Topography changes and endothelial cell loss after temporal 1.8 mm coaxial microincision cataract surgery (MICS)

INTRODUCTION. The purpose of this paper was to determine surgically-induced changes both in corneal topographic parameters and in endothelial cell loss after coaxial microincision cataract surgery (MICS) through temporal 1.8 mm incision. MATERIALS AND METHODS. Evaluation was performed in forty eyes of thirty patients who underwent cataract sur­gery. Topographic parameters including corneal astigmatism, surface regularity index (SRI), and surface asymmetry index (SAI) were estimated preoperatively and at one week, four weeks, and eight weeks after surgery. A specular microscope was also used for the measurement of the corneal endothelial density (cells/mm2). The surgically-induced astigmatism (SIA) was calculated by means of vector analysis using Alpins’ method. RESULTS. Eight weeks after surgery the final mean value of SIA was 0.42 D and the differences in topographic parameters such as corneal astigmatism, SRI, and SAI were not statistically significant. Also, the decrease in endothelial cell density eight weeks after surgery was 6.02%. CONCLUSIONS. The changes in SIA and topographic parameters after temporal coaxial 1.8 mm MICS are minimal throughout an eight-week follow up period

Living-related limbal allograft transplantation for bilateral stem cell deficiency in a patient with bilateral chemical burn

INTRODUCTION. The purpose of this paper was to report the long-term outcome of a living-related limbal allograft transplantation followed by penetrating keratoplasty in a patient with severe bilateral stem cell deficiency. MATERIALS AND METHODS. A 50-year-old woman presented with extensive bilateral stem cell deficiency secondary to ocular acid burn on both eyes. Visual acuity was counting fingers at 30 cm on the right eye and counting fingers at 1 m Snellen line on the left. Limbal allograft transplantation on the right eye from a first-degree living-related relative was performed. The recipient was prepared by removing the abnormal corneal epithelium and vascularised pannus of the right eye under general anaesthesia. Two limbal allografts (mean length of 2–3 corresponding anatomic posi­tions on the recipient). Postoperatively, the host received systemic immunosuppression (steroids and cyclosporine). RESULTS. The cornea of the right eye achieved reepithelialisation within two weeks after surgery, followed by re­duction in vascularity in eight weeks time. After one year of regular follow up, the corneal surface remained stable whereas the stroma was opaque and the vision was low. Therefore, the patient underwent penetrating keratoplasty on the same eye. After the surgery the corneal graft was clear and the visual acuity on the right eye improved to 20/50 Snellen line. No graft rejection occurred after a five-year follow-up. CONCLUSION. Living-related limbal allograft transplantation is a good alternative option in cases of total bilateral stem cell deficiency whenever a conjunctival limbal autograft transplantation is not possible

Phototherapeutic keratectomy for the treatment of dense subepithelial infiltrates after epidemic keratoconjunctivitis

This is a case report of a patient who developed dense subepithelial corneal infiltrates after epidemic keratoconjunctivitis and was treated with phototherapeutic keratectomy (PTK). The purpose of this case report is to explain the surgical technique and the results of PTK procedure

Partial transepithelial topography-guided PRK combined with corneal collagen crosslinking in patients with keratoconus

INTRODUCTION. The aim of this study is to identify the visual outcome and possible complications of partial transepithelial topography-guided PRK combined with collagen crosslinking in patients with keratoconus. MATERIALS AND METHODS. Twenty eyes (20 patients) were treated with partial transepithelial topography-guided PRK combined with collagen crosslinking. Patients were evaluated preoperatively for best spectacle corrected visual acuity (BSCVA), clinical signs of keratoconus via slit lamp examination, and Scheimpflug-generated corneal topography. All eyes were treated with Amaris 750s Excimer Laser and KXL system. RESULTS . Mean BCVA was improved from 20/100 to 20/25, postoperatively. Mean flat K was 46.8 ± 0.14 D preoperatively and was reduced to 45.2 ± 0.7 D postoperatively. Mean steep K was reduced from 50.2 ± 0.10 D to 47 ± 0.6 D. Total corneal astigmatism was 4.5 ± 0.14 D and decreased to 2.5 ± 0.10 D postoperatively. Average thinnest pachymetry was reduced from 465 ± 9.9 μm to 416 ± 11.3 μm. Total RMS (corneal aberrations) was 15.5 ± 7.4μm and was significantly reduced to 5.5 ± 2 μm. CONCLUSIONS. Partial transepithelial topography-guided PRK combined with collagen crosslinking can benefit patients fitting the criteria for such a procedure, by stabilising their cornea as well as improving their BSCVA.

Evaluating the safety and efficacy of photorefractive keratectomy combined with corneal collagen crosslinking for the treatment of myopia and myopic astigmatism

INTRODUCTION. The purpose of the study was to evaluate the safety and efficacy of photorefractive keratectomy (PRK) combined with corneal collagen crosslinking (CXL) in patients with potential risk of developing postoperative ectasia, who were not good candidates for LASIK. MATERIALS AND METHODS. Twenty eyes were treated with transepithelial PRK combined with CXL. Patients were evaluated preoperatively for best corrected visual acuity (BCVA), refraction, keratometry, topography, and endothelial cell count. All eyes were treated with Amaris 750s Excimer Laser and KXL system for 90 seconds at 30 mW/cm2. RESULTS. Mean BCVA was improved from 0.0075 ± 0.08 logMAR to 0.025 ± 0.05 logMAR postoperatively. Average keratometry reduced from 44.9 ± 1.9 D to 39.8 ± 3.9 D. Mean minimal corneal thickness reduced from 504 ± 16.7 μm to 405 ± 41 μm. None of the cases developed regression, corneal ectasia, or corneal haze. CONCLUSIONS. Photorefractive keratectomy combined with high-fluence corneal collagen crosslinking (PRK XTRA) appears to be a safe and effective treatment for patients who are not good candidates for LASIK

Implementation of an Interactive Crowd-Enhanced Content Management System for Tourism Development

This paper investigated the role of interactive tourist mobile apps in tourism development. The researchers presented the e-Tracer application, which was developed taking into consideration the recent advantages in mobile computing, the importance of user-generated content and the needs of northern Greece and the lower Balkan countries. Apart from crowd-based content creation, a new generation of apps for tourism development may include additional components like serious games for tourists, map-based navigation systems and augmented/virtual reality applications, in order to offer memorable user experiences for tourists. An agile content management system design methodology was followed by taking into account the needs of alternative tourist destinations, small to medium sized real-world museums and driver rest areas located around highways which connect cross-country destinations in the lower Balkan countries and Turkey. This work positioned the role of interactive crowd-enhanced platforms for content management of tourist-related information in tourism development, economic growth and sustainability of the Egnatia motorway surrounding areas in Greece. Keywords: mobile computing, content management systems, recommender systems, serious games, virtual/augmented reality, tourism developmen

The positive and negative impact of an intergenerational digital technology education programme on younger people’s perceptions of older adults

In order to meet the technological needs of older adults, and ensure digital inclusion, it is important for digital technology designers to accurately assess and understand older adults’ needs and requirements, free from the influence of societal assumptions of their capabilities. This study evaluated the impact of an intergenerational digital technology education programme on younger adults’ stereotypes of older people. Using an experimental design, results show that compared to a control group, students taking part in the programme subsequently rated older adults as more friendly but less competent. Practical implications for developing intergenerational education programmes are discussed

The Hellenic type of nondeletional hereditary persistence of fetal hemoglobin results from a novel mutation (g.-109G>T) in the HBG2 gene promoter

Nondeletional hereditary persistence of fetal hemoglobin (nd-HPFH), a rare hereditary condition resulting in elevated levels of fetal hemoglobin (Hb F) in adults, is associated with promoter mutations in the human fetal globin (HBG1 and HBG2) genes. In this paper, we report a novel type of nd-HPFH due to a HBG2 gene promoter mutation (HBG2:g.-109G>T). This mutation, located at the 3′ end of the HBG2 distal CCAAT box, was initially identified in an adult female subject of Central Greek origin and results in elevated Hb F levels (4.1%) and significantly increased Gγ-globin chain production (79.2%). Family studies and DNA analysis revealed that the HBG2:g.-109G>T mutation is also found in the family members in compound heterozygosity with the HBG2:g.-158C>T single nucleotide polymorphism or the silent HBB:g.-101C>T β-thalassemia mutation, resulting in the latter case in significantly elevated Hb F levels (14.3%). Electrophoretic mobility shift analysis revealed that the HBG2:g.-109G>T mutation abolishes a transcription factor binding site, consistent with previous observations using DNA footprinting analysis, suggesting that guanine at position HBG2/1:g.-109 is critical for NF-E3 binding. These data suggest that the HBG2:g-109G>T mutation has a functional role in increasing HBG2 transcription and is responsible for the HPFH phenotype observed in our index cases

Clinical features and outcomes of patients with tubercular uveitis treated with antitubercular therapy in the collaborative ocular tuberculosis study (COTS)-1

IMPORTANCE Eradication of systemic tuberculosis (TB) has been limited by neglected populations and the HIV pandemic. Whereas ocular TB often presents as uveitis without any prior evidence of systemic TB, the existing uncertainty in the diagnosis of TB uveitis may perpetuate missed opportunities to address systemic TB. OBJECTIVE To examine the clinical features of TB uveitis and the associations with response to antitubercular therapy (ATT). DESIGN, SETTING, AND PARTICIPANTS This retrospective multinational cohort study included patients from 25 ophthalmology referral centers diagnosed with TB uveitis and treated with ATT from January 1, 2004, through December 31, 2014, with a minimum follow-up of 1 year. MAIN OUTCOMES AND MEASURES Treatment failure, defined as a persistence or recurrence of inflammation within 6 months of completing ATT, inability to taper oral corticosteroids to less than 10mg/d or topical corticosteroid drops to less than 2 drops daily, and/or recalcitrant inflammation necessitating corticosteroid-sparing immunosuppressive therapy. RESULTS A total of 801 patients (1272 eyes) were studied (mean [SD] age, 40.5 [14.8] years; 413 [51.6%] male and 388 [48.4%] female; 577 [73.6%] Asian). Most patients had no known history (498 of 661 [75.3%]) of systemic TB. Most patients had bilateral involvement (471 of 801 [58.8%]). Common clinical signs reported include vitreous haze (523 of 1153 [45.4%]), retinal vasculitis (374 of 874 [42.8%]), and choroidal involvement (419 of 651 [64.4%]). Treatment failure developed in 102 of the 801 patients (12.7%). On univariate regression analysis, the hazard ratios (HRs) associated with intermediate uveitis (HR, 2.21; 95%CI, 1.07-4.55; P = .03), anterior uveitis (HR, 2.68; 95%CI, 1.32-2.35; P = .006), and panuveitis (HR, 3.28; 95%CI, 1.89-5.67; P < .001) were significantly higher compared with posterior distribution. The presence of vitreous haze had a statistically significant association (HR, 1.95; 95%CI, 1.26-3.02; P = .003) compared with absence of vitreous haze. Bilaterality had an associated HR of 1.50 (95%CI, 0.96-2.35) compared with unilaterality (HR, 1 [reference]), although this finding was not statistically significant (P = .07). On multivariate Cox proportional hazards regression analysis, the presence of vitreous haze had an adjusted HR of 2.98 (95%CI, 1.50-5.94; P = .002), presence of snow banking had an adjusted HR of 3.71 (95%CI, 1.18-11.62; P = .02), and presence of choroidal involvement had an adjusted HR of 2.88 (95%CI, 1.22-6.78; P = .02). CONCLUSIONS AND RELEVANCE A low treatment failure rate occurred in patients with TB uveitis treated with ATT. Phenotypes and test results are studied whereby patients with panuveitis having vitreous and choroidal involvement had a higher risk of treatment failure. These findings are limited by retrospectivemethods. A prospectively derived composite clinical risk score might address this diagnostic uncertainty through holistic and standardized assessment of the combinations of clinical features and investigation results that may warrant diagnosis of TB uveitis and treatment with ATT

SAFEFOODNET : a survey on the activities related to diet definition in new member countries and associated countries of the European Union

The SAFEFOODNET project (Chemical Food Safety Network for the enlarging Europe) has as primary objectives the harmonisation and integration of Associated Candidate Countries (ACC) and New Member States (NMS) infrastructures and activities in the field of chemical food safety with those of Member States (MS). SAFEFOODNET consortium has 20 partners from 17 countries, which include 4 MS (Italy, Denmark, Germany and Belgium), 10 NMS (Hungary, Czech Republic, Slovakia, Poland, Latvia, Lithuania, Estonia, Slovenia, Malta, Cyprus), and 3 ACC (Bulgaria, Romania, Turkey). The structure of the general work plan has been broken down into 5 work packages to respond in a practical way to the SAFEFOODNET proposed objectives. Regarding the possibilities for dietary assessment, individual country profiles assemble information with respect to the identification of existing resources, organisational features, data sources and availability, with a view of establishing a \u201cstandard diet\u201d (according for instance to the indications of GEMS/FOOD of WHO) and consumption patterns. In order to retrieve and collect the information available in the field of dietary intake for each country, a questionnaire on diet was prepared. The questionnaire was divided in two parts: the first one regarding the institutions involved in the assessment of food consumption through performance of food intake surveys at national level, participation in relevant international projects, creation and maintenance of databases, or any other activity in the field of diet definition. The second part was focused at collecting further details on the individual surveys performed, such as type, methodology, population involved, availability and form of data acquired, as well as the suitability of the data to be used for acute intake estimates. The data are still being elaborated however some local specificities can be observed