analizar resultados tanto clínicos como teóricos para proporcionar un mayor entendimiento del funcionamiento de las lentes intraoculares (LIOs) trifocales. Para ello, se ha realizado una búsqueda bibliográfica, incluyendo tanto artículos de simulaciones en banco óptico como aquellos que muestran resultados clínicos. En la búsqueda se han encontrado artículos sobre tres LIOs trifocales: AT.LISA tri839MP (Carl Zeiss Meditec), FineVision (PhysIOL) y MIOL-Record (Repper-NN). En los estudios teóricos se ha demostrado que las LIOs trifocales presentan una mejora con respecto a las LIOs bifocales en cuanto a visión intermedia pero con una disminución en cuanto a calidad óptica en distancias lejanas y cercanas. Por el contrario, en cuanto a resultados clínicos, las LIOs trifocales proporcionan buenas agudezas visuales en visión lejana y agudezas visuales variables pero siempre aceptables en visión intermedia y cercana. En conclusión, LIOs trifocales ofrecen una opción a aquellos pacientes que necesitan trabajar en visión intermedia y buscan no tener que depender del uso de gafas tras cirugía de catarata

Stress monitoring in conflict resolution situations

Online Dispute Resolution is steadily growing to become the major alternative to litigation in court. In fact, given the characteristics of current disputes, technology-based conflict resolution may be a quite efficient approach. However, in this shift of paradigm, there are also threats that should be considered. Specifically, in this paper we deal with the problem of the lack of important context information when parties communicate in a virtual setting. In that sense, we propose the addition of a monitoring framework capable of measuring the level of stress of the parties in a non-invasive way. This information will be used by the platform and the mediator throughout the complete conflict resolution process to adapt strategies in real-time, resulting in a context-aware and more efficient approach.The work described in this paper is included in TIARAC - Telematics and Artificial Intelligence in Alternative Conflict Resolution Project (PTDC/JUR/71354/2006), which is a research project supported by FCT (Science & Technology Foundation), Portugal. The work of Davide Carneiro is supported by a doctoral grant by FCT (SFRH/BD/64890/2009). This work is also partially supported by the Spanish Ministerio de Ciencia e Innovacion under project TIN2010-20845-C03-01 and by the Spanish Junta de Comunidades de Castilla-La Mancha under projects PII2I09-0069-0994 and PEII09-0054-9581

Analysis and comparison of monofocal, extended depth of focus and trifocal intraocular lens profiles

To test the feasibility of using profilometers to extract information about IOL surfaces design. A standard monofocal IOL (Tecnis 1), a monofocal IOL that provided some depth of focus (Eyhance), an extended depth of focus IOL based on refractive optics (Mini Well) and a trifocal IOL based on diffractive optics were used in this study (Tecnis Synergy). The surface topography of the IOLs was measured by using a multimode optical profilometer. Posterior surface of Tecnis 1 IOL was spherical and the anterior surface aspherical. In the Eyhance IOL, posterior surface was spherical and anterior surface did not fit to any of our reference surfaces, indicating a higher order aspheric surface design. In the Mini Well Ready IOL, a best-fit sphere surface was obtained for the second surface and a high order aspherical surface design was deduced for the first surface. The anterior surface of the Synergy IOL was aspherical and the base curve of the diffractive structure fitted very well to a spherical surface. To consider an aspheric surface as possible best-fit surface provided more information than if only best-fit spherical surface was considered. The high order aspheric surface designs employed in the IOLs studied presented differences, regarding best-fit asphere surface, higher than 1 micron. These differences were correlated with the generation of spherical aberration complex profiles (with Zernike terms higher than 4th order) and with the production of distinct amounts of depth of focus. This method was also useful to deduce the base curve of diffractive surfaces.This work was supported by the “Generalitat Valenciana” of Spain (project AICO/2021/130)

La importancia del diseño de una página web de un departamento

En este proyecto pretendemos mejorar la visibilidad de la página web del departamento de Óptica, Farmacología y Anatomía a partir de la creación de un nuevo diseño de la misma. Trataremos por tanto de diseñar una estrategia de promoción de toda la actividad que esté relacionada con el departamento y del personal que lo conforma. Diversos aspectos deberán ser analizados y definidos para la puesta en marcha del proyecto. Primero de todo es importante determinar cuál es la información que debe aparecer en la página web y de qué manera. Para ello se debe establecer un mecanismo de toma de decisiones que decida la política de la página web. Los resultados de este nuevo diseño y estrategia serán analizados a partir de las estadísticas que ofrece la propia página web institucional. Estableceremos comparativas entre las visitas realizadas antes y después de crear el nuevo diseño y también analizaremos la actividad generada entorno a la página web. Por último, trataremos de establecer cuáles serían los recursos mínimos que se deberían destinar los departamentos para mantener una página web actualizada y atractiva de manera viable y duradera en el tiempo

Intrasession repeatability of refractive and ocular aberrometric measurements obtained using a multidiagnostic device in healthy eyes

Purpose: To evaluate the intrasession repeatability of refractive and ocular aberrometric measurements obtained using a new multidiagnostic device in healthy eyes. Patients and methods: A total of 107 eyes of 107 patients, age ranging from 23 to 65 years, were enrolled in this study. A complete eye examination was performed in all eyes, including an ocular examination using the VX120 system. Three consecutive measurements were obtained using this device to assess the intrasession repeatability of different refractive and ocular aberrometric parameters. The within-subject standard deviation (Sw), intrasubject precision (1.96×Sw), and intraclass correlation coefficient (ICC) were calculated. Results: Sw and intrasubject precision for refractive data were below 0.12 and 0.20 D, respectively, in all cases. The ICC ranged from 0.947 for the J45 power vector component to 0.997 for the sphere. Concerning aberrometric measurements Sw and intrasubject precision values were below 0.05 µm and 0.10 µm, respectively. Likewise, the ICC ranged from 0.805 for the quadrafoil root mean square to 0.954 for the primary spherical aberration. Poor correlations were found between most of the refractive parameters and their Sw (–0.033≤r≤0.053, p≥0.064). Moderate and significant positive correlations were found between the magnitude of the aberrometric parameters evaluated and their Sw (r≥0.446, p<0.001). Conclusion: The new multidiagnostic device evaluated is able to provide consistent measurements of refraction and ocular aberrations in healthy eyes. Future studies should confirm if this consistency is also observed in highly aberrated eyes

Understanding the Real Effect of the High-Order Aberrations after Myopic Femto-Lasik

In this work we try to understand the real effect of increase in aberrations after Femto-LASIK surgery on the patient’s final visual quality, specifically when the visual acuity measurement is considered. A clinical study with 37 eyes of 20 patients that underwent myopic Femto-LASIK surgery and different personalized eye model simulations were carried out. In clinical study, correlations between pre- and postoperative parameters with visual acuity were analysed. Eye simulations (based on real data) provided simulations of vision quality before and after surgery. Our main results showed a significant increase in aberrations was obtained after surgery; however, no differences were found between the preoperative corrected distance visual acuity (CDVA) and the postoperative uncorrected distance visual acuity (UDVA). This absence of differences in visual quality could be explained by performing different simulations on three eyes that would cover most of the possible clinical situations. Simulations were implemented considering a pupil size of 2.5 mm and the personalized data of each patient. Results showed that final visual acuity (VA) change are determined by the final high-order aberrations (HOAS) and their increase after surgery but measured under photopic conditions. In conclusion, customized analysis of higher-order aberrations in scotopic pupils better predicts patient visual acuity after Lasik surgery.This work was supported by the “Generalitat Valenciana” of Spain (project AICO/2021/130)

Comparison of the optical quality vision between real post-LASIK myopic laser surgery and the simulated implantation of a phakic IOL in low myopia

A phakic intraocular lens (PIOL) of − 4.5 D was characterized from its wavefront aberration profile. A preclinical study was conducted using pre- and post-surgery data from four patients that had undergone myopic laser refractive surgery. All these patients would have needed a PIOL of − 4.5 D. Pre-surgery data were used to simulate the effect of a PIOL implantation. Post myopic refractive surgery data were used to calculate the post-LASIK eye model. Modulation transfer function (MTF), point spread function (PSF) and simulation of optotypes vision were obtained and compared. The PIOL did not worsen the optical quality of the eyes evaluated. High order Aberrations were always higher in the post-LASIK eye model. Optics quality trended to be better in PIOL implantation than post-LASIK surgery as pupil size increased.This work was supported by the “Generalitat Valenciana” of Spain (project AICO/2021/130)

Clinical Evaluation of a New Approach for IOL Power Calculation in Keratoconus

Purpose: To obtain an expression of the adjusted IOL power (PIOLadj) in keratoconus eyes associated with minimal errors in IOL power calculation. Materials and methods: This retrospective study included a total of 25 eyes of 25 patients with ages ranging from 20 years to 76 years. The following IOLs were implanted: Acrysof IQ Toric, Acrysof SA60AT in 9 eyes, Sensar in 3 eyes, Tecnis 1 in 4 eyes, and Tecnis Toric in 2 eyes. The PIOLadj is based on Gauss equations, using adjusted keratometric index (nkadj) specific to keratoconus eyes. From this nkadj, an adjusted keratometric corneal power is calculated (Pkadj). The PIOLadj calculation was performed after estimating the effective lens position (ELP) using a mathematical expression obtained by multiple regression analysis (named ELPadj). Comparison between the PIOLadj and the real intraocular power implanted in each patient (PIOLreal) was carried out. Results: No significant differences between PIOLreal and PIOLadj were found. However, differences could be clinically relevant up to of 2.54 D as PIOLreal increases. But, in the range of PIOLreal between 0 and 20 D, differences were lower than 1.5 D, being most of them below 1 D. Conclusion: A new formula of IOL power calculation (PIOLadj) based on the use of an adjusted keratometric power (Pkadj) that considers a variable keratometric index due to the influence of the posterior corneal surface (nkadj) and adjusted effective lens position (ELPadj) is useful for estimating IOL power in low-to-moderate keratoconus, with more limitation in the most advanced keratoconus.David P Piñero is supported by the Spanish Ministry of Economy, Industry, and Competitiveness within the program Ramón y Cajal, RYC-2016-20471

Estudio descriptivo sobre el recuerdo del paciente tras la comunicación del diagnóstico y del pronóstico en oncología

The communication doctor – patient plays a fundamental role in their relationship. Bad communication can imply a negative influence between patient and his family. The aim of this work is to obtain better insight in the process of the information that is contributed by the medical oncologist and to check whether the patients remembers this information after fifteen days. The information we present corresponds with the second phase of the “descriptive study on the process of communicating the diagnosis and the prognosis in oncology”. Cohort consisted in 71 cancer patients, who remembered the initial interview and performed a second one. The results obtained show that data collection is depending on the complexity of the transmitted information as well as of its emotional impact; which means that, the simpler and the more emotional impact, better to remember. Therefore this information supports the idea that communication is an evolutionary and continuing process, and is not limited to certain situations, being able to attend the needs both of the patient and his family, facilitating the patient a better adaptation to the oncological disease.La comunicación juega un papel fundamental en la relación médico-paciente. La mala comunicación así mismo, puede llegar a tener una influencia negativa en el paciente y sus familiares. El objetivo de este trabajo es profundizar en el proceso de información aportada por el médico oncólogo y el recuerdo que mantiene el paciente de dicha información transcurridos quince días. Los datos que presentamos se corresponden con la segunda fase del “estudio descriptivo sobre el proceso de comunicar el diagnóstico y el pronóstico en oncología”. La muestra esta formada por 71 pacientes, todos ellos realizaron una segunda entrevista y recordaban la entrevista inicial. Los resultados obtenidos muestran que el recuerdo está en función de la complejidad de la información transmitida así como del impacto emocional de la misma; es decir, a mayor simplicidad y mayor impacto emocional, mejor recuerdo. Por tanto estos datos apoyan la necesidad de que la comunicación sea un proceso evolutivo, y continuado, y no se reduzca a un momento puntual, atendiéndose a las necesidades tanto del paciente como de sus familiares, facilitándose así una mejor adaptación al proceso oncológico

Use of the termotherapy in the sport environment

La aplicación del calor con fines terapéuticos (termoterapia) se ha utilizado durante siglos para el tratamiento de enfermedades y lesiones traumáticas. Aunque recientemente, su uso en el tratamiento inmediato de las lesiones músculo-esqueléticas ha sido reemplazado por el frío. Este trabajo pretende describir cual es el uso de la termoterapia superficial y los baños de contraste en el deporte, sus efectos, las diferentes formas de aplicación, indicaciones y contraindicaciones aportadas por la literatura científica. La metodología utilizada es la revisión bibliográfica de monografías y bases de datos científicas como Medline, Isi Web of Science, Cochrane Database of Systematic Reviews, Science Direct. Conclusiones: Tanto el frío como el calor superficial tienen efectos terapéuticos. Por mecanismo diferentes ambos pueden romper el ciclo muscular de dolor-espasmo-dolor y reducir la inflamación Aunque existen diferentes criterios para elegir el método de termoterapia más indicado para cada afección y los parámetros de aplicación difieren de unos autores a otros, es conocido que el calor aumenta la distensibilidad de los tejidos colágenos, disminuye la rigidez articular, reduce el dolor y la inflamación, alivia el espasmo muscular y aumenta el flujo sanguíneo.The heat use with therapeutic aims (thermotherapy) has been used during centuries for the treatment of diseases and traumatic injuries. Recently, the heat use in the immediate treatment of the muscle-skeletal injuries has been replaced by the cold use. This study tries to describe the superficial thermotherapy use and the contrast-water therapy in the sport, his effects, applications, indications and contraindications contributed by scientific literature. Methods: the bibliographical revision of monographs and scientific databases: Medline, Isi Web of Science, Cochrane Database of Systematic Reviews, Science Direct. Conclusion: As much the cold as the superficial heat have therapeutic effects. By different mechanisms both can break the muscular cycle of pain-spasm-pain and reduce inflammation . Although, there are different criteria to choose the method of thermotherapy more suitable for each pathology and the application parameters are different from authors to others, is known that the heat increases the distensibilidad of collagen tissues, diminishes the rigidity to joint, reduces the pain and the inflammation, alleviates muscular spasm and increases to the blood flow.peerReviewe