The results demonstrated that the trifocal FineVision IOL is able to restore near, intermediate, and distance visual function.

PurposeTo evaluate the subjective and objective visual results after the implantation of a new trifocal diffractive intraocular lens.MethodsA new trifocal diffractive intraocular lens was designed combining two superimposed diffractive profiles: one with +1.75 diopters (D) addition for intermediate vision and the other with +3.50 D addition for near vision. Fifty eyes of 25 patients that were operated on by one surgeon are included in this study. The uncorrected and best distance-corrected monocular and binocular, near, intermediate, and distance visual acuities, contrast sensitivity, and defocus curves were measured 6 months postoperatively. In addition to the standard clinical follow-up, a questionnaire evaluating individual satisfaction and quality of life was submitted to the patients.ResultsThe mean age of patients at the time of surgery was 70 ± 10 years. The mean uncorrected and corrected monocular distance visual acuity (VA) were LogMAR 0.06 ± 0.10 and LogMAR 0.00 ± 0.08, respectively. The outcomes for the binocular uncorrected distance visual acuity were almost the same (LogMAR −0.04 ± 0.09). LogMAR −010 ± 0.15 and 0.02 ± 0.06 were measured for the binocular uncorrected intermediate and near VA, respectively. The distance-corrected visual acuity was maintained in mesopic conditions. The contrast sensitivity was similar to that obtained after implantation of a bifocal intraocular lens and did not decrease in mesopic conditions. The binocular defocus curve confirms good VA even in the intermediate distance range, with a moderate decrease of less than LogMAR 0.2 at −1.5 D, with respect to the best distance VA at 0 D defocus. Patient satisfaction was high. No discrepancy between the objective and subjective outcomes was evidenced.ConclusionThe introduction of a third focus in diffractive multifocal intraocular lenses improves the intermediate vision with minimal visual discomfort for the patient.

The use of a generalized TFF in combination with well-calibrated radial pressure curves yields estimates of SBP in good agreement with carotid tonometry. Although AIx derived from a measured radial pressure curve correlates surprisingly closely with AIx measured on a synthesized aortic pressure curve, the correlation with a directly measured AIx on carotid signals is relatively poor.

Abstract-The advocated SphygmoCor procedure uses a radial-to-aorta transfer function with calibration on brachial instead of radial artery pressure to assess the central pulse pressure. We compared these values with carotid artery pulse pressures obtained from a validated calibration method, assuming mean minus diastolic blood pressure constant throughout the large artery tree. From 44 healthy subjects (21 males; 22 to 68 years) pressure waves were obtained at the radial, brachial, and carotid artery with applanation tonometry. Using the calibration method, radial and carotid artery pressures were assessed from brachial artery waves and pressures. The effect of brachial-to-radial pulse pressure amplification, brachial pulse pressure, mean pressure, age, gender, height, body mass index, and smoking on differences between the 2 methods was assessed. Brachial artery pressure was 118Ϯ12/72Ϯ10 mm Hg. SphygmoCor central pulse pressure was 9.7Ϯ4.6 mm Hg lower (PϽ0.001) than the carotid artery pulse pressure (33.0Ϯ6.8 versus 42.7Ϯ8.9 mm Hg). The difference between the 2 methods strongly depended (PϽ0.001) on brachial-to-radial artery pulse pressure amplification (5.8Ϯ5.1 mm Hg; 12Ϯ11%) and less on brachial artery pulse pressure (Pϭ0.005). After calibration of the radial pressure wave with radial instead of brachial artery pressures, the difference between SphygmoCor central pulse pressure and carotid pulse pressure decreased with 4 mm Hg. The advocated SphygmoCor procedure systematically underestimates the central pulse pressure with brachial-to-radial pulse pressure amplification as important determinant. Therefore, calibration of radial artery pressure waves on brachial artery pressures should be avoided. The underestimation of central aortic pulse pressure caused by the radial-to-aorta transfer function itself is much less than previously reported.

A 45-year-old man presented with binocular diplopia in primary gaze for 1 year. Orthoptic evaluation showed 10-prism diopter right eye hypotropia and 6-prism diopter right eye esotropia. The elevation and abduction of the right eye were mechanically restricted. This was associated with systemic features suggestive of acromegaly. Magnetic resonance imaging (MRI) of the brain demonstrated a pituitary macroadenoma. An elevated serum insulin-like growth factor I level and the failure of growth hormone suppression after an oral glucose load biochemically confirmed the diagnosis of acromegaly. Computed tomography (CT) of the orbit demonstrated bilateral symmetrical enlargement of the medial rectus and inferior rectus muscle bellies. All tests regarding Graves-Basedow disease were negative. Although rare, diplopia due to a restrictive extraocular myopathy could be the presenting symptom of acromegaly.

Objective: To evaluate clinical results of a high-frequency, low-energy, small spot femtosecond laser for the creation of thin corneal flaps in laser in situ keratomileusis (LASIK) used in a comparative case series at a private practice in Brussels, Belgium. Methods: A series of 75 patients selected for LASIK refractive surgery were enrolled for treatment with the Ziemer FEMTO LDV femtosecond laser and received a corneal flap of either 90 µm (59 patients, 103 eyes) or 80 µm (16 patients, 27 eyes) nominal thickness. Prospective evaluation included flap dimensions, intra-and post-operative complications and visual outcomes. 1-5 A thin flap may thus be desirable: it enables the treatment of higher corrections, permits larger ablation zones, induces fewer aberrations, has a lower enhancement rate and better functional results than a conventional >100 µm flap. Moreover, thin flaps help to maximise the RSB -staying further away from the critical 250 µm barrier -and preserve the biomechanical stability of the cornea, hence reducing the risk of ectasia.A critical prerequisite for thin flaps to be a practical alternative is to use a flap-making modality that creates flaps of uniform and predictable thickness. Femtosecond lasers have been shown to meet this condition better than mechanical microkeratomes. The practical limits of femtosecond lasers are determined by the mechanical stability and precision of the docking mechanism that applanates the cornea, by the pulse energy, by the capability of the laser optics to focus the laser beam in the cutting plane and finally by the quality of the achieved dissection.A thinner than conventional flap blends the advantages of lamellar and surface approaches: to preserve as much tissue as possible and at the same time retain an intact flap for fast recovery and protection. 1,6,7 Sub-Bowman keratomileusis (SBK) is a laser procedure that involves the use of a customised corneal flap between 90 and 110 µm with a diameter that is closely matched to the ablation zone of the excimer laser being used, typically ± 8.5 mm. 8One of the principal concerns in thin-flap LASIK is that very thin flaps induce the risk of intraoperative complications (pseudo-buttonhole): the thinner the flap, the closer you get to Bowman's layer. Ultra thin flaps are more difficult to handle and more easily displaced enhancing the risk of flap striae and irregular astigmatism. [9][10][11] Remaining tissue bridges can cause force to be required for separating the flap, which may cause a very thin flap to tear or to over-stretch.

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