bluuebunny/crossref_metadata_2025 huggingface dataset:
Errors of Residual Stromal Thickness Estimation in LASIK
Authors: Cheng Huey-Chuan , Chen Yen-Tung , Yeh Shu-I , Yau Chi-Wang
Published: March 2009

Background and Objective:
To investigate inaccuracy and variability in residual stromal thickness estimation in LASIK by pachymetry and measurements of corneal thickness, flap thickness, and ablation depth.

Patients and Methods:
In 73 eyes of 37 patients, preoperative and postoperative corneal thicknesses were obtained with slit-scanning elevation topography and the ultrasound pachymeter. LASIK was performed and corneal flaps were created with a microkeratome. Flap thickness and ablation depth (expected and achieved) were calculated. Residual stromal thickness estimation error was analyzed.

Results:
The mean preoperative corneal thicknesses were 559.58 ± 23.47 and 554.92 ± 29.95 μm for the ultrasound pachymeter and slit-scanning elevation topography, respectively. Measurement differences ranged from −36 to 30 μm. With the pachymeter, calculated mean flap thickness was 139.58 ± 17.59 μm. With this device, predicted ablation depth differed from achieved depth by 20% or more in approximately one-third (30.14%) of treated patients; ablation differences ranged from 10.0% to 19.99% in 37% of patients and 1.00% to 9.99% in 31.5% of patients.

Conclusion:
Imprecision of microkeratome cuts, preoperative corneal pachymetry, and laser ablation depth have a significant impact on the inaccuracy of residual stromal thickness prediction. Especially in patients with borderline corneal thickness, intraoperative pachymetry measurements and a residual stromal thickness higher than the safety margin of 250 μm are recommended to minimize iatrogenic ectasia.
Modified Epinucleus Pre-Chop for the Dense Posterior Polar Cataract
Authors: Lim Zena , Goh Jon
Published: March 2009

A novel technique for the surgical management of dense posterior polar cataracts is described. In instances where hydrodelineation may be difficult to achieve due to the density of the nucleus, the anterior epinucleus is first pre-chopped in a piecemeal in situ maneuver before mobilizing, segmenting, and emulsifying the dense endonucleus. This is followed by the removal of the posterior epinucleus and the posterior polar plaque. Because the chopper is repositioned at different meridians in the mid-periphery of the anterior epinucleus, it stops short of the central posterior epinucleus, thus avoiding extension of the crack toward the posterior polar plaque and the posterior capsule.
Inclination of the Superomedial Orbital Rim in Relation to that of the Nasolacrimal Drainage System
Authors: Narioka Junji , Matsuda Seiji , Ohashi Yuichi
Published: March 2009

The influence of the height of the superomedial orbital rim on the ease of nasolacrimal intubation has not been investigated. The authors measured the inclination of the height of the superomedial orbital rim and the nasolacrimal drainage system in 46 sides of Japanese cadavers. The inclinations to the coronal plane of the lacrimal sac and the nasolacrimal duct were measured. A straight probe was inserted into the lacrimal sac and allowed to rest on the superomedial orbital rim. The angle made by this probe and the coronal plane, defined as the inclination of the height of the superomedial orbital rim, was measured. The lacrimal sac was inclined 27.2° ± 7.6°, the nasolacrimal duct was inclined 22.5° ± 9.7°, and the height of the superomedial orbital rim was inclined 26.1° ± 9.1°. For the height of the superomedial orbital rim–nasolacrimal duct angle, there were 33 sides with the anterior type and 13 sides with the posterior type. These results indicate that the height of the superomedial orbital rim may affect the ease of nasolacrimal intubation.
Bilateral Atonic Pupils After Cataract Surgery
Authors: Tekwani Shivan , Ghafouri Roya , Andreoli Michelle , Davis Patricia , Bouchard Charles
Published: March 2009

This case report describes the unusual finding of bilateral atonic pupils after cataract extraction by phacoemulsification in an 84-year-old woman with multiple cardiopulmonary risk factors.
The Efficacy of Retrobulbar Block Anesthesia Only in Pars Plana Vitrectomy and Transconjunctival Sutureless Vitrectomy
Authors: Lim Taehyung H. , Humayun Mark S. , Yoon Young Hee , Kwon Yong Hyuk , Kim June-gone
Published: March 2009

BACKGROUND AND OBJECTIVE To evaluate the adequacy of retrobulbar block anesthesia only in vitreoretinal surgery.

PATIENTS AND METHODS The study involved 90 patients, 25 who underwent 25-gauge transconjunctival sutureless vitrectomy and 65 who underwent 20-gauge standard pars plana vitrectomy. Twenty-five of the 90 patients also underwent combined phacoemulsification and posterior intraocular lens implantation. The efficacy of retrobulbar block anesthesia only was assessed by monitoring vital signs during surgery, reviewing patient responses to a questionnaire regarding their experience during surgery, and analyzing surgical outcomes.

RESULTS Four patients complained of moderate pain during surgery, but no patient complained of severe pain. Infiltrative anesthesia was additionally required in 14 patients. No patient experienced intraoperative complications due to head movement. Increased systolic blood pressure greater than 15 mm Hg occurred in 11 patients and increased respiratory rate by 3 breaths per minute or greater occurred in 7 patients. Anatomical and functional success rates were 95% and 80%, respectively. Complications included manageable retrobulbar bleeding (1 patient) and postoperative neovascular glaucoma (2 patients).

CONCLUSION Vitreoretinal surgery, particularly 25-gauge transconjunctival sutureless vitrectomy, can be safely and efficiently performed under retrobulbar block anesthesia only. Retrobulbar block anesthesia only could become a more acceptable anesthesia for vitreoretinal surgery for selected patients. [Ophthalmic Surg Lasers Imaging 2008;39:191-195.] AUTHORS From the Department of Ophthalmology (THL, YHY, YHK, J-GK), Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea; and the Doheny Retina Institute (MSH), Keck School of Medicine, University of Southern California, Los Angeles, California. Accepted for publication October 10, 2007. Presented at the Association for Research in Vision and Ophthalmology annual meeting, Fort Lauderdale, Florida, May 3, 2005. Address correspondence to Young-Hee Yoon, MD, Department of Ophthalmology, Asan Medical Center, 388-1 Poongnab-dong, Songpa-gu, Seoul, 136-738, Korea.
Nd:YAG Laser Capsulotomy in the Prone Position Under General Anesthesia
Authors: Subash Mala , Horgan Simon Edward
Published: March 2009

Neodymium:YAG (Nd:YAG) capsulotomy is the most common treatment for posterior capsule thickening. Occasionally, patients are unsuitable for receiving this treatment by slit lamp and require alternative surgical options. A technique enabling patients to undergo Nd:YAG laser capsulotomies while under general anesthesia is described. After induction of anesthesia in the supine position, the patient is transferred into the prone position and his or her neck is extended with the chin supported onto the Nd:YAG laser delivery slit lamp before the administration of the laser treatment. The procedure was performed in three individuals, who experienced good outcomes. [Ophthalmic Surg Lasers Imaging 2008;39:257-259.]

AUTHORS From the Royal Eye Unit, Kingston Hospital, Kingston-Upon-Thames, United Kingdom. Accepted for publication January 14, 2008. Address correspondence to Mala Subash, BM, BSc(Hons), MRCOphth, Flat 75 Avante Court, The Bittoms, Kingston upon Thames, KT1 2AN, UK.
Laser Treatment for Retinopathy of Prematurity Through the Incubator Wall
Authors: Dogra Mangat R. , Vinekar Anand , Viswanathan Kavitha , Sangtam Tiakumzuk , Das Pranab , Gupta Amod , Dutta Sourab
Published: March 2009

In this era of early treatment for retinopathy of prematurity, sick infants who develop aggressive diseases or remain oxygen and temperature dependent may be treated while they are inside the incubator itself, thus avoiding unnecessary delays. This article describes the treatment of eight infants with retinopathy of prematurity who were dependent on an incubator by using a laser indirect ophthalmoscope delivery system through the slanting transparent wall of the incubator. In this series, which is the largest to date, the relative advantages and disadvantages of the procedure are discussed.
Vitrectomy and Translocation of the Anterior Chamber Intraocular Lens to the Sulcus: A Closed Microsurgical Technique for the UGH Syndrome
Authors: Gualtieri William , Rossini Paolo , Forlini Cesare
Published: March 2009

This interventional case report presents an anterior chamber intraocular lens (AC-IOL) translocation technique to manage a case of uveitis–glaucoma–hyphema (UGH) syndrome associated with posterior dislocation of nuclear fragments and vitreitis as a consequence of capsule rupture during cataract surgery. Pars plana vitrectomy followed by an AC-IOL translocation from the anterior chamber to the sulcus without additional surgical corneal incision was performed. At 12 months’ follow-up, the original AC-IOL was in stable position in the posterior chamber, with binocular refractive balance and no further astigmatism and resolution of the UGH syndrome.
Regression of Vasoproliferative Tumor with Systemic Infliximab
Authors: Japiassú Ricardo M. , Moura Brasil Oswaldo F. , Cunha Aníbal L. , de Souza Eduardo C.
Published: March 2009

The anti-tumor necrosis factor (TNF) monoclonal antibody infliximab inhibits the pleiotropic actions of TNF and is widely used for the treatment of inflammatory diseases, such as uveitis. A pathogenetic role of TNF in ocular inflammatory conditions has recently emerged. The authors describe a patient with collagen mixed disease who had decreased vision in the left eye. Fundus examination disclosed bilateral peripheral vasoproliferative tumors and macular edema in the left eye. The patient underwent treatment with infliximab intravenously for his systemic condition. Regression of the vasoproliferative tumors in both eyes and improvement of macular edema in the left eye was observed. Although the data are limited, anti-TNF antibodies such as infliximab may be useful in the treatment of retinal vascular tumors.
Macular Holes Associated with Diabetic Tractional Retinal Detachments
Authors: Mason John O. , Somaiya Mamta D. , White Milton F. , Vail Rachel S.
Published: March 2009

Background and Objective:
Evaluation of surgical treatment of full-thickness macular holes secondary to diabetic tractional retinal detachments was conducted.

Patients and Methods:
A retrospective review of medical records, fluorescein angiograms, fundus photographs, optical coherence tomography images, and operative findings of six consecutive patients with full-thickness macular holes and diabetic tractional retinal detachments was completed. Each eye was treated with pars plana vitrectomy, tractional retinal detachment repair, membranectomy, indocyanine green-assisted internal limiting membrane peeling, and intraocular gas tamponade.

Results:
Surgical intervention resulted in the closure of all full-thickness macular holes. Mean best-corrected visual acuity was 20/250 preoperatively and 20/100 postoperatively, with all patients having improvement after a mean follow-up of 10 months.

Conclusion:
Closure of tractional retinal detachments related to full-thickness macular holes can be achieved via pars plana vitrectomy, complete membranectomy, and intraocular gas. Vitrectomy with dissection of proliferative membranes helps to relieve the tractional forces responsible for full-thickness macular hole formation, enabling successful closure of the diabetic full-thickness macular holes and resulting in visual acuity improvement.
Endocapsular Cellulomonas as a Cause of Persistent Postoperative Endophthalmitis
Authors: Sharma Shobha , Saffra Norman A. , Chinyadza Tanyanyiwa , Ghitan Monica , Chapnick Edward K.
Published: March 2009

Sequestration of bacteria within the capsular fornices after cataract extraction with intraocular lens implantation can cause both acute and chronic inflammation. A case of persistent postoperative endophthalmitis caused by capsular sequestration of Cellulomonas is described. The patient underwent uncomplicated cataract extraction with intraocular lens implantation and subsequently developed acute postoperative endophthalmitis. Inflammation persisted despite several vitreous taps and the injection of intravitreal antibiotics. Definitive treatment required pars plana vitrectomy, intraocular lens explantation, capsular bag removal, and intravitreal and parenteral antibiotics. In patients with postoperative endophthalmitis, one must consider atypical organisms as the source and should consider explantation of the intraocular lens with capsular bag removal.
Oral Niacin Can Increase Intraocular Pressure
Authors: Tittler Ethan H. , Monteiro de Barros Daniela S. , Kuntz Navarro Julia B. V. , Freitas Daniel G. J. , Gheith Moataz E. , Siam Ghada A. , Spaeth George L.
Published: March 2009

The intraocular pressure of a 73-year-old man with a history of primary open-angle glaucoma had been approximately 21 and 17 mm Hg in the right and left eyes, respectively, while taking latanoprost 0.005% and dorzolamide hydrochloride 2%. When taking 500 mg of oral niacin (also known as vitamin B3 or nicotinic acid), his intraocular pressure increased to 37 and 27 mm Hg in the right and left eyes, respectively, on one occasion. On reexamination, the intraocular pressure had increased to 28 and 23 mm Hg in the right and left eyes, respectively. Each time the niacin was stopped, the intraocular pressure decreased to the original levels.
Phthisis After Endoscopic Cyclophotocoagulation
Authors: Ahmad Saad , Wallace Dana J. , Herndon Leon W.
Published: March 2009

A 47-year-old man was treated with one session of endoscopic cyclophotocoagulation for uncontrolled, elevated intraocular pressure. Before treatment, the eye was quiet and uninflamed. Pretreatment visual acuity was 4/200 and the intraocular pressure was 24 mm Hg. Treatment was applied to the ciliary processes for nearly 360°. During the postoperative follow-up, the patient developed eye pain and persistent ocular inflammation. This ultimately led to phthisical changes evident 5 months postoperatively, when visual acuity was 1/200 and the intraocular pressure was 7 mm Hg. Eighteen months after endoscopic cyclophotocoagulation, visual acuity was light perception and intraocular pressure was less than 1 mm Hg. Phthisis is among the complications that may result after treatment with endoscopic cyclophotocoagulation.
Combined Viscocanalostomy–Trabeculectomy for Management of Far-Advanced Glaucoma: Evaluation of the Early Postoperative Course
Authors: Eid Tarek M.
Published: March 2009

Background and Objective:
To study the early postoperative efficacy and safety of combined viscocanalostomy with trabeculectomy (VISCO-TRAB) for treating far-advanced glaucoma.

Patients and Methods:
Patients with far-advanced glaucoma scheduled for glaucoma surgery were enrolled in the study. Surgery included viscocanalostomy until Schlemm’s canal was deroofed and dilated with viscoelastic, followed by penetrating corneotrabeculectomy, peripheral iridectomy, and tight closure of lamellar flap. Patients with severe glaucoma who were treated with trabeculectomy only (TRAB) in the preceding year were used for comparison.

Results:
The study included 39 eyes in the VISCO-TRAB group and 40 eyes in the TRAB group. Mean intraocular pressure was significantly lower in the VISCO-TRAB group during the early postoperative period (P < .05). The postoperative course was less eventful in the VISCO-TRAB group with minimal hypotony or suture lysisrelated complications.

Conclusion:
During the early postoperative period, VISCO-TRAB proved efficacious and safe in reducing intraocular pressure to target levels in patients with far-advanced glaucoma.
Double Descemet’s Membranes After Penetrating Keratoplasty with Anterior Segment Optical Coherence Tomography
Authors: Ide Takeshi , Yoo Sonia H. , Kymionis George D. , Shah Pulin A. , O’Brien Terrence P.
Published: March 2009

An 83-year-old man underwent penetrating keratoplasty for pseudophakic bullous keratopathy in the left eye. Postoperatively, a thin transparent membrane in the anterior chamber was noted. The differential diagnosis included vitreous prolapse, retained capsule, fibrinous anterior chamber membrane, and retained Descemet’s membrane in the anterior chamber, but the diagnosis was uncertain due to corneal edema and Descemet’s membrane folds. Anterior segment optical coherence tomography was used to determine the diagnosis of retained host Descemet’s membrane. This case report demonstrates that anterior segment optical coherence tomography is a useful and noninvasive instrument for diagnosing and following complications from penetrating keratoplasty.
Conjunctival Myxoma: a Clinicopathologic Report
Authors: Kiliç Adil , Kösem Mustafa , Demirok Ahmet , Çinal Adnan , Yasar Tekin
Published: March 2009

A conjunctival myxoma was identified in a specimen obtained from a 45-year-old woman via excisional biopsy. The patient presented with a slowly growing painless epibulbar mass. The paucicellular tumor included stellate and spindle-shaped cells, mast cells, and dilated lymphatic channels embedded in a loose collagenous matrix. The differential diagnosis of conjunctival myxoma should include tumors that have myxoid patterns and richly myxoid malignant neoplasms.
External Refinement of the Donor Lenticule Position During Descemet’s Stripping and Automated Endothelial Keratoplasty
Authors: Koenig Steven B. , Meisler David M. , Dupps William J. , Rubenstein Jonathan B. , Kumar Radhika
Published: March 2009

The authors describe a technique to facilitate the centration of the donor lenticule during Descemet’s stripping and automated endothelial keratoplasty. The donor corneal lenticule is unfolded and grossly centered in the anterior chamber using a barbed 30-gauge needle on a 3-cc air syringe or a reverse Sinsky hook. Fine adjustments to center the lenticule can be achieved by applying external pressure to the cornea with a laser in-situ keratomileusis flap roller. This simple technique provides a mechanism for simultaneously removing interface fluid and allows the surgeon to center the donor corneal lenticule without further risk of direct mechanical trauma to the donor endothelium.
Optic Fibre Free Intravitreal Surgical System (OFFISS) in Retinal Detachment Surgery
Authors: Nawrocki Jerzy , Michalewska Zofia , Michalewski Janusz
Published: March 2009

Background and Objective:
Scleral buckling is widely used for the treatment of rhegmatogenous retinal detachment. The use of the Optic Fibre Free Intravitreal Surgical System (OFFISS) (Topcon Inc., Paramus, NJ) in scleral buckling performed as a complete microsurgical procedure is described.

Patients and Methods:
Seven eyes of seven consecutive patients with rhegmatogenous retinal detachment underwent scleral buckling. The OFFISS was used as the illumination and visualization system during all surgical steps.

Results:
Anatomic success occurred in 6 of 7 eyes (85.7%). After a second intervention, the retina was reattached in all cases. Functional success, described as improvement or stabilization of visual acuity, was observed in 6 of 7 eyes (85.7%).

Conclusion:
The OFFISS is a useful tool for observation of the posterior segment of the eye during surgery for retinal detachment. All surgical steps are performed under high magnification and surgery can be more precise. Intraoperative complications are minimized.
Alcaligenes Xylosoxidans Endophthalmitis Following Phacoemulsification and Intraocular Lens Implantation
Authors: Robert Pierre-Yves , Chainier Delphine , Garnier Fabien , Ploy Marie-Cécile , Parneix Pierre , Adenis Jean-Paul , Martin Christian
Published: March 2009

Five consecutive cases of endophthalmitis that developed after cataract extraction by a single surgeon using the same operating room during one morning session are described. Following preoperative topical administration of ciprofloxacin, surgery consisted of phacoemulsification with peristaltic pump and fluid venting, polymethylmethacrylate intraocular lens implantation, and corneal suture. No complications occurred during surgery. All five patients developed endophthalmitis caused by infection with Alcaligenes xylosoxidans in less than 24 hours. Pulsed-field gel electrophoresis was used to prove similarity between strains. Bacterial inquiry on contamination of the operating room environment revealed massive colonization of phacoemulsifier irrigation channels by Pseudomonas fluorescens bacteria from an unestablished source. Four of the five patients ultimately recovered visual acuity better than 20/60.
A New Device for Ocular Globe Enucleation
Authors: Torres Virgínia L. L. , Schor Paulo , Erwenne Clélia M.
Published: March 2009

It is important to perfect the enucleation technique, especially in cases of intraocular malignancy, to obtain an adequate amount of tissue for histologic analysis and to cause a minimum amount of trauma to the remaining orbital structures. This study describes the use of a new device for ocular globe enucleation. The new instrument has been employed in 16 consecutive enucleation procedures with no complications. The new device has promoted good division of the optic nerve and allowed severing of the optic nerve stump at a length of more than 10 mm.
Acute Visual Acuity Loss Following Intravitreal Bevacizumab for Diabetic Macular Edema
Authors: Chen Eric , Hsu Jason , Park Carl H.
Published: March 2009

A 58-year-old woman with non-proliferative diabetic retinopathy presented with decreased visual acuity from chronic macular edema. She had undergone multiple treatments previously, including focal laser treatment and intravitreal triamcinolone acetonide. Within 2 days of treatment with intravitreal bevacizumab, the patient noted a significant decrease in visual acuity. Fluorescein angiogram demonstrated an enlargement of the foveal avascular zone and persistent late leakage following intravitreal bevacizumab; optical coherence tomography performed before and after treatment revealed persistent cystoid macular edema. The use of intravitreal bevacizumab in chronic, refractory diabetic macular edema may cause acute visual acuity loss by disrupting an already fragile vascular perfusion status, leading to macular ischemia.
[Ophthalmic Surg Lasers Imaging 2009;40:68–70.]
Deep Lamellar Keratoplasty for Recurrent Advanced Pterygium
Authors: Das Sujata , Ramamurthy Balasubramanya , Sangwan Virender S.
Published: March 2009

The authors report a case of recurrent advanced pterygium managed by deep lamellar keratoplasty and conjunctival autograft. A woman presented with bilateral recurrent advanced pterygium (more prevalent in the left eye) associated with corneal thinning in the left eye. Two-thirds of the cornea was covered by pterygia. Her visual acuity was counting fingers at 1 meter in the right eye and light perception with projection of rays being accurate in all quadrants in the left eye. She underwent deep anterior lamellar keratoplasty and conjunctival autograft in her left eye. Clarity, state of corneal graft, and postoperative visual acuity were noted. The graft was clear and the patient's best-corrected visual acuity improved to 20/60 after the surgery. Deep lamellar keratoplasty with conjunctival autograft is a good option as a single-stage surgery for recurrent advanced pterygium.
[Ophthalmic Surg Lasers Imaging 2009;40:43–45.]
Intravitreal Toxicity of Ketorolac Tris Salt and Flurbiprofen
Authors: Morales Ana Munoz , Kivilcim Muhamet , Peyman Gholam A. , Main Muhammad , de Almada Manzano Roberta Pereira
Published: March 2009

Background and Objective:

To determine the retinal toxicity of intravitreal ketorolac tris salt and flurbiprofen.

Materials and Methods:

Thirty-two New Zealand rabbits were injected intravitreally with 125, 250, or 500 µg or 1 mg of ketorolac tris salt or flurbiprofen in one eye and 8 fellow eyes were injected with 5% dextrose as a control. All animals underwent indirect ophthalmoscopy and slit-lamp biomicroscopy before injection and on days 1, 7, and 14 after the intravitreal injection. Electroretinography was performed on all animals before injection and on day 14 after the injection before the animals were killed. The enucleated eyes were prepared for histology.

Results:

Clinical examination, electroretinography results, and histological evaluation demonstrated no signs of retinal toxicity for either drug at any dose.

Conclusions:

Intravitreal doses up to 1 mg of ketorolac tris salt and 1 mg of flurbiprofen did not cause retinal toxicity in the rabbit eye.

[Ophthalmic Surg Lasers Imaging 2009;40:38–42.]
Outcomes of Nd:YAG Laser Treatment for Valsalva Retinopathy Due to Intense Military Exercise
Authors: Mumcuoglu Tarkan , Durukan Ali Hakan , Erdurman Cuneyt , Hurmeric Volkan , Karagul Suat
Published: March 2009

Background and Objective:

Valsalva retinopathy may occur due to intense physical exercise. Soldiers must undergo vigorous physical training to sustain a high level of readiness. The aim of this study was to evaluate the recovery period and the outcomes of Valsalva retinopathy due to physical exercise in the Turkish Army.

Patients and Methods:

Twelve soldiers had Valsalva retinopathy related to military exercise. All patients received Nd:YAG laser membranotomy and were observed for an average of 12.6 months.

Results:

All eyes had visual acuities of 20/20 at the end of the first month of follow-up. Therefore, the soldiers could continue their training. No complications were observed and additional surgeries were not needed during the 1-year follow-up.

Conclusions:

Early visual recovery is important to continue training and reduce health costs in the Turkish Army, where military service is mandatory for a required period of time. For that reason, Nd:YAG laser treatment for Valsalva retinopathy related to military exercise is an effective and safe procedure.

[Ophthalmic Surg Lasers Imaging 2009;40:19–24.]
Secondary Open-Angle Glaucoma and Central Retinal Vein Occlusion in a Patient With Primary Pulmonary Hypertension
Authors: Senthil Sirisha , Kaur Bhavleen , Jalali Subhadra , Garudadri Chandrashekar
Published: March 2009

A 22-year-old man with primary pulmonary hyper-tension presented with dilated episcleral veins and increased intraocular pressures. His increased intraocular pressure was resistant to therapy with topical and systemic anti-glaucoma medications. He developed serous macular detachment in one eye that resolved spontaneously. He later presented with central retinal vein occlusion in the same eye, which responded to intravitreal bevacizumab. Ocular manifestations of primary pulmonary hypertension develop as a result of reduced venous outflow due to increased venous pressures. Management of ocular complications in patients with systemic disease resulting in short life expectancy remains a challenge.
[Ophthalmic Surg Lasers Imaging 2009;40:50–53.]
Nursing Home Staffing and Training Recommendations for Promoting Older Adults’ Quality of Care and Life: Part 1. Deficits in the Quality of Care Due to Understaffing and Undertraining
Authors: Maas Meridean L. , Specht Janet P. , Buckwalter Kathleen C. , Gittler Josephine , Bechen Kate
Published: March 2009

Caught between the inability or unwillingness of nursing home corporations and owners to redistribute revenue and the reluctance of federal and state agencies to increase payments to nursing homes, the nation’s most vulnerable older adults are not receiving the care they deserve. Widespread recognition of substandard care and quality of life of older adults in nursing homes has existed for decades. In addition, there is substantial evidence that poor quality of care is related to inadequate numbers and training of nursing staff. Still, policy makers and nursing home owners have failed to take needed action. In the first article of this two-part series, major deficits in the care of older adult nursing home residents are reviewed, and research documenting the relationship between nursing home staffing and the quality of care and life of residents is summarized.
Local Strain Imaging during Mechanical Loading of Lamellar Microstructures in Titanium Based Alloys
Authors: Babout L. , Quinta Da Fonseca J. , Preuss Michael
Published: March 2009

In this work optical microscopy in situ tensile testing has been carried out to study the localisation of surface strain in fully lamellar titanium alloys. The localised strain was measured by analysing the recorded optical micrographs using image correlation, and the orientation of the a lamellae colony was determined by using Electron Back Scatter Diffraction (EBSD). The results show a localisation of strain, which seems to depend on the crystallographic orientation of the a lamellae colony in the lamellar microstructure. No significant strain was observed in the former b grain boundary region.
Development of Metallic Digital Strain Gauges
Authors: Yan T. , Jones B.E. , Rakowski R.T. , Tudor M.J. , Beeby S.P. , White Nicholas M.
Published: March 2009

A joint Brunel-Southampton Universities’ research team has developed digital strain
gauges based on a metallic triple-beam resonator structure with thick-film piezoelectric sensor elements. The resonator, an oscillating structure vibrating at resonance, is designed such that its resonant frequency is a function of the measurand. The resonator substrate was fabricated by a double-sided photochemical etching technique and the thick-film piezoelectric elements were
deposited by a standard screen-printing process. The new metallic digital strain gauges can be used on stiff structures, have high overload capacities, low power consumption, frequency output for digital processing, and offer prospects for wireless-batteryless operation. The device can be easily mass-produced at low cost for use in a wide range of measuring systems, e.g. load cells, weighing
machines, torque transducers and pressure sensors.
Measurement of Material Properties for Metal Foam Cored Polymer Composite Sandwich Construction
Authors: McKown S. , Mines Robert A.W.
Published: March 2009

Material properties are required for the numerical simulation of the impact progressive collapse of metal foam cored polymer composite sandwich beams, using LS-DYNA. As far as the metal foam, Alporas, is concerned, multi-axial tension and compression data is required. This includes large scale crush and tensile rupture. An Arcan test fixture was developed, in which a sample of foam can be subject to tensile and shear deformation simultaneously. The data was also used to calibrate the crushable foam material model in LS-DYNA. For the skin, tensile and compression data was generated for a cross ply glass fibre thermoplastic laminate. The data was then used to calibrate the composite damage material model in LS-DYNA. Inclusion of calibrated material models into the simulation of the progressive collapse of metal foam cored composite sandwich beams will be briefly discussed.
Sports Engineering Past and Present
Authors: Haake Steve
Published: March 2009

This paper aims to define sports engineering through the use of historical and
contemporary examples. The historical development of the technology in the sprint and in the javelin are discussed, from their introduction to the Olympics over two and a half thousand years ago to the current day. The rules pertaining to tennis racquets are described and the ways in which manufacturers and researchers attempt to maximize performance using technology are examined. Two models for a tennis racquet are shown, one in which the racquet is modelled as a rigid body
and one in which it is modelled as a flexible beam. Use of the models shows that further advances in racquet technology using stiffer and lighter materials are unlikely to speed the game up. It was concluded that technology can be used by athletes and manufacturers to enhance performance. Equally, the ruling bodies of sport can also use technology to limit performance, leading to a delicate balance between technology and tradition.
Ultrasonic Cutting with High-Gain Blades
Authors: MacBeath Alan , Cardoni Andrea , Smith Lorna , Lucas Margaret
Published: March 2009

The design of high power ultrasonic cutting devices is based on tuning a blade to a
longitudinal mode of vibration at a low ultrasonic frequency, usually in the range 20-100 kHz. To achieve the required cutting amplitude, gain is designed into the blade via profiling. It is expected that the use of higher-gain blades could enable longitudinal-mode guillotine-type cutting of a range of materials traditionally difficult to cut using this technology. Using a conventional high-gain blade, a feasibility study of ultrasonic cutting of bone is conducted using compact tension specimens of bovine femur. Finite element (FE) models are created, based on the assumption that the ultrasonic blade causes a crack to propagate in a controlled mode 1 opening. The models are compared with the experimental data collected from ultrasonic bone cutting experiments. Although the proposed cutting mechanism is supported by the
data, the blade gain is insufficient to enable through cutting of long bone or other difficult to cut materials. Consequently, the paper examines the relationship between gain, profile, stress and nodal position for a range of ultrasonic cutting blades with increased gain.
On Non-Ideal Simple Portal Frame Structural Model: Experimental Results under a Non-Ideal Excitation
Authors: Balthazar José Manoel , Brasil Reyolando Manoel Lopes Rabelo da Fonseca , Garzeri F.J.
Published: March 2009

We present measurements of the non-linear oscillations of a portal frame foundation for a non-ideal motor. We consider a three-time redundant structure with two columns, clamped in their bases and a horizontal beam. An electrical unbalanced motor is mounted at mid span of the beam. Two non-linear phenomena are studied: a) mode saturation and energy transfer between modes; b)interaction between high amplitude motions of the structure and the rotation regime of a real limited
power motor. The dynamic characteristics of the structure were chosen to have one-to-two internal resonance between the anti-symmetrical mode (sway motions) and the first symmetrical mode natural frequencies. As the excitation frequency reaches near resonance conditions with the 2nd natural frequency, the amplitude of this mode grows up to a certain level and then it saturates. The surplus energy pumped into the system is transferred to the sway mode, which experiences a sudden increase in its amplitude. Energy is transformed from low amplitude high frequency motion into high amplitude low frequency motion. Such a transformation is potentially dangerous. We consider the fact that real motors, such as the one used in this study, have limited power output. In this case, this energy source is said to be non-ideal, in contrast to the ideal source whose amplitude and frequency are independent of the motion of the structure. Our experimental research detected the Sommerfeld Effect: as the motor accelerates to reach near resonant conditions, a
considerable part of its output energy is consumed to generate large amplitude motions of the structure and not to increase its own angular speed. For certain parameters of the system, the motor can get stuck at resonance not having enough power to reach higher rotation regimes. If some more power is available, jump phenomena may occur from near resonance to considerably higher motor speed regimes, no stable motions being possible between these two.
Fatigue Life and Residual Strength Analysis of Steel-Composite Joints
Authors: Boyd S.W. , Blake J.I.R. , Shenoi R.A. , Mawella J.
Published: March 2009

There are many instances where the use of weight saving composite materials for an entire structure is either; too complex, too expensive or unfeasible. In these circumstances the use of a hybrid structure can incorporate the benefits of traditional construction materials, for example steel, coupled with the advantages of composite materials in weight critical areas. In the present study, an investigation was undertaken into the fatigue life characterisation of a hybrid joint for marine application. In addition the residual strength of the joint, after a fixed number of fatigue cycles, was assessed under axial compression and bending loads. A progressive damage model was developed to predict the location of major stress concentrations, the path of damage and subsequent loss in stiffness of the joint under axial compression.
Research on Dynamic Scheduling of Job-Shop Production with the Ant Colony Optimal Algorithm
Authors: Liu Yong Xian , Xiong J. , Sun B.M.
Published: March 2009

Job-shop dynamic scheduling is an important subject in the fields of production
management and combinatorial optimization. It is usually hard to achieve the optimal solution with
classical methods due to the high computational complexity of the problem. A solution of job-shop
scheduling problem based on multi-agent is presented for the comparability between the dynamic
scheduling problem of job-shop production and the TSP problem. The dynamic scheduling of
job-shop production is designed according to the pattern of TSP problem which can be applied with
ACO. By the application case, the ACO is the new method to solve the dynamic scheduling of
job-shop production.
Research on the Technique of Product Configuration in PDM
Authors: Lin Lin , Wang Guo Lei , Zhong S.S.
Published: March 2009

The technology of product configuration in a Product Data Management (PDM) system
was discussed in this paper. The paper presented the product configuration modeling technology by
based on the ‘and/or’ tree of product configuration, the process relation and coupling relation
between components, and then, a general model of the product configuration scheme was proposed.
The product configuration algorithm based on the product configuration scheme was also
introduced and the feasibility from the theory model to the program was proved. The paper also
discussed the application of Case-Based Reasoning(CBR) technology in product configuration, and,
the emphasis was given towards the similar component search by the Nearest Neighbor(N-N)
method. Finally, the product configuration technology was implemented on hydro-generator design
process, and the result indicated this technology was valuable to realize intelligentization and
automation of product configuration.
A Fuzzy Set AHP-Based DFM Tool under Concurrent Engineering Environment
Authors: Liu H.G. , Mo Rong , Fan Qing Ming , Chang Zhi Yong , Zhao Y.
Published: March 2009

In the light of growing global competition, organizations around the world today are constantly under pressure to produce high-quality products at an economical price. The integration of design and manufacturing activities into one common engineering effort has been recognized as a key strategy for survival and growth. Design for manufacturability (DFM) is an approach to design that fosters the simultaneous involvement of product design and process design. The implementation of the DFM approach requires the collaboration of both the design and manufacturing functions within an organization. At present, For some reasons DFM approach is ineffectively including lack of interdisciplinary expertise of designers; inflexibility in organizational structure, which hinders interaction between design and manufacturing functions. Design for manufacture is the practice of designing products with manufacturing in mind. Early consideration of manufacturing issues can shorten product development cycle time, minimi overall development cost and ensure a smooth transition into production. In this paper, part manufacturability under Concurrent Engineering (CE) environment was analyzed in detail. An evaluation system of DFM was proposed according to CE ideas. A fuzzy set-based manufacturability evaluation algorithm is formulated to generate relative manufacturability indices to provide product designers with a better understanding of the relative ease or difficulty of machining the features in their designs. An analytic hierarchy process (AHP) method is introduced to assign weighting factors to features to reflect their functional importance. Results from the case studies show the method available and practicable.
A Web-Based Collaborative Design Advisory System for Micro Product Design Assessment
Authors: Dai Xiao , Qin Yi , Juster Neal P.
Published: March 2009

A web-based collaborative design advisory system for designing micro products is being
developed, which is based on use of both knowledge and rules. The system is aimed at helping
designers to assess/optimise the design of micro products to be manufactured with micro-forming.
The Microsoft C# programming language, ASP.Net technique and Microsoft Access database
system have been used to develop this system. The system is composed of various assessment
modules such as product geometry features, forming processes, materials, machines, tools and cost
assessment modules. Clients can use/browse the user interface of the integrated system through the
internet to import a CAD design model and define design parameters. The system is not only able to
assess the client’s design but also to generate preliminary process plans for the selected
micro-forming processes. A micro-pin design is used as an example to test the capability of the 1st
prototype system. With such a system, some advantages such as increasing the design efficiency in
the web-based collaborative design environment have been identified.
Evaluation Model of the Product Design Team under Internet Environment
Authors: Wang Neng Jian , Liu Qin Hui , He Z.
Published: March 2009

Aiming at the characteristics of the product design team under internet environment, the intelligent resource selecting method through price is put forward. Based on this, the evaluation model of the product design team under internet environment is established, and meanwhile, the practical case is introduced to provide an effective method for the optimization of the intelligent resources.
Product Numbering System Design for Single Piece or Small Batch Customization Manufacture and its Process Organization
Authors: Gao Hang , Liu Xue Shu , Li Q. , Guo Dong Ming
Published: March 2009

In this paper, a kind of product numbering system for single piece/small batch
customization manufacturing and its process organization is put forward based on the current status
of Shenyang Heavy Machine Manufacture Group Co. Ltd. and the trends of advanced
manufacturing technology such as PDM/ERP etc. The numbering system developed includes all
of relative public information data such as product order, design, process plan, manufacturing,
marketing, consumer servicing and so on. A more favorable condition is created to realize the
share of relative information in the different departments of the company and to improve the
response to the market.
Design of a Crab-Like Octopod Robot
Authors: Ma Hong Wen , Wang L.Q. , Chen D.L. , Hao X.W. , Luo H.W.
Published: March 2009

A crab-like octopod robot is introduced in this paper. The body structure of the robot is
simuliar with a real crab. Each leg has three jionts which are driven by servomotors. The control
system is a distributed hierarchical system with a top layer as gait generator and a bottom layer as
servomotor controller. The bottom layer has enght individual control units every of which can
control three servomotors using PID control method. The sensor systerm is composed of force
sensors mounted at the end of the leg and a inclinometer provides pitch and roll angles of the body.
Research on Cooling Action and Simulation of Temperature Distribution with Water Vapor as Coolants and Lubricants in Green Cutting
Authors: Liu Jun Yan , Han Rong Di , Wang Yang
Published: March 2009

Water vapor is a good, pollution-free and economical coolants and lubricants in green
machining. In order to research the cutting temperature distributions with water vapor as coolants
and lubricants in machining, the experiments conducted under the conditions of water vapor as
coolants and lubricants and dry cutting. The cutting temperatures are studied by metal cutting
theory, and then by employing the finite element method (FEM), the temperature distribution of
cutting region is simulated with application of water vapor as coolants and lubricants and dry
cutting conditions. The results show that the water vapor jet flow has high force-convection heat
transfer coefficient and directly cooling action to reduce cutting temperature, and the stress, the
length of tool-chip interface are reduced with application of water vapor lubrication. So that the
cutting thermal is decreased and water vapor has indirect cooling action. Under the conditions of
indirect and direct cooling action, the cutting temperature is reduced obviously with application of
water vapor as coolants and lubricants.
Research on the Key Technologies in Optimization of a Self-Sealing Flange
Authors: Wang Hui Feng , Wang Guang Lin , Zou S.
Published: March 2009

This paper deals with a self-sealing flange system using O-ring as the potted component,
and defines the design variables, restrictions and object function in the optimization. This study
analyzes sealing performance of the flange system and quantifies it in optimization, and introduces
the parameter of “maximal sealing gap” in optimizing computation instead of the concept of
“sealing performance” which is too abstract to calculate, and then this paper analyzes the flange
bolting and deduces the just bolt group of the flange system.
Numerical Study of the Effect of Welding Parameters on the Strength of Spot-Welded Joints
Authors: Kong X. , Li B. , Yang Qing Xiang , Rothwell G. , English R. , Ren X.J.
Published: March 2009

Resistance spot welding (RSW) is widely employed in sheet metal fabrication, in
particular in automotive bodies and structures. Manufacturers are increasingly demanding reduced
design periods with improved safety requirements, which could potentially be achieved through
computational simulations. This paper presents an integrated approach combining simulation of the
welding process, materials characterisation and mechanical modelling to study the effect of welding
parameters on the strength of spot-welded joints. The welding process was simulated and the
dimensional attributes were used to build the mechanical models for strength analysis. The
constitutive material properties of the base, nugget and the heat-affected-zone (HAZ) were
determined by an inverse FE modelling approach using indentation test data. The predicted
deformation of spot-welded joints of a typical automotive steel under tensile-shear load showed a
good agreement with experimental results. The validated models were further used to predict effects
of welding parameters on the strength and failure behaviour of weld joints. Potential uses of the
approach in optimising welding parameters for strength were also discussed.
Experimental Research on the Influence of Indenter Tip Radius to Indentation Hardness
Authors: Zhou L. , Yao Ying Xue , Liu Qiang
Published: March 2009

Aiming at the influence law of indenter tip radius to indentation hardness, testing on the
hardness of single-crystal silicon was carried out based on nanoindentation technique. Two kinds of
Berkovich indenter with radius 40nm and 60nm separately were used in this experiment. According
to the load-depth curve, the hardness of single-crystal silicon was achieved by Oliver-Pharr method.
Experimental results are presented which show that indenter tip radius influence the hardness, the
hardness value increases and the indentation size effect becomes obvious with the increasing of tip
radius under same indentation depth.