Systematic review of potential causes of intraocular lens opacification

Intraocular lens (IOL) opacification is an infrequent complication of cataract surgery. Surface analysis has demonstrated that the opacification of IOLs is related to calcium or phosphate precipitation on or within the lenses, but the associated mechanisms are unknown, and the scientific literature is heterogeneous and limited to case series and retrospective studies. The purpose of this systematic review was to analyse the most frequent conditions associated with opacification of IOLs reported by studies. A search was carried out using the PubMed MEDLINE, Web of Science and Scopus databases. The quality of the studies selected was evaluated using the Pierson tool. The search provided a total of 811 articles, of which 39 were selected following the inclusion and exclusion criteria. The most common opacified lenses were hydrophilic IOLs according to our analysis. The mean time of appearance of lens opacification was 14.93 ± 17.82 months. The most frequent conditions associated with opacification of the IOLs were Descemet Stripping with Automated Endothelial Keratoplasty (DSAEK/DSEK) and diabetes mellitus (DM), followed by pars plana vitrectomy (PPV), blood hypertension (HT), and glaucoma. Concerning the quality analysis, the mean score was 7.00 ± 1.43 (scoring range from 0 to 10), indicating an acceptable quality of the case reports and retrospective studies. In conclusion, DSAEK/DSEK, DM, PPV, glaucoma and hypertension are conditions with potential risk of IOL opacification after cataract surgery, especially when implanting hydrophilic acrylic IOLs.Ministry of Economy, Industry and Competitiveness of Spain, Grant/Award Number: RYC‐2016‐20471

Long-Term Efficacy, Visual Performance and Patient Reported Outcomes with a Trifocal Intraocular Lens: A Six-Year Follow-up

(1) Background: To evaluate the efficacy at 6 years postoperative after the implantation of a trifocal intraocular lens (IOL) AT Lisa Tri 839MP. The secondary objective was to evaluate the contrast sensitivity defocus curve (CSDC), light distortion analysis (LDA), and patient reported outcomes (PROs). (2) Methods: Sixty-two subjects participated in phone call interviews to collect data regarding a visual function questionnaire (VF-14), a patient reported spectacle independence questionnaire (PRSIQ), and questions related to satisfaction and decision to be implanted with the same IOL. Thirty-seven of these subjects were consecutively invited to a study visit for measurement of their visual acuity (VA), CSDC, and LDA. (3) Results: The mean monocular distance corrected VA was −0.05, 0.08, and 0.05 logMAR at far and distances of 67 cm and 40 cm, respectively. These VAs were significantly superior to those reported in previous literature (p < 0.05). The total area under the CSDC was 2.29 logCS/m−1 and the light distortion index 18.82%. The mean VF-14 score was 94.73, with 19.4% of subjects requiring spectacles occasionally for near distances, and 88.9% considering the decision of being operated again; (4) Conclusions: Long-term AT LISA Tri 839MP IOL efficacy results were equal or better than those reported 12 months postoperatively in previous studies. The spectacle independence and satisfaction rates were comparable to those reported in short-term studies.This research was funded by grant support from Carl Zeiss Meditec AG

New contributions on the arrabal emiral de Šaqunda. About the archaeological remains from Gitanos 8 (Córdoba)

Durante la excavación arqueológica de calle Gitanos 8 (Córdoba) apareció un fragmento de cerámica con grafía árabe incisa. Este pequeño fragmento epigrafiado se localizó dentro del contexto histórico del arrabal emiral de Šaqunda y nos puede dar cierta idea acerca del grado de alfabetización e islamización de este populoso arrabal cordobés a lo largo del siglo VIII, antes de su posterior destrucción y abandono durante el famoso motín del arrabal, a inicios del siglo IX. A propósito de la presentación de este grafito, aprovechamos también para dar a conocer nuevos datos sobre los restos arqueológicos donde se encontraba enmarcada la pieza.A fragment of ceramic with Arabic inscription was discovered during the archaeological excavation in Calle Gitanos 8 (Cordoba). This small epigraphic fragment was located within the historical context of the emiral suburb of Šaqunda and can shed some light on the degree of literacy and Islamification of this populous neighbourhood throughout the 8th century, before its later destruction and abandonment during the famous uprising which took place there, at the beginning of the 9th century. With regard to the presentation of this graffiti, we also take the opportunity to reveal the archaeological remains in which the piece was framed

Elongación de tibia hasta 14 cms en niña caboverdiana

Introduction: lower limbs discrepancy is due to numerous causes, either congenital or sequels of several diseases. External fixators, in their various presentations, are designed to solve this problem, above all when the elongation is larger than ten centimeters.Case presentation: female patient, black race, 14 years old, with antecedents of septic arthritis in left hip, being a sequel a 18-cm elongation of the left lower limb. Besides presenting a left equinovarus foot countervailing for strolling, in the rest of the physical examination no data of interest was collected that indicate any circulatory affection, nervous conduction, or muscular force of that limb, reason why it is concluded to start the 14-cm elongation from a tibia and fibula proximal corticotomy at different level and the placement of a metaphysiary distracting fixator RALCA to elongation at 1 mm per day up to the wanted length, and thus to prepare the patient for the future placement of a total hip prosthesis. Conclusions: the external fixator RALCA metaphysiary distracting device is a good choice for elongations over 10cm in children tibia with the minimum of complications, providing safeness in the ossification of the new bone.Introducción: la discrepancia de los miembros inferiores obedecen a numerosas causas, ya sean congénitas o secuela de múltiples enfermedades. Los fijadores externos, en sus más disímiles presentaciones se diseñan para resolver este problema, sobre todo cuando el alargamiento será mayor a diez cm.Presentación de caso: paciente femenino, raza negra, 14 años de edad, con antecedentes de haber padecido una artritis séptica en cadera izquierda, quedando como secuela un acortamiento del miembro inferior izquierdo de 18 cm. Además de presentar un equino del pie izquierdo compensatorio para la deambulación, el resto del examen físico no se recogieron datos de interés que indicaran afectación de la circulación, conducción nerviosa, o fuerza muscular de dicha extremidad, por lo que se decide comenzar a realizar el alargamiento de 14 cms partiendo de una corticotomía proximal de tibia y peroné a diferente nivel y la colocación de un fijador distractor metafisario RALCA para elongar a razón de un milímetro por día hasta llegar a la longitud deseada y así preparar al paciente para la futura colocación de una prótesis total de cadera. Conclusiones: el fijador externo RALCA, distractor metafisario es una buena elección para lograr un alargamiento que supere los 10 cm en la tibia de un niño con el mínimo de complicaciones, ofreciendo seguridad en la osificación del hueso formado

Elongación de tibia hasta 14 cms en niña caboverdiana

Introduction: lower limbs discrepancy is due to numerous causes, either congenital or sequels of several diseases. External fixators, in their various presentations, are designed to solve this problem, above all when the elongation is larger than ten centimeters.Case presentation: female patient, black race, 14 years old, with antecedents of septic arthritis in left hip, being a sequel a 18-cm elongation of the left lower limb. Besides presenting a left equinovarus foot countervailing for strolling, in the rest of the physical examination no data of interest was collected that indicate any circulatory affection, nervous conduction, or muscular force of that limb, reason why it is concluded to start the 14-cm elongation from a tibia and fibula proximal corticotomy at different level and the placement of a metaphysiary distracting fixator RALCA to elongation at 1 mm per day up to the wanted length, and thus to prepare the patient for the future placement of a total hip prosthesis. Conclusions: the external fixator RALCA metaphysiary distracting device is a good choice for elongations over 10cm in children tibia with the minimum of complications, providing safeness in the ossification of the new bone.Introducción: la discrepancia de los miembros inferiores obedecen a numerosas causas, ya sean congénitas o secuela de múltiples enfermedades. Los fijadores externos, en sus más disímiles presentaciones se diseñan para resolver este problema, sobre todo cuando el alargamiento será mayor a diez cm.Presentación de caso: paciente femenino, raza negra, 14 años de edad, con antecedentes de haber padecido una artritis séptica en cadera izquierda, quedando como secuela un acortamiento del miembro inferior izquierdo de 18 cm. Además de presentar un equino del pie izquierdo compensatorio para la deambulación, el resto del examen físico no se recogieron datos de interés que indicaran afectación de la circulación, conducción nerviosa, o fuerza muscular de dicha extremidad, por lo que se decide comenzar a realizar el alargamiento de 14 cms partiendo de una corticotomía proximal de tibia y peroné a diferente nivel y la colocación de un fijador distractor metafisario RALCA para elongar a razón de un milímetro por día hasta llegar a la longitud deseada y así preparar al paciente para la futura colocación de una prótesis total de cadera. Conclusiones: el fijador externo RALCA, distractor metafisario es una buena elección para lograr un alargamiento que supere los 10 cm en la tibia de un niño con el mínimo de complicaciones, ofreciendo seguridad en la osificación del hueso formado

Energy, emissions and economic impact of the new nZEB regulatory framework on residential buildings renovation: Case study in southern Spain

Spanish residential buildings built in the decade of the housing bubble (2000–2009) had to comply with the Basic Buildings Standard on thermal conditions in buildings. At the end of this period, the Basic Energy Savings Document of the Technical Building Code published in the Royal Decree 314/2006, transposing European Directive 2002/91/EC, entered into force. Recently, this regulatory framework has been updated by the Royal Decree 732/2019, which transposes European Directives 2010/31/EU, 2012/27/EU and 2018/844/EU. A case study is used to analyse the energy, emissions and economic impact of these regulatory changes on an attached house located in all municipalities of Andalusia (South of Spain). The thermal behaviour of this house is compared with the one adapted to the new regulations. The TRNSYS transient system simulation tool is used for the energy study. The house adaptation is carried out by partially modifying the envelope, including a solar-thermal contribution to domestic hot water supply, and photovoltaic energy production to reduce electricity consumption. The results showed that the European objectives are greatly exceeded. Energy savings range from 69% to 127%, carbon dioxide emissions decrease by 65%–118%, and energy bills are reduced from 71% to 125%. © 2021 The Author

Above-average defocus curves in photopic and mesopic vision with multifocal intraocular lenses after laser assisted in situ keratomileusis

Letter to the Edito

New Approach for the Calculation of the Intraocular Lens Power Based on the Fictitious Corneal Refractive Index Estimation

Purpose. To identify the sources of error in predictability beyond the effective lens position and to develop two new thick lens equations. Methods. Retrospective observational case series with 43 eyes. Information related to the actual lens position, corneal radii measured with specular reflection and Scheimpflug-based technologies, and the characteristics of the implanted lenses (radii and thickness) were used for obtaining the fictitious indexes that better predicted the postoperative spherical equivalent (SE) when the real effective lens position (ELP) was known. These fictitious indexes were used to develop two thick lens equations that were compared with the predictability of SRK/T and Barrett Universal II. Results. The SE relative to the intended target was correlated to the difference between real ELP and the value estimated by SRK/T (ΔELP) (r = −0.47, p = 0.002), but this only predicted 22% of variability in a linear regression model. The fictitious index for the specular reflection (nk) and Scheimpflug-based devices (nc) were significantly correlated with axial length. Including both indexes fitted to axial length in the prediction model with the ΔELP increased the r-square of the model up to 83% and 39%, respectively. Equations derived from these fictitious indexes reduced the mean SE in comparison to SRK/T and Barrett Universal II. Conclusions. The predictability with the trifocal IOL evaluated is not explained by an error in the ELP. An adjustment fitting the fictitious index with the axial length improves the predictability without false estimations of the ELP