Selective area multilayer graphene synthesis using resistive nanoheater probe.

Graphene has been a material of interest due to its versatile properties and wide variety of applications. However, production has been one of the most challenging aspects of graphene and multilayer graphene (MLG). Most synthesis techniques require elevated temperatures and additional steps to transfer graphene or MLG to a substrate, which compromises the integrity of the film. In this paper, metal-induced crystallization is explored to locally synthesize MLG directly on metal films, creating an MLG-metal composite and directly on insulating substrates with a moving resistive nanoheater probe at much lower temperature conditions (~ 250 °C). Raman spectroscopy shows that the resultant carbon structure has properties of MLG. The presented tip-based approach offers a much simpler MLG fabrication solution by eliminating the photolithographic and transfer steps of MLG.

Profesionales de la salud en series médicas de televisión: rol durante el trabajo de parto y el nacimiento (2017-2022) / Health professionals on medical tv series: role during labor and birth (2017 – 2022)

Objetivo: Explorar el rol de los profesionales de la salud en el proceso del trabajo de parto y nacimiento en el fenómeno de las series médicas televisivas entre 2017 y 2022. Materiales y método: Estudio cualitativo de tipo fenomenográfico hermenéutico. Se utilizaron como fuentes documentales series médicas disponibles en plataformas de vídeo en demanda. El muestreo fue de tipo propositivo de criterio, seleccionando las series médicas New Amsterdam, Bajo presión, The Good Doctor y Grey's Anatomy. Las unidades de análisis corresponden a las escenas de trabajo de parto y nacimiento de las series. Se establecieron tres categorías a priori: paradigmas de la atención del trabajo de parto y nacimiento, estándar según la Confederación Internacional de Matronas (ICM), y la relevancia de los profesionales de la salud en el trabajo de parto y nacimiento. Durante el análisis de contenido emerge una cuarta categoría identificada como representación social del nacimiento. Resultados: Se analizaron 32 escenas, de 14 temporadas, resultando en 150,44 minutos de visionado por cada una de las investigadoras. De las categorías establecidas se observó: persistencia del modelo biomédico en el tiempo, sobrerrepresentación de los profesionales de medicina en diversos roles, subrepresentación de otros profesionales de la salud, ausencia de profesionales de obstetricia y escaso cumplimiento de los estándares de atención propuestos por la ICM. Conclusiones: Es necesario reenfocar las series médicas, ya que hoy en día existen cambios que consisten en nuevos criterios, paradigmas y modelos de atención en los procesos de trabajo de parto y nacimiento que podrían informar mejor a las mujeres y a las personas gestantes. (AU)

Objective: To explore the role of healthcare professionals in the process of labor and birth in the phenomenon of medical series between 2017-2022. Materials and method: Qualitative hermeneutic phenomenographic study. Medical series available on video-on-demand platforms were used as documentary sources. Propositive criterion sampling was used, selecting the medical series New Amsterdam, Bajo Presión, The Good Doctor, and Grey's Anatomy. The units of analysis correspond to labor and birth scenes from the series. Three a priori categories were established: labor and birth care paradigms, standards according to the International Confederation of Midwives (ICM), and the relevance of healthcare professionals in labor and delivery. During content analysis, a fourth category emerged: the social representation of birth. Results: 32 scenes from 14 seasons were analyzed, resulting in 150.44 minutes of viewing by each of the researchers. From the established categories, the persistence of the biomedical model over time was observed, with over-representation of doctors in various roles, under-representation of non-medical professionals, absence of obstetrics professionals, and poor compliance with the ICM's proposed standards of care. Conclusions: It is necessary to refocus medical series as there are changes today consisting of new criteria, paradigms, and care models in labor and delivery processes that could better inform women and childbearing people. (AU)

Influencia del cambio de uso del suelo sobre las reservas de carbono orgánico en el Parque Natural Regional Cortadera, Boyacá (Colombia)

Los páramos almacenan grandes reservas de carbono orgánico en el suelo (COS), influenciados por las condiciones climáticas y biogeoquímicas, propias del ecosistema; sin embargo, su progresiva conversión hacia cultivos, ganadería o minería incide directamente en las reservas de COS. Con el fin de determinar el efecto que ejerce el cambio de uso de suelo sobre la variabilidad de las reservas de COS, se realizó un monitoreo de COS entre 2013, 2018 y 2020, en el Parque Natural Regional Cortadera. Se estudiaron parcelas permanentes de muestreo (PPM), ubicadas bajo tres diferentes usos del suelo: conservado, en recuperación e intervenido. Se analizaron muestras de carbono orgánico y densidad aparente, a dos profundidades (0-15 cm y 15-30 cm). Se encontró que la PPM en escenario conservado presentó los contenidos más altos de COS, con valores de 290,37; 199,22 y 257,5 tC ha-1, para cada uno de los años en estudio; seguido por la PPM en recuperación, que evidenció valores de COS 215,3 tC ha-1, en el 2020, en contraste con la PPM intervenida, que presentó contenidos mínimos de 15,50; 34,01 y 88,06 tC ha-1. Se observó que los mayores contenidos de COS se encuentran a la profundidad de 15 a 30 cm. Dichos aspectos, resaltan la importancia de avanzar en acciones enfocadas a la protección de ecosistemas estratégicos, considerando las constantes amenazas relacionadas con la transformación del paisaje y, con ello, la posibilidad de proveer funciones y servicios asociados a la captura de carbono y la regulación climática.

The paramos accumulate high stocks of soil organic carbon (SOC), influenced by the climatic and biogeochemical conditions of the ecosystem. However, their progressive conversion to crops, livestock, or mining has a direct impact on the SOC stocks. To determine the effect of land use change on the variability of SOC stocks, monitoring of SOC content was conducted between the years 2013, 2018, and 2020 in the Parque Natural Regional Cortadera. Permanent sampling plots (PPS) located under three different land uses were studied: conserved, recovering, and intervened. To do so, samples of soil organic carbon and bulk density at two depths were analyzed (0-15 cm and 15-30 cm). The conserved PPS showed the highest SOC contents, with maximum values of 290.37; 199.22, and 257.5 tC ha-1 for each of the years under study; follow by the recovery PPM that presented COS values of 215.3 tC ha-1 in 2020, in contrast to the intervened PSP that showed minimum contents of 15.50; 34.01 and 88.06 tC ha-1. Furthermore, the highest SOC contents were found at 15-30 cm depth. These factors emphasize the importance of carrying out actions focused on protecting strategic ecosystems such as paramos, taking into account the continuous threats related to the transformation of the landscape and, consequently, the possibility of providing ecosystem functions and services related to carbon capture and climate regulation.

Percepción de stakeholders de Chile Crece Contigo, acerca de su implementación en la comuna de Concepción, Chile / Perception of Chile Crece Contigo stakeholders on its implementation in the Commune of Concepción, Chile

RESUMEN Objetivo Explorar la percepción de los stakeholders vinculados al subsistema de protección de la infancia "Chile Crece Contigo" en lo que respecta a su implementación en la comuna de Concepción, Chile. Métodos Estudio cualitativo. Se utilizaron entrevistas semiestructuradas y un focus group como técnicas de recolección de información. Se realizó un muestreo teórico en base a la representación de los niveles de decisión y poder respecto a la implementa-ción de Chile Crece Contigo en la comuna de Concepción. Los datos fueron analizados con el software ATLAS.ti 6.2. Resultados Destacaron como logros la alta valoración de Chile Crece Contigo, junto con, la capacidad de instalar temas tan relevantes como el cuidado de la primera infancia. El aspecto no logrado más importante fue el aprovechamiento de los beneficios entregados y la difusión de la política. El mayor facilitador de la implementación fue el compromiso con el Chile Crece Contigo, mientras la mayor barrera, la situación contractual de los profesionales. Finalmente, como aspectos a mejorar se apuntaron la infraestructura, la articulación de la red Chile Crece Contigo y los recursos asociados a la política. Conclusión La implementación de Chile Crece Contigo en la comuna de Concepción ha alcanzado una alta valoración y reconocimiento en la comunidad, sin embargo, aún se requiere trabajar en el logro de aspectos relacionados con la articulación de los distintos stakeholders que componen la red Chile Crece Contigo, la difusión de la política en todos los niveles y el mejor aprovechamiento de los beneficios entregados a la población.(AU)

ABSTRACT Objective To explore the perception of stakeholders on the implementation policy of the childhood protection subsystem "Chile Crece Contigo" in the Commune of Concepción, Chile. Materials and Methods Qualitative study. Semi-structured interviews and a focus group were used as information gathering techniques. A theoretical sampling was carried out based on the representation of decision and power levels with regard to the implementation of Chile Crece Contigo in the Commune of Concepción. The data were analyzed with the ATLAS.ti 6.2 software. Results The most notable achievements highlighted by interviewees were the high valuation of Chile Crece Contigo, along with the possibility of placing relevant subjects such as first childhood care into the agenda. On the contrary, taking advantage of benefits delivered by the program and the dissemination of the policy were deemed as not achieved. The main facilitator of the implementation was the commitment of the beneficiaries to Chile Crece Contigo, while the most important barrier identified was the contract modality of professionals. Finally, aspects to be improved included infrastructure of facilities, the Chile Crece Contigo network articulation and the funds to secure sustainability of the program over time. Conclusion The implementation of Chile Crece Contigo in the Commune of Concepción has achieved high recognition in the community, however, it is still necessary to work on the achievement of aspects related to the articulation of the different stakeholders that make up the Chile Crece Contigo network, the diffusion of politics at all levels, and the best use of the benefits delivered to the population.(AU)

[Perception of "Chile Crece Contigo" stakeholders on its implementation in the Commune of Concepción, Chile]. / Percepción de stakeholders de "Chile Crece Contigo", acerca de su implementación en la comuna de Concepción, Chile.

OBJECTIVE: To explore the perception of stakeholders on the implementation policy of the childhood protection subsystem "Chile Crece Contigo" in the Commune of Concepción, Chile. MATERIALS AND METHODS: Qualitative study. Semi-structured interviews and a focus group were used as information gathering techniques. A theoretical sampling was carried out based on the representation of decision and power levels with regard to the implementation of Chile Crece Contigo in the Commune of Concepción. The data were analyzed with the ATLAS.ti 6.2 software. RESULTS: The most notable achievements highlighted by interviewees were the high valuation of Chile Crece Contigo, along with the possibility of placing relevant subjects such as first childhood care into the agenda. On the contrary, taking advantage of benefits delivered by the program and the dissemination of the policy were deemed as not achieved. The main facilitator of the implementation was the commitment of the beneficiaries to Chile Crece Contigo, while the most important barrier identified was the contract modality of professionals. Finally, aspects to be improved included infrastructure of facilities, the Chile Crece Contigo network articulation and the funds to secure sustainability of the program over time. CONCLUSION: The implementation of Chile Crece Contigo in the Commune of Concepción has achieved high recognition in the community, however, it is still necessary to work on the achievement of aspects related to the articulation of the different stakeholders that make up the Chile Crece Contigo network, the diffusion of politics at all levels, and the best use of the benefits delivered to the population.

OBJETIVO: Explorar la percepción de los stakeholders vinculados al subsistema de protección de la infancia "Chile Crece Contigo" en lo que respecta a su implementación en la comuna de Concepción, Chile. MÉTODOS: Estudio cualitativo. Se utilizaron entrevistas semiestructuradas y un focus group como técnicas de recolección de información. Se realizó un muestreo teórico en base a la representación de los niveles de decisión y poder respecto a la implementa-ción de Chile Crece Contigo en la comuna de Concepción. Los datos fueron analizados con el software ATLAS.ti 6.2. RESULTADOS: Destacaron como logros la alta valoración de Chile Crece Contigo, junto con, la capacidad de instalar temas tan relevantes como el cuidado de la primera infancia. El aspecto no logrado más importante fue el aprovechamiento de los beneficios entregados y la difusión de la política. El mayor facilitador de la implementación fue el compromiso con el Chile Crece Contigo, mientras la mayor barrera, la situación contractual de los profesionales. Finalmente, como aspectos a mejorar se apuntaron la infraestructura, la articulación de la red Chile Crece Contigo y los recursos asociados a la política. CONCLUSIÓN: La implementación de Chile Crece Contigo en la comuna de Concepción ha alcanzado una alta valoración y reconocimiento en la comunidad, sin embargo, aún se requiere trabajar en el logro de aspectos relacionados con la articulación de los distintos stakeholders que componen la red Chile Crece Contigo, la difusión de la política en todos los niveles y el mejor aprovechamiento de los beneficios entregados a la población.

Sequential Customized Therapeutic Keratectomy for Reis-Bücklers' Corneal Dystrophy: Long-term Follow-up.

PURPOSE: To report long-term outcomes of sequential customized therapeutic keratectomy for Reis-Bücklers' corneal dystrophy. METHODS: This was a retrospective review of 14 eyes of 8 patients with Reis-Bücklers' corneal dystrophy that underwent surgical peeling with a spatula of the epithelium and subepithelial membrane present in Reis-Bücklers' corneal dystrophy, with subsequent sequential customized therapeutic keratectomy featuring a multi-step approach with sequential, repeated customized excimer laser photoablations alternating with repeat intraoperative topographies to monitor and progressively reduce corneal irregularities. RESULTS: At the last follow-up of 5.09 ± 4.67 years (range: 0.29 to 12.87 years), mean corrected distance visual acuity improved from 20/50 (range: 20/630 to 20/30) to 20/25 (range: 20/20 to 20/40) (P < .01), whereas mean refraction changed from -0.29 ± 1.91 diopters (D) sphere and -0.75 ± 0.81 D cylinder preoperatively to 1.25 ± 2.10 D sphere and -1.08 ± 0.53 D cylinder postoperatively. Mean central keratometry values changed minimally from 42.67 ± 2.26 D preoperatively to 42.65 ± 2.30 D postoperatively. Coma significantly decreased from 0.60 ± 0.40 to 0.35 ± 0.28 µm (P < .05), whereas total higher order aberrations, spherical aberration, and trefoil remained stable. No patient underwent corneal transplantation. Disease recurrence required re-treatment using the same protocol in 14.28% of eyes (n = 2) for a mean of 5.86 ± 0.31 years (range: 5.64 to 6.08 years) after initial surgery. CONCLUSIONS: Five years after sequential customized therapeutic keratectomy, most eyes with Reis-Bücklers' corneal dystrophy showed improved visual acuity, stable refraction, and improved or stable higher order aberrations. [J Refract Surg. 2018;34(10):682-688.].

Allometric trends reveal distinct evolutionary trajectories for avian communication.

Acoustic signal production is affected by allometric relationships, by which the larger the animal, the lower its call frequency. In this paper, three evolutionary acoustic hypotheses were tested: the Signal-to-Noise Ratio Hypothesis (SNRH), in which evolution maximizes call ranges by increasing the signal-to-noise ratio; the Stimulus Threshold Hypothesis (STH), in which evolution maximizes the range of a specific signal threshold; and the Body Size Hypothesis (BSH), in which the emission of long wavelengths is enabled by body size. Three spectral metrics were measured, Dominant Frequency (FDOM), Minimum Fundamental Frequencies (FFMIN), and Maximum Fundamental Frequencies (FFMAX) of Neotropical Parrots, New World Doves, Woodcreepers, Tinamous, and Thrushes. A Ranged Major Axis (RMA) regression showed that body mass is significantly correlated with all of the spectral parameters in Parrots, Doves, and Woodcreepers, but only with the fundamental frequencies of Tinamous. The FDOM of Parrots corroborated the SNRH. The FFMIN of Woodcreepers and Tinamous corroborated the SNRH and BSH. The FFMAX of Parrots corroborated the STH and BSH. Those acoustic hypotheses could shed light on the evolutionary processes involved in avian communication, although results indicate that these depend on the taxa and spectral parameters considered.

Nutritional status, cardiovascular health, VO2 max and habits in university students: a comparison between two health promotion careers / Estado nutricional, salud cardiovascular, VO 2 máx y hábitos de vida en estudiantes universitarios: comparación entre dos carreras promotoras de salud

Abstract Introduction: University students are at a moment of their life cycle that is key for the adoption of different lifestyles. Objective: The purpose of this study was to determine and compare VO2 max, fat mass percentage, biochemical profile, and alcohol and tobacco consumption in university students of two undergraduate programs. Materials and methods: 53 first year students with an average age of 19.25 years were included in this study. 30 were enrolled in the in Physical Education Pedagogy program, and 23 in the Nutrition and Dietetics program offered by Universidad La Frontera, class of 2014. Assessment included weight, size, BMI, waist circumference, fat mass percentage, blood pressure, biochemical profile and VO2 max. Results: 32% of the students were overweight, 50.9% reported altered blood pressure, 28.3% had prehypertension, and 22.6% had high blood pressure. Furthermore, 50.9% had a fat mass level above normal, 18.8% were regular smokers, and 41.5% reported frequent alcohol use. Regarding VO2 max, 48.9% were in the poor to fair range. The comparison by program showed significant differences in the variables height, VO2 max (maximum aerobic capacity) and fat mass percentage (p<0.05). Conclusions: Students are prone to develop chronic noncommunicable diseases, which is a worrying situation since they will become promoters of healthy lifestyles according to their career path.

Resumen Introducción. Los estudiantes universitarios se encuentran en una etapa del ciclo vital clave para la adopción de estilos de vida. Objetivo. El propósito de este estudio fue determinar y comparar el VO2máx, el porcentaje de masa grasa, el perfil bioquímico y el consumo de alcohol y tabaco en estudiantes universitarios de dos carreras. Materiales y métodos. Participaron en la investigación 53 estudiantes universitarios de primer año con un promedio de 19.25 años de edad. 30 eran de la carrera de Pedagogía en Educación Física y 23 de Nutrición y Dietética de la Universidad de La Frontera en el año 2014. Se evaluó peso, talla, índice de masa corporal, contorno cintura, porcentaje de masa grasa, presión arterial, perfil bioquímico y VO2máx. Resultados. El 32% de los estudiantes presentó exceso de peso, 50.9% reportó alteración de la presión arterial, 28.3% tuvo prehipertensión y 22.6%, hipertensión arterial. A su vez, el 50.9% presentó un nivel sobre lo normal de masa grasa, el 18.8% manifestó hábito tabáquico y el 41.5% reconoció consumir alcohol con frecuencia. En relación al VO2máx, se observó que un 48.9% estaba ubicado en el rango de malo a regular. Respecto a la comparación por carreras, se encontraron diferencias significativas en las variables talla, VO2máx (capacidad aeróbica máxima) y porcentaje de masa grasa (p<0.05). Conclusiones. Los estudiantes son propensos al desarrollo de enfermedades crónicas no transmisibles, lo que supone una situación preocupante, pues en el área profesional se transformarán en promotores de estilos de vida saludable.

Advanced Surface Ablation With a New Software for the Reduction of Ablation Irregularities.

PURPOSE: To compare visual outcomes and postoperative aberrations after surface ablation performed with a 750-Hz versus a 1,050-Hz excimer laser coupled with an ablation software designed to reduce corneal surface irregularity. METHODS: Retrospective comparative trial of myopic eyes that had refractive surgery consecutively treated with transepithelial advanced surface ablation with a 750-Hz excimer laser (750 group) versus a 1,050-Hz excimer laser coupled with the Smart Pulse Technology ablation software (SPT group). The SPT algorithm is a laser pulse technology software aimed at reducing surface irregularity of the stromal bed at the end of treatment. The authors evaluated the effect of this smoothing on final visual acuity. Patients were observed for 6 months. RESULTS: A total of 139 eyes in the 750 group and 40 eyes in the SPT group were evaluated. Epidemiological and preoperative refractive data of the two groups were comparable. Uncorrected distance visual acuity improved with time and was significantly better in the SPT group (-0.04 ± 0.61 logMAR for the SPT group vs 0.02 ± 0.78 logMAR for the 750 group) (P < .001). At 6 months, 55% versus 21% achieved 20/16 or better (P = .005) and 90% versus 65% achieved 20/20 or better (P = .019) visual acuity in the SPT and 750 groups, respectively. Corrected distance visual acuity improved with time and appeared to be influenced by group (P = .054), with better results in the SPT group. Coma and trefoil improved significantly with time in a similar manner in both groups. CONCLUSIONS: Surface ablation with the 1,050-Hz excimer laser and SPT software, aimed at reducing the final superficial stromal irregularity, led to improvement of 6-month uncorrected visual acuity. [J Refract Surg. 2017;33(2):89-95.].

Effects of high-intensity interval training on the anthropometric profile of overweight and obese adult women / Efectos del entrenamiento físico intervalado de alta intensidad sobre el perfil antropométrico de mujeres adultas con sobrepeso u obesidad

Abstract Introduction: Sedentary lifestyle, overweight and obesity in adult women have high prevalence. Objective: To determine the effects of a high intensity interval training program on the anthropometric profile of overweight or obese women. Materials and methods: 24 adult women, including 16 with overweight and 8 with obesity, between 26 and 49 years of age, were selected to participate in a two month high intensity training program (three sessions per week). Weight, height, BMI, muscle mass percentage, and fat mass and visceral fat percentages were assessed. Results: The adherent group (≥75% assistance) was composed by 16 participants, while the non-adherent group (assistance <75%), by 8 participants. No significant differences were found among both groups previous to and after the intervention (p≥0.05).The non-adherent group did not show any significant change, while the adherent group improved (p<0.05) their variables of weight (p<0.001), BMI (p<0.001), fat mass percentage (p<0.001), muscle mass percentage (p<0.001) and visceral fat percentage (p=0.020) after the intervention. Conclusions: The training program improved the anthropometric profile of the participants without requiring specialized equipment or involving high costs, thus, this procedure is recommended for the treatment of malnutrition by excess in this type of population.

Resumen Introducción. Existe una alta prevalencia de sedentarismo, sobrepeso y obesidad en mujeres adultas. Objetivo. Determinar los efectos de un programa de entrenamiento intervalado de alta intensidad sobre el perfil antropométrico de mujeres con sobrepeso u obesidad. Materiales y métodos. 24 mujeres adultas (16 con sobrepeso y 8 con obesidad) entre 26 y 49 años fueron reclutadas para participar en un programa de entrenamiento de alta intensidad durante dos meses (tres sesiones/semana). Se evaluó peso, talla, IMC, porcentaje de masa muscular, porcentaje de masa grasa y porcentaje de grasa visceral. Resultados. El grupo adherente (asistencia ≥75%) quedó compuesto por 16 participantes y el grupo no adherente (asistencia <75%) por ocho participantes. No existieron diferencias significativas pre y post intervención entre ambos grupos (p≥0.05). El grupo no adherente no presentó cambios importantes mientras que el grupo adherente mejoró (p<0.05) las variables peso (p<0.001), IMC (p<0.001), porcentaje de masa grasa (p<0.001), porcentaje de masa muscular (p<0.001) y porcentaje de grasa visceral (p=0.020). Conclusiones. El programa de entrenamiento mejoró el perfil antropométrico de las participantes sin requerir implementos ni costos elevados para su desarrollo, por lo que es un procedimiento recomendable para el tratamiento de la malnutrición por exceso.

Macrosomía neonatal y diabetes gestacional / Neonatal macrosomia and gestational diabetes

Antecedentes: la macrosomía neonatal es la principal complicación que sufre el hijo de madre diabética. Objetivo: identificar la relación existente entre la macrosomía neonatal y el diagnóstico tardío de la diabetes gestacional (DG), el exceso de peso al inicio del embarazo, la ganancia excesiva de peso durante la gestación, el mal control glucémico, la hipertrigliceridemia y la hipercolesterolemia, y un peso fetal mayor que 97 percentil al inicio del tercer trimestre en el embarazo complicado con DG...

Transition zone design and smoothing in custom laser-assisted subepithelial keratectomy.

PURPOSE: To evaluate the results of custom laser-assisted subepithelial keratectomy (LASEK) with a specially designed transition zone and smoothing for the treatment of refractive errors. SETTING: Department of Ophthalmology, Istituto Clinico Humanitas, Rozzano-Milan, Italy. METHODS: This prospective study involved myopic eyes having refractive surgery with the butterfly LASEK technique and the Nidek EC-5000 excimer laser. The treatment was based on the surgeon's analysis of topographic and aberrometric data provided by Final Fit ablation software, which features the Custom Aspheric Transition Zone software algorithm. After the ablation, smoothing was performed to remove corneal microirregularities. RESULTS: Fifty-five eyes of 38 patients were treated. The mean preoperative spherical equivalent (SE) refraction was -6.58 diopters (D) +/- 2.24 (SD) (range -12.13 to -1.75 D). At 1 year, the mean SE refraction was -0.26 +/- 0.79 D (range -4.00 to +0.75 D). CONCLUSION: The surface ablation technique provided satisfactory results and took into account strategies to reduce unpredictability factors such as corneal biomechanical forces, haze induced by an irregular postoperative surface, and a high curvature gradient in the transition zone.

One-year results of custom laser epithelial keratomileusis with the Nidek system.

PURPOSE: To evaluate long-term results of custom laser epithelial keratomileusis (LASEK) for correction of myopia and hyperopia using the Custom Ablation Transition Zone (CATz) software and hyaluronic acid masking fluid (Laservis) for final corneal smoothing. METHODS: We conducted a prospective study of 297 eyes of 167 patients. All eyes had LASEK for correction of myopia or hyperopia. The Nidek EC-5000 excimer laser, FinalFit software, and CATz ablation profile was used in all eyes. Laservis was used as masking fluid to remove corneal micro-irregularities during the final phase of the treatment. RESULTS: Mean preoperative spherical equivalent refraction was -5.46 +/- 2.57 D (range -14.13 to +3.50 D). At 1 year after LASEK, mean spherical equivalent refraction was -0.15 +/- 0.50 D (range -4.00 D to +1.00 D). CONCLUSIONS: LASEK with the Nidek EC-5000 excimer laser, FinalFit and Custom Ablation Transition Zone (CATz) software, with corneal smoothing, was safe and effective at 1 year after surgery.

Applications of confocal microscopy in refractive surgery.

PURPOSE: To evaluate applications of the Confoscan 2.0, a computerized confocal optical microscopy system by Nidek, in refractive surgery. METHODS: We used the Confoscan 2.0 to evaluate the tissue reparative response after PRK, LASEK, and LASIK in 60 eyes of 40 patients. Confoscan 2.0 provided highly detailed images of the corneal layers, up to the cellular level. Furthermore, it measured corneal thickness as well as precise positioning of each single recorded corneal layer. The Confoscan was also used to analyse the LASIK flap. RESULTS: Findings in the transition zone between epithelium and anterior stroma in PRK and LASEK eyes were divided into two groups: Group 1, with marked hyper-reflectivity, and Group 2, with less hyper-reflectivity, similar to normal eyes. Group 2 eyes belonged to patients that underwent smoothing with a masking solution after ablation. Group 1 eyes received no smoothing. In LASIK eyes, we evaluated the quality of the flap interface. Hyper-reflecting specks could be observed in the interface, showing a tendency to decrease over time. Depth of the LASIK flap was measured, and showed variable thickness with all microkeratomes tested. CONCLUSION: We hypothesize that a more regular corneal surface, obtained with smoothing in PRK and LASEK, allows a better reparative response after refractive surgery. In LASIK eyes, the Confoscan provided precise measurement of the residual stromal bed, information particularly valuable for the prevention of ectasia in retreatments.