Blue-Light Filtering Monofocal Intraocular Lenses: A Study on Optical Function and Tolerance to Misalignment.

PURPOSE: To investigate the optical performance and tolerance to misalignment of blue-light filtering monofocal intraocular lenses (IOLs). METHODS: The optical properties of two monofocal IOLs featuring yellow chromophores, CT Lucia 621 PY (Carl Zeiss Meditec AG) and Clareon CNA0T0 (Alcon Laboratories, Inc), were assessed in monochromatic and polychromatic light while introducing spherical aberration (SA). Optical quality metrics derived from the modulation transfer function were assessed after optimal IOL centration at 3- and 4.5-mm pupils. In addition, each IOL's tolerance to misalignment was examined by inducing up to 1 mm of decentration and the effect of tilting it by 5 degrees at 3 mm. RESULTS: The IOLs' resolution and contrast, while tested using a 3-mm aperture and an SA-neutral corneal model, indicated the CT Lucia 621 PY had a slightly higher modulation transfer function (MTF) at 50 lp/mm than the CNA0T0 under monochromatic conditions (0.77 vs 0.69). On introducing SA with (0.49 vs 0.40) and without (0.75 vs. 0.70) chromatic aberration, the CT Lucia 621 PY maintained its minimally better performance. When assessed with a 4.5-mm aperture in monochromatic light, the CT Lucia 621 PY displayed improved MTF with aberration-free cornea (0.71 vs 0.40) but performed worse after introducing SA (0.44 vs 0.62). However, both lenses achieved comparable MTF values under spherical and chromatic aberrations (0.28 vs 0.27). The IOL misalignment test revealed a better tolerance to tilt and decentration of the CT Lucia 621 PY across all conditions. CONCLUSIONS: The CT Lucia 621 PY and CNA0T0 showed similar optical quality in different situations, with equal simulated distance visual acuity for both models. However, the CT Lucia 621 PY's aspheric design offers an advantage when dealing with often imperfect physiological conditions, displaying a more robust performance under tilt and decentration. [J Refract Surg. 2024;40(2):e79-e88.].

Characterizing glare effects associated with diffractive optics in presbyopia-correcting intraocular lenses.

PURPOSE: To objectively quantify glare of intraocular lenses (IOLs) using a diffractive principle to extend the visual range and to identify models with increased susceptibility to inducing glare. SETTING: David J Apple Laboratory, Heidelberg, Germany. DESIGN: Laboratory investigation. METHODS: Glare was assessed by means of a straylight parameter with a standard C-Quant intended for 7 degrees. In addition, 2 C-Quant modifications were used to test lower angles (ie, 2.5 degrees and 3.5 degrees). The following IOL models were assessed: PanOptix, AT Lisa Tri, Synergy, and Triumf, the latter 2 with chromatic aberration correction at distance. Straylight from trifocal IOLs was compared against a monofocal W-60R lens. The C-Quant test was performed through the studied IOLs by using additional optical components attached to their ocular. RESULTS: Straylight (deg 2 sr -1 ) of the control was <1 at all tested angles, with the trifocal models showing comparable straylight at 7 degrees. At 3.5 degrees, Triumf's straylight increased to 15.5 ± 0.6, followed by Synergy (6.2 ± 1.1), PanOptix (4.1 ± 0.3), and AT Lisa Tri (2.0 ± 0.8). The chromatic aberration-correcting models demonstrated correspondingly higher straylight (Synergy: 18.8 ± 1.3; Triumf: 17.3 ± 0.5) at 2.5 degrees compared with PanOptix (4.3 ± 0.4), AT Lisa Tri (2.1 ± 0.1), and monofocal IOLs yielding minimal or no increase. CONCLUSIONS: Trifocal IOLs induced increased straylight, but it was limited to lower angles, which may cause difficulties detecting these effects using a standard clinical approach. The latest IOL designs featuring chromatic aberration correction at far focus seem more susceptible than the established trifocal IOLs to inducing a glare phenomenon.

Management of biofilm by an innovative layer-structured membrane for membrane biofilm reactor (MBfR) to efficient methane oxidation coupled to denitrification (AME-D).

Aerobic methane oxidation coupled with denitrification (AME-D) has garnered significant attention as a promising technology for nitrogen removal from water. Effective biofilm management on the membrane surface is essential to enhance the efficiency of nitrate removal in AME-D systems. In this study, we introduce a novel and scalable layer-structured membrane (LSM) developed using a meticulously designed polyurethane sponge. The application of the LSM in advanced biofilm management for AME-D resulted in a substantial enhancement of denitrification performance. Our experimental results demonstrated remarkable improvements in nitrate-removal flux (92.8 mmol-N m-2 d-1) and methane-oxidation rate (325.6 mmol m-2 d-1) when using an LSM in a membrane biofilm reactor (L-MBfR) compared with a conventional membrane reactor (C-MBfR). The l-MBfR exhibited 12.4-, 6.8- and 3.4-fold increases in nitrate-removal rate, biomass-retention capacity, and methane-oxidation rate, respectively, relative to the control C-MBfR. Notably, the l-MBfR demonstrated a 3.5-fold higher abundance of denitrifying bacteria, including Xanthomonadaceae, Rhodocyclaceae, and Methylophilaceae. In addition, the denitrification-related enzyme activity was twice as high in the l-MBfR than in the C-MBfR. These findings underscore the LSM's ability to create anoxic/anaerobic microenvironments conducive to biofilm formation and denitrification. Furthermore, the LSM exhibited a unique advantage in shaping microbial community structures and facilitating cross-feeding interactions between denitrifying bacteria and aerobic methanotrophs. The results of this study hold great promise for advancing the application of MBfRs in achieving efficient and reliable nitrate removal through the AME-D pathway, facilitated by effective biofilm management.

Optical-Quality Analysis and Defocus-Curve Simulations of a Novel Hydrophobic Trifocal Intraocular Lens.

Purpose: The optical function of a novel refractive-diffractive trifocal intraocular lens (IOL) was tested in vitro to provide preclinical metrics that predict postoperative performance and may guide patient selection. Methods: Fundamental optical characteristics of a trifocal hydrophobic-acrylic IOL with a C-loop haptic configuration (AT ELANA 841P, Carl Zeiss Meditec) were assessed using a fully automated optical test device under both monochromatic and polychromatic conditions combined with increased or compensated spherical aberration (SA). The area under the modulation transfer function (MTFa) was calculated across a defocus range from +1D to -3.5D and used to simulate visual acuity (VA). A polychromatic point spread function (PSF) was employed to assess the light distribution and identify photic phenomena. Results: The highest MTFa values were obtained under monochromatic conditions using an SA-neutral corneal model. Nevertheless, after introducing SA and polychromatic light, the IOL performance remained good. Simulated VA values were 0.00 logMAR for distance, 0.1 logMAR at 100 cm, and progressively improving to 0.05 logMAR at 40 cm from the intermediate point. The light-spread analysis confirmed halos around the PSF center, which is a characteristic of trifocal technology. Conclusion: AT ELANA 841P demonstrated good optical performance across various distances, independently of spectral and SA conditions, resulting in good simulated VA. Although light spread resembles standard trifocal IOLs, clinical studies are essential to confirm these laboratory results.

Video analysis of optic-haptic-interaction during hydrophobic acrylic intraocular lens implantation using preloaded injectors.

OBJECTIVE: To compare the optic-haptic interaction of different hydrophobic acrylic IOLs after using six preloaded injectors. METHODS: We reviewed the video-recordings of procedures on a total of 388 eyes that underwent phacoemulsification and intraocular lens (IOL) implantation. For six preloaded injectors: multiSert (Hoya Surgical Optics) [System 1], TECNIS Simplicity (Johnson & Johnson Vision) [System 2], TECNIS iTec (Johnson & Johnson Vision) [System 3], AutonoMe (Alcon, Laboratories) [System 4], Bluesert (Carl Zeiss Meditec) [System 5], and Prosert (OphthalmoPro GmbH) [System 6], we noted in each case the time of IOL delivery and made a descriptive observation of IOL insertion and optic-haptic-interaction. RESULTS: We defined standard haptic behavior where the haptics emerged "folded" from the injector and quickly recovered their pre-implantation appearance. The incidence where the leading haptic emerged in a deformed way for System 1 was 20%, System 2: 19%, System 3: 14%, System 4: 56%, System 5: 24% and System 6: 5%. For trailing haptic deformed behavior, the incidence was 36%, 6%, 4%, 8%, 18% and 2%, respectively for Systems 1 to 6. Optic-haptic adhesion occurred in 2% of cases for System 1, 44% for System 2, 52% for System 3, 48% for System 4, and 11% for System 6 (P < 0.05). Adhesion was not found with System 5. CONCLUSIONS: We observed different deformed behavior for leading and trailing haptics in the six preloaded systems, some systems had as much as 52% optic-haptic adhesion.

Optical Quality and Higher Order Aberrations of Refractive Extended Depth of Focus Intraocular Lenses.

PURPOSE: To compare the optical quality and higher order aberrations of four different refractive extended depth of focus intraocular lens (EDOF IOL) models (Lentis Comfort [Teleon Surgical BV], MiniWell (SIFI), LuxSmart [Bausch & Lomb], and AcrySof IQ Vivity [Alcon Laboratories, Inc]) and a monofocal IOL (Tecnis ZCB00; Johnson & Johnson Surgical Vision, Inc). METHODS: An optical metrology instrument (OptiSpheric IOL PRO2; Trioptics GmbH) was used to study image quality metrics of the different IOLs. The modulation transfer function (MTF) was measured at pupil sizes 1 to 5 mm in 1-mm steps. Area under the MTF and simulated visual acuity were calculated for different pupil diameters. Wavefront aberrations were measured with the SHS Ophthalmic device (Optocraft GmbH), which features a Hartmann-Shack sensor. RESULTS: All EDOF lenses yielded a simulated far visual acuity of 0.00 logMAR (20/20 Snellen) or better. At the 0.20 logMAR visual acuity level, the EDOF IOLs showed an increased depth of focus of at least 0.75 diopters compared to the monofocal IOL. Pupil dependency was more pronounced with the MiniWell, LuxSmart, and Vivity, whereas the Lentis showed a more consistent behavior at different apertures. The wavefront measurement revealed increased central aberrations for the MiniWell, LuxSmart, and Vivity IOL compared to the monofocal control. CONCLUSIONS: All EDOF IOLs demonstrated increased depth of focus while maintaining good simulated visual acuity at the far focus. Pupil dependency differed between the IOL models. The wavefront analysis revealed the complex design of the different EDOF IOLs with several zones with varying aberrations. [J Refract Surg. 2023;39(10):668-674.].

Chromatic aberration and spectral dependency of extended-range-of-vision intraocular lens technology.

This study compared the optical quality and chromatic performance of refractive-diffractive intraocular lenses (IOLs) that are designed to extend the range of vision of pseudophakic patients and alter chromatic aberration. Five IOLs were evaluated, Tecnis Synergy and Triumf POD L GF, both intended to compensate for eye's chromatism, as well as Acriva Trinova Pro C-a lens that increases chromatic aberration, and AT Lisa Tri and AcrySof IQ PanOptix. An optical setup composed of a corneal model inducing monochromatic and chromatic aberrations and incorporating various spectral conditions was employed. The two chromatic-aberration correcting IOLs demonstrated the lowest far-focus dispersion, but it was negative only, with the Synergy indicating its ability to reduce eye's chromatic aberration. Although the Trinova increased far-point chromatism, it was close to the level of the PanOptix, but higher than that of the AT Lisa. All the studied models demonstrated varying optical quality in response to light color. Still, the strongest spectral dependency was associated with achromatizing technology. Therefore, chromatic aberration and wavelength dependency should be considered in IOL optimization and predicting visual function, particularly in non-white spectral conditions.

Epidemiology and survival of non-malignant and malignant meningiomas in middle-aged females, 2004-2018.

Background: The incidence of meningioma is disparate to sex: meningiomas are more common in women than in men, especially in middle-aged women. Understanding the epidemiology and survival of middle-aged women with meningiomas would help estimate their public health impacts and optimize risk stratification. Methods: Data on middle-aged (35-54 years) female patients with meningiomas between 2004 and 2018 were obtained from the SEER database. Age-adjusted incidence rates per 100 000 population-years were calculated. Kaplan-Meier and multivariate Cox proportional hazard models were utilized in the overall survival (OS) analysis. Results: Data from 18302 female patients with meningioma were analyzed. The distribution of patients increased with age. Most patients were White and non-Hispanic, according to race and ethnicity, respectively. Over the past 15 years, non-malignant meningiomas have shown an increasing trend; however, malignant meningiomas have shown an opposite trend. Older age, Black population, and large non-malignant meningiomas tend to have worse prognoses. Surgical resection improves OS, and the extent of resection is a critical prognostic factor. Conclusions: This study observed an increase in non-malignant meningiomas and a decrease in the incidence of malignant meningiomas in middle-aged females. The prognosis deteriorated with age, in Black people, and with large tumor size. Additionally, the extent of tumor excision was found to be a significant prognostic factor.

Comparison of a Presbyopia-Correcting Supplementary Intraocular Lens Combination and a Capsular-Bag Lens: An In Vitro Study.

We evaluated the optical quality of two approaches to trifocality: polypseudophakia versus monopseudophakia. The combination (polypseudophakia) of a monofocal Basis Z B1AWY0 and AddOn Trifocal A4DW0M intraocular lens (IOL) was compared to using one Basis Z Trifocal B1EWYN IOL, all from 1stQ GmbH. In both approaches, we measured modulation transfer function (MTF) and Strehl Ratio (SR) values at 3.0 and 4.5 mm pupil sizes. We determined the through-focus (TF) MTF at 25, 50 and 100 lp/mm for the 3 mm aperture. United States Air Force (USAF) target images were recorded. MTF measurement of the trifocal lens and the combined monofocal and trifocal AddOn IOL showed good performance at the far and near focus for the 3 mm aperture. For the 4.5 mm aperture the MTF improved for the far focus but decreased for the intermediate and near focus. TF MTF showed better contrast at the far focus for the polypseudophakic setup but at the expense of the efficiency at the near focus. However, the USAF chart images revealed only minimal differences between both approaches. The optical quality of the polypseudophakic approach was not affected by the presence of two IOLs instead of one and proved to be comparable with the performance of one capsular-bag-fixated trifocal IOL. Differences between the single vs. two-lens approach seen in the TF MTF analysis could be attributed to the optical design that varied between the trifocal models.

Comparison of Five Presbyopia-Correcting Intraocular Lenses: Optical-Bench Assessment with Visual-Quality Simulation.

Presbyopia correction through implantation of a trifocal intraocular lens (IOL) is a modality offered to both cataract and refractive-lens exchange patients. To maximize postoperative satisfaction, IOL selection needs to be made based on patients' requirements aligned with the available technology. Five Trifocal IOLs were assessed in this study, and their differentiating features were identified: Triumf POD L GF, AT Lisa Tri, Tecnis Synergy, AcrySof IQ PanOptix, and Acriva Trinova Pro C. The optical quality was assessed using the modulation-transfer-function principle. Simulated defocus curves were derived from a non-linear formula. Far-focus simulated visual acuity (simVA) was 0.03 logMAR or better for all the studied IOLs, showing minimal differences. However, each IOL's intermediate focus position differed across a range from 61 cm to 80 cm; and for the near focus, it was 36 cm to 44 cm. Triumf demonstrated improved intermediate point at the expense of the near focus resulting in a lower predicted near VA. PanOptix exhibited the shortest range of vision without a clear distinction between intermediate and near-point. The remaining lenses presented three foci of comparable optical quality and, thus, simVA performance. Each model, however, revealed a different aperture-change response. Trinova function improved at intermediate but was worse at near for larger pupils. The opposite was observed for AT Lisa. Synergy's optical quality change was predominantly associated with lower pupil diameter. In conclusion, the trifocal IOLs can be differentiated according to their secondary-foci position, light-energy distribution, and pupil-size-related behavior. The observed differences may translate directly into a clinical effect showing that the trifocal IOLs vary in their ability to deliver optimal vision at different distances, with some providing improved intermediate while others favor reading distance. The knowledge gained through this objective testing can support IOL selection, postoperative patient counselling and increase the chance of spectacle independence after surgery.

Epidemiology and risk stratification of low-grade gliomas in the United States, 2004-2019: A competing-risk regression model for survival analysis.

Background: Understanding the epidemiology and prognostic factors of low-grade gliomas (LGGs) can help estimate the public health impact and optimize risk stratification and treatment strategies. Methods: 3 337 patients diagnosed with LGGs were collected from the Surveillance, Epidemiology, and End Results (SEER) dataset, 2004-2019. The incidence trends of LGGs were analyzed by patient demographics (sex, age, race, and ethnicity). In addition, a competing risk regression model was used to explore the prognostic factors of LGGs by patient demographics, tumor characteristics (histological subtypes, invasiveness, and size), treatment modality, and molecular markers (IDH mutation and 1p/19q codeletion). Results: LGGs occurred more frequently in male, non-Hispanic, and White populations. The incidence rate of mixed gliomas was stable from 2004 to 2013 and decreased dramatically to nearly zero until 2019. The risk of death increased 1.99 times for every 20-year increase in patient age, and 60 years is a predictive cut-off age for risk stratification of LGGs. Male patients showed poorer LGG-specific survival. Among the different subtypes, astrocytoma has the worst prognosis, followed by mixed glioma and oligodendroglioma. Tumors with larger size (≥5 cm) and invasive behavior tended to have poorer survival. Patients who underwent gross total resection had better survival rates than those who underwent subtotal resection. Among the different treatment modalities, surgery alone had the best survival, followed by surgery + radiotherapy + chemotherapy, but chemotherapy alone had a higher death risk than no treatment. Furthermore, age, invasiveness, and molecular markers were the most robust prognostic factors. Conclusion: This study reviewed the incidence trends and identified several prognostic factors that help clinicians identify high-risk patients and determine the need for postoperative treatment according to guidelines.

Spectral Effects and Range of Focus in a Multizonal-Refractive Intraocular Lens Compared with a Standard Trifocal Diffractive Design.

INTRODUCTION: This study was performed to compare the optical performance of a multizonal presbyopia-correcting intraocular lens (IOL) and a conventional trifocal model. METHODS: The optical quality and simulated visual acuity (VA) of 570 Precizon Presbyopic NVA (OPHTEC BV) and AcrySof IQ PanOptix (Alcon) were compared. The Precizon features a refractive design consisting of alternating optical zones that converge the incident light into two principal foci and a transitional zone for intermediate vision. By contrast, the PanOptix applies a diffractive (non-apodized) profile to achieve trifocality. Simulated VA was derived from the modulation transfer function. Chromatic aberration effects were also studied. RESULTS: The diffractive and multizonal-refractive lenses yielded comparable simulated VAs at far focus (0.00 logMAR). All curves showed a reduction in expected VA with an increase in negative defocus. At - 1.0 D, the multizonal-refractive IOL's VA dropped by 0.05 logMAR, but for the diffractive model, it was one line (0.11 logMAR). The multizonal-refractive lens's VA prediction at the secondary peak was 0.03 logMAR-minimally better than the 0.06 logMAR of the diffractive lens at - 2.5 D. The refractive lens exhibited a 24% decrease in polychromatic optical quality due to material dispersion. The performance of PanOptix was more substantially affected, showing a 44% loss at 50 lp/mm at far, with minimal effects at other distances. CONCLUSION: The multizonal-refractive lens does not fall short of the established trifocal IOL, and it can be used to extend the visual range of pseudophakic patients. Although the multizonal-refractive lens has lower material dispersion, the diffractive model corrects chromatism beyond far focus.

Changes in the vitreous body after experimental vitreous hemorrhage in rabbit: An interdisciplinary study.

PURPOSE: To explore the changes in vitreous body after vitreous hemorrhage and assess its prognosis from the perspective of vitreoretinal interface. METHODS: The experiment was performed on 32 New Zealand rabbits (64 eyes), weighing 2500-3000 g for 4 months and unlimited gender, which was injected with 0.2 mL of autologous blood into the center of vitreous cavity-the study group (right eyes), and the control one was treated in the same manner with equal volumes of saline. The rabbits were randomly and equally divided into the following four batches according to the days of observation: Days 3, 7, 14, and 30 after injection. IOP and severity grading were evaluated before rabbits' execution and eyeballs were enucleated. The anterior segment was separated to flow out the vitreous body naturally to detect the liquefaction degree and viscosity. Then, chemical composition of electrolytes, PCT and bFGF were determined by colorimetry and enzyme-linked immunosorbent assay (ELISA). Finally, the incidence of posterior vitreous detachment (PVD) was observed after vitreous sampled. The studies were double-blind. RESULTS: After injection, the extent of vitreous opacity and coagulum size decreased over time. Both the degree of liquefaction and the length of tow differed significantly between two groups at different time points (all p < 0.001). The liquefaction degree in the study group rose obviously from the Day 14, which the viscosity declined significantly on the initial time. Biochemical markers fluctuated temporarily, except for basic fibroblast growth factor (bFGF), which continued to rise and was correlated with the liquefaction degree (r = 0.658, p < 0.001). Besides, the incidence of PVD increased from the 14th day (p < 0.05), and it was highly positively correlated with the number of macrophages (r = 0.934; p < 0.001). CONCLUSION: After vitreous hemorrhage, the changes of the vitreous body are relatively minor earlier (2-4 weeks), but irreversible later. Specifically, the degree of liquefaction increases with a decrease in viscosity, and the chemotaxis of macrophages and bFGF induce incomplete PVD.

Trifocal Intraocular Lens Selection: Predicting Visual Function From Optical Quality Measurements.

PURPOSE: To apply in vitro quality metrics to assess and compare three trifocal intraocular lenses (IOLs). METHODS: The optical performance of the AT LISA tri 839MP (Carl Zeiss Meditec AG), AcrySof IQ PanOptix (Alcon Laboratories, Inc), and TECNIS Synergy (Johnson & Johnson Vision) was compared. The modulation transfer function (MTF) metrics were obtained using an optical bench set-up. A polychromatic light source and a model cornea inducing chromatic and spherical aberrations were used to mimic in vivo characteristics. The area under the MTF was calculated at each defocus position, which served as a parameter in a nonlinear formula applied to predict postoperative visual acuity (VA). RESULTS: All of the studied IOLs had a predicted VA of 0.2 logMAR or better throughout the range of 0.00 to -3.00 diopters (D). Simulated VA differences between the IOLs were negligible (< 0.01 logMAR) at the far point. Although the three models were comparable at -1.00 D, at -2.00 D the AT LISA tri 839MP's VA was 0.06 and 0.08 logMAR worse than with the TECNIS Synergy and AcrySof IQ PanOptix, respectively. At near focus, the AcrySof IQ PanOptix's estimated VA was 0.06 logMAR (40 cm); for the AT LISA tri 839MP and TECNIS Synergy, it was 0.06 and 0.03 logMAR, respectively, at 36 cm. CONCLUSIONS: Although simulated distance VA was comparable between the studied models, differences can be found in the intermediate focus' position and quality and the expected reading distance. Therefore, simulations of defocus curves from optical quality metrics provide insight into IOL characteristics and highlight differences between the IOLs, which may guide the selection of a trifocal lens based on patients' needs. [J Refract Surg. 2023;39(2):111-118.].

Hopping Light Vat Photopolymerization for Multiscale Fabrication.

3D objects with features spanning from microscale to macroscale have various applications. However, the fabrication of such objects presents challenges to additive manufacturing (AM) due to the tradeoffs among manufacturable feature resolution, maximum build area, and printing speed. This paper presents a projection-based AM process called hopping light vat photopolymerization (HL-VPP) to address this critical barrier. The key idea of HL-VPP is to synchronize linear scanning projection with a galvo mirror's rotation. The projector moves continuously at a constant speed while periodically rotating a one-axis galvo mirror to compensate for the projector's linear movement so synchronized hopping motion can be achieved. By this means, HL-VPP can simultaneously achieve large-area (over 200 mm), fast-speed (scanning speed of 13.5 mm s-1 ), and high-resolution (10 µm pixel size) fabrication. The distinguishing characteristic of HL-VPP is that it allows for hundreds of times lower refresh rates without motion blur. Thus, HL-VPP decouples the fabrication efficiency limit imposed by the refresh rate and will enable super-fast curing in the future. This work will significantly advance VPP's use in applications that require macroscale part size with microscale features. The process has been verified by fabricating multiple multiscale objects, including microgrids and biomimetic structures.

Visualization of Ray Propagation through Extended Depth-of-Focus Intraocular Lenses.

Extended depth-of-focus (EDoF) presbyopia-correcting intraocular lens (IOL) models differ in their optical design and performance. In the laboratory, we compared the ray propagation and light intensity profiles of four IOLs: the non-diffractive AcrySof IQ Vivity (Alcon Inc., Fort Worth, TX, USA) and two diffractive models, Symfony ZXR00 (Johnson & Johnson Vision, Jacksonville, FL, USA) and AT Lara 829 MP (Carl Zeiss Meditec, Berlin, Germany). A fourth lens, the monofocal AcrySof IQ SN60WF (Alcon Inc.) acted as the control. We projected a 520 nm laser light through each submerged lens in a bath of fluorescein solution. A camera mounted on a microscope captured the light that emerged from the IOL. We recorded the IOLs' point spread function (PSF) to determine the presence of unwanted visual effects. The ray propagation visualization and light intensity profile of the monofocal control showed one distinct focus, while the AcrySof IQ Vivity demonstrated an extended focus area. We observed two distinct foci with each diffractive IOL. We found a lower level of light spread beyond the PSF center for the AcrySof IQ Vivity compared to the diffractive IOLs. In conclusion, we could confirm the extended range of focus for all the EDoF IOL models. However, the non-diffractive AcrySof IQ Vivity appears to have a smoother transition from a far to an intermediate range. We discuss whether, in clinical use, the higher level of spurious light we found in the diffractive designs may translate into increased dysphotopsia.

TGF-ß2 levels in the aqueous humor are elevated in the second eye of high myopia within two weeks after sequential cataract surgery.

Transforming growth factor-ß (TGF-ß) is the critical regulator of physiological and pathological conditions in lens. The TGF-ß signaling pathway is closely associated with high myopia patients. Thirty eyes from fifteen patients with high myopia who received sequential cataract surgery were enrolled in this prospective study. Ten cataract patients with non-myopia were chosen as a control group. Aqueous humor (AH) samples were used to detect the levels of TGF-ß1, TGF-ß2, and TGF-ß3 in both groups. Compared with the non-myopic cataracts patient group, the highly myopic cataracts group had a significantly higher TGF-ß2 (P = 0.019). Besides, the level of TGF-ß2 of the second eye was significantly higher than that in the first eye in high myopia cataract patients group (P = 0.037). And TGF-ß1 showed significant differences with age and axial length of high myopia cataract patients. Therefore, TGF-ß2 may contribute to the development of high myopia and cataract surgery increased the expression of TGF-ß2.

Incidence and survival of benign, borderline, and malignant meningioma patients in the United States from 2004 to 2018.

Meningioma is the most common primary central nervous system tumor, and its incidence is increasing. A systematic epidemiological and clinical analysis is required to better estimate its public health impact and understand its prognostic factors. Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2018 for all types of meningiomas without an age restriction. Age-adjusted incidence rates (IRs) and 95% confidence intervals were estimated according to sex, age, race, ethnicity, and tumor location. Kaplan-Meier analysis and multivariate Cox proportional hazard models were used to analyze the overall survival (OS). The competing risk regression model of Fine-Gray was used to analyze cause-specific survival. Data from a total of 109 660 meningioma patients were analyzed. A majority of patients were older than 60 years, and only 0.41% of patients were 0-19 years. The meningioma IRs were higher in females, Black, and non-Hispanic patients than in males, White, and Hispanic patients, respectively, and IRs increased with age. The ratio of IRs for females to males was 2.1 and also increased with age, peaking at 3.6 in the 45-49-year-old group. Older and male patients with all types of meningiomas, Black patients with benign and borderline meningiomas, and patients with larger borderline and malignant meningiomas showed poorer prognosis. For all meningioma types, surgical resection improved survival. The reported incidence rates and survival trends covered all demographics and subtypes of meningiomas. Older age, male sex, Black race, and tumor size may be important prognostic factors for meningioma cases, and tumor resection can substantially improve survival among meningioma patients.

A laboratory evaluation of nozzle tip damage in four generations of intraocular lens injector systems using a self-developed damage scale.

During intraocular lens (IOL) implantation it is not uncommon for the injector's nozzle-tip to get damaged. However, the damage has not been systematically described or evaluated using an objective scale. In this study we developed our own system-the Heidelberg Score for IOL Injector Damage ("HeiScore"), which was used to grade 60 injectors from four generations of injector models (Monarch III D, AcrySert C, UltraSert, AutonoMe) made by the same manufacturer. (Alcon Laboratories Inc.) HeiScore has six grades of nozzle-tip damage: no damage (which was graded 0); slight scratches (1), deep scratches (2), extensions (3), cracks (4) and bursts (graded number 5). The score for each injector model was the sum of all grades (total number), and we could compare the four injector models. The injectors showed varying damage profiles, from "no damage" to "crack". A tendency of a lower damage score in the newer generations of IOL injectors was noted. However, a statistically significant difference was observed only between Monarch III D and AutonoMe. The "Heidelberg Score for IOL Injector Damage" could efficiently and effectively evaluate the damage to IOL injector systems, which might help manufacturers optimize the positioning of the IOL in the injector during pre-loading.

Aerosol water content enhancement leads to changes in the major formation mechanisms of nitrate and secondary organic aerosols in winter over the North China Plain.

In recent years, severe air pollution still frequently occurs in winter despite the effective implementation of clean air actions in China. Therefore, field measurements of particle composition and gas precursors were collected from December 1, 2018 to January 15, 2019 at an urban site in a central Chinese city to investigate the existing mechanisms of pollution. The hourly averaged PM2.5 concentration during the campaign was 92.7 µg m-3, with nitrate and organic aerosol (OA) demonstrated as the principal components. Generally, NO2 oxidation in the daytime was observed as the major mechanism for nitrate generation, and aerosol water content (AWC) showed its influential role with the associated increases in the nitrogen oxidation and nitrate partitioning ratios. When AWC increased from dozens to hundreds of µg m-3 after the afternoon, nocturnal N2O5 hydrolysis was demonstrated as the overriding mechanism and provoked extreme contamination of nitrates. Five sources of organic aerosols (OAs) were identified: hydrocarbon-like OAs (HOAs, 16.5%), coal combustion OAs (CCOAs, 19.2%), biomass burning OAs (BBOAs, 9.9%), semi-volatile oxygenated OAs (SV-OOAs, 29.4%), and low-volatile oxygenated OAs (LV-OOAs, 25.0%). SV-OOAs and LV-OOAs were identified as gasSOAs and aqSOAs according to their sensitivities to the atmospheric oxidation capacity and AWC. In addition, aqueous-phase processing was found to be the dominant pathway for SOA formation when the AWC concentration was higher than 80 µg m-3. As an influential factor for nitrate and SOA formation, AWC could be greatly affected by RH and the concentrations of inorganic species. Sulfate, which was mainly contributed by anthropogenic emissions, was demonstrated to be a significant factor for active aqueous phase reactions, although SO2 has been dramatically reduced in recent years. Above all, this study revealed the significant role of AWC in current pollution episode in winter, and will assist in establishing future measures for pollution mitigation.