Evaluation of a Novel Non-Diffractive Extended Depth of Focus Intraocular Lens : First Results from a Prospective Study

Purpose: To evaluate a novel hydrophobic, non-diffractive, extended depth of focus (EDOF) intraocular lens (IOL) design in comparison to two monofocal aspheric lenses. Methods: Inclusion criteria for this prospective, monocentric cohort study were opacification of the crystalline lens and patients’ wishes for surgery. In the case of the EDOF IOL, patients asked for a presbyopia correction. All patients received surgery on both eyes. Corrected and uncorrected distance visual acuity (CDVA, UCDVA), uncorrected and distance corrected intermediate visual acuity (UIVA, DCIVA) and defocus curves (all monocular and binocular) were compared three months postoperatively. Results: Fifty-six eyes were implanted with an EDOF IOL (LuxSmartTM, Bausch & Lomb GmbH, Berlin, Germany), 50 eyes with a monofocal aspheric IOL: 32 eyes with a clear IOL (PolylensVR AS 61, Polytech Domilens, Roßdorf, Germany), 16 eyes with a yellow IOL (iSertVR 251, Hoya Surgical Optics GmbH, Frankfurt, Germany). Three months postoperatively, UCDVA was comparable with the EDOF IOL, versus the monofocal IOL (P> 0.9). Binocular DCIVA in the EDOF IOL was significantly higher than in the monofocal IOL (P¼ 0.001). Monocular DCIVA better than 20/23 Snellen was achieved in 10% with the monofocal IOL and in 68% (P< 0.0001) with the EDOF IOL. Defocus curves showed a depth of focus at 20/23 Snellen of 1.6 vs. 0.83 diopters (D) in the EDOF IOL, vs. the monofocal IOL. No patient reported halos or starbursts in non-standardized questioning. Conclusion: This non-diffractive EDOF IOL provided comparably high UCDVA and significantly higher DCIVA than the mono-focal lenses, causing only mild optical phenomena

Lifetime history of indoor tanning in young people: a retrospective assessment of initiation, persistence, and correlates

<p>Abstract</p> <p>Background</p> <p>Despite educational and public health campaigns to convey the risks of indoor tanning, many individuals around the world continue to engage in this behavior. Few descriptive studies of indoor tanning have collected information pertaining to the lifetime history of indoor tanning, thereby limiting our ability to understand indoor tanning patterns and potentially target interventions for individuals who not only initiate, but continue to persistently engage in indoor tanning.</p> <p>Methods</p> <p>In-person interviews elicited detailed retrospective information on lifetime history of indoor tanning among white individuals (n = 401) under age 40 seen by a dermatologist for a minor benign skin condition. These individuals were controls in a case-control study of early-onset basal cell carcinoma. Outcomes of interest included ever indoor tanning in both males and females, as well as persistent indoor tanning in females - defined as females over age 31 who tanned indoors at least once in the last three or all four of four specified age periods (ages 11-15, 16-20, 21-30 and 31 or older). Multivariate logistic regression was used to identify sociodemographic and lifestyle correlates of ever and persistent indoor tanning in females.</p> <p>Results</p> <p>Approximately three-quarters (73.3%) of females and 38.3% of males ever tanned indoors, with a median age of initiation of 17.0 and 21.5, respectively. Among indoor tanners, 39.3% of females and 21.7% of males reported being burned while indoor tanning. Female ever indoor tanners were younger, had darker color eyes, and sunbathed more frequently than females who never tanned indoors. Using unique lifetime exposure data, 24.7% of female indoor tanners 31 and older persistently tanned indoors starting as teenagers. Female persistent indoor tanners drank significantly more alcohol, were less educated, had skin that tanned with prolonged sun exposure, and sunbathed outdoors more frequently than non-persistent tanners.</p> <p>Conclusions</p> <p>Indoor tanning was strikingly common in this population, especially among females. Persistent indoor tanners had other high-risk behaviors (alcohol, sunbathing), suggesting that multi-faceted behavioral interventions aimed at health promotion/disease prevention may be needed in this population.</p

THE CONCEPT OF LAW AND EFFICACY

Jedno od značenja izraza ‘učinkovitost’ odnosi se na činjenicu da se adresati pravnih normi stvarno ponašaju onako kako to od njih zahtijevaju pravne norme. To se značenje izraza obično koristi u filozofskopravnim raspravama glede toga je li učinkovitost bitan element pojma prava. Prema pravnom pozitivizmu, učinkovitost je u nekim slučajevima i na određene načine uvjet važenja (vrijeđenja) pravnih normi i pravnih sustava. S druge strane, pravni je realizam sklon potpunom poistovjećivanju pravnog važenja s učinkovitosti ili njegovu svođenju na učinkovitost. Prema tome, u oba je filozofskopravna pravca učinkovitost u pravilu uključena u oblikovanje njihovih pojmova prava. Međutim, dok pravnopozitivističko shvaćanje ne utječe na najuobičajenije značenje važenja pravne norme (pripadanje pravne norme pravnom sustavu), a utvrđivanjem učinkovitosti kao kriterija postojanja pravnog sustava ne dodaje mnogo objašnjenju pojma prava, pravnorealističko se shvaćanje suočava s ozbiljnim prigovorima glede svoje objašnjavalačke prikladnosti.One of the senses of the term ‘efficacy’ refers to the fact that norm-addresses actually behave as is required of them by legal norms. This sense of the term is one which is generally used within the jurisprudential discussions about whether efficacy is the essential element of the concept of law. According to legal positivism, efficacy is in some cases and in certain ways the condition of legal validity of both legal norms and legal systems. On the other hand, legal realism tends to entirely identify legal validity or reduce it to efficacy. Thus, in both jurisprudential approaches, efficacy tends to play a role in shaping their respective concepts of law. However, while the legal positivistic view does not affect the most standard sense of legal validity of the legal norm (i.e. the legal norms’ membership in the legal system), and does not add much to the explanation of the concept of law by identifying efficacy as the criterion of legal systems’ existence, the legal realistic view is faced with some serious objections regarding its explanatory adequacy

Laser flare photometry for identification of high-risk patients for proliferative vitreoretinopathy

Proliferative vitreoretinopathy (PVR) is a complication of rhegmatogenous retinal detachment and trauma, which occurs in approximately 10% following vitreoretinal surgery. The visual prognosis for established PVR is poor and so far there is no established conservative treatment for PVR. In the currently recruiting PRIVENT trial the aim is to find a prophylactic treatment possibility for PVR. The PRIVENT study examines the influence of intraoperative adjuvant pharmacotherapy on reducing the incidence of PVR; however, this requires the identification of eyes with increased risk for PVR. Laser flare photometry is a simple method to predict the individual risk for PVR. It is a non-invasive technique that objectifies the Tyndall effect. Various laser flare meter devices are available on the market. In previous studies it could be shown that laser flare photometry can predict the development of PVR in eyes with primary rhegmatogenous retinal detachment with a sensitivity of 80%. The identification of these high-risk eyes for PVR could be the first step towards solving the problem of PVR

Merkel cell carcinoma of the eyelid. An often unrecognized tumor entity. Clinical aspects and treatment strategies

Merkel cell carcinoma of the eyelid is an aggressive, highly malignant tumor of the skin. Totaling approximately 0.5 % of all tumors of the eyelid, it constitutes a relatively small group of lid tumors. Nevertheless Merkel cell carcinoma is of significance to the ophthalmologist. Because of its clinical presentation it can be easily confused as a chalazion, a hordeolum or the lesser aggressive basal cell carcinoma. This often leads to delayed treatment. In this article we describe clinical aspects, which aim to help the ophthalmologist suspect Merkel cell carcinoma earlier. Additionally we outline a diagnostic and therapeutic workup taking into consideration the special anatomy of the eyelid

Rebound tonometry after vitreoretinal surgery

The aim of this study was to analyze the practicability and comparability of the Icare rebound tonometer (RT) versus the Schiotz indentation tonometer (SIT) and the Goldmann applanation tonometer (GAT) for measuring intraocular pressure (IOP) in patients after pars plana vitrectomy (PPV). A total of 100 eyes from 100 patients who underwent vitreoretinal surgery in the Department of Ophthalmology, University of Cologne were included in this prospective analysis. The IOP was measured using RT preoperatively, on the day of surgery and 2 days after surgery, using SIT on the day of surgery and GAT preoperatively and 2 days after surgery. For the evaluation eyes were divided into subgroups with respect to the endotamponade selected and the IOP level. The mean preoperative IOP for all enrolled eyes was 15.4 +/- 8.0 mmHg for RT and 16.1 +/- 7.9 mmHg for GAT. Bland-Altman analysis revealed a bias between RT and GAT of -aEuro parts per thousand 0.6 mmHg. Bland-Altman analysis for the postoperative course of all eyes revealed a bias of 3.0 mmHg between RT and SIT on the day of surgery and no bias between RT and GAT in the further postoperative follow-up. Rebound tonometry seems to provide precise IOP values after vitreoretinal surgery. Divergence from SIT values on the day of surgery is presumably due to a general tendency of SIT to underestimate IOP values. Therefore, RT can be used in the clinical routine after vitreoretinal surgery as an alternative to GAT

Reduced nerve growth factor levels in stress-related brain regions of folate-deficient mice

Folate deficiency has been linked to neurodegenerative and stress-related diseases such as stroke, dementia and depression. The role of the neurotrophins nerve growth factor (NGF) and neurotrophin-3 (NT-3) in stress-related disorders and neurodegeneration has garnered increasing attention in recent years. Uracil misincorporation is involved in the neuropsychiatric dysfunction induced by experimental folate deprivation. However, the effects of folate deficiency on the expression of NGF and NT-3 in brain tissue have not yet been investigated. In a 2×2 design, aged mice lacking uracil-DNA N-glycosylase (Ung(-/-)) versus wild-type (Ung(+/+)) controls were subjected to a folate-deficient diet versus a regular diet for three months. Independent of genotype, folate deficiency led to decreased NGF protein levels in the frontal cortex and amygdala. In the hippocampus, NGF levels were increased in UNG(-/-) mice on the normal diet, but not under folate deficiency, while in UNG(+/+) mice, folate deprivation did not affect hippocampal NGF content. NT-3 protein concentrations were neither affected by genotype nor by folate deficiency. Altogether, the results of our study show that folate deficiency affects NGF levels in the frontal cortex, amygdala and hippocampus. The decrease in NGF content in the hippocampus in response to folate deficiency in Ung(-/-) mice may contribute to their phenotype of enhanced anxiety and despair-like behavior as well as to selective hippocampal neurodegeneration