bluuebunny/crossref_metadata_2025 huggingface dataset:
Penerapan Algoritma Knuth-Morris-Pratt pada Fungsi Pencarian Dokumen untuk Sistem Informasi Administrasi Sekolah Berbasis Website
Authors: Maulana Imam
Published: September 2019

The document search function in the quality assurance unit's information system uses the Knuth-Morris-Pratt algorithm. This KMP algorithm is a search algorithm that will match the pattern or arrangement of words to be searched from left to right at the beginning of the text and then shift the order of words until the word order is at the end of the text. The KMP algorithm has the advantage of matching matches on large files. The system development method used is the Rapid Application Development method. This RAD method is a life cycle strategy aimed at providing development that is much faster and gets results with better quality compared to results achieved through traditional cycles. Application of School Administration Information System is expected to be able to overcome problems arising from conventional document control processes to make it easier and more precise.

Abstrak: Fungsi pencarian dokumen pada sistem informasi unit jaminan mutu menggunakan algoritma Knuth-Morris-Pratt. Algoritma KMP ini merupakan algoritma pencarian yang akan mencocokkan pattern atau susunan kata yang akan dicari dari kiri ke kanan pada awal teks dan kemudian menggeser susunan kata sampai susunan kata tersebut berada di ujung teks. Algoritma KMP memiliki keunggulan pencarian kecocokan pada file yang berukuran besar. Metode pengembangan sistem yang digunakan yaitu metode Rapid Application Development. Metode RAD ini adalah strategi siklus hidup yang ditujukan untuk menyediakan pengembangan yang jauh lebih cepat dan mendapatkan hasil dengan kualitas yang lebih baik dibandingkan dengan hasil yang dicapai melalui siklus tradisional. Aplikasi Sistem Informasi Administrasi Sekolah ini diharapkan dapat mengatasi permasalahan yang timbul dari proses pengendalian dokumen secara konvensional agar lebih mudah dan tepat.
Caracterización clínica y microbiológica de la bacteriemia por Staphylococcus aureus
Authors: Hincapié-Osorno Carolina , Caraballo-Cordovez César , Tibaduiza-García María Fernanda , Garcés-Rodríguez Daniela de Jesús , Echeverri-Toro Lina , Ascuntar-Tello Johana , León-Álvarez Alba Luz , Jaimes-Barragán Fabián
Published: September 2019

Introducción: Staphylococcus aureus es una frecuente causa de bacteriemias y el incremento en las tasas de resistencia dificulta su tratamiento inicial. La incidencia de bacteriemias por S. aureus resistente a meticilina (SAMR) ha aumentado, principalmente en las infecciones adquiridas en el medio hospitalario. Este estudio pretende caracterizar clínicamente a los pacientes con bacteriemia por S. aureus detectados en un hospital de Medellín y definir su perfil de resistencia microbiana.

Métodos: cohorte retrospectiva en un hospital de tercer nivel. Se incluyeron pacientes ≥16 años con aislamiento para Staphylococcus aureus en sangre periférica. Se registró información relacionada con el episodio, el sitio de adquisición, la clasificación microbiológica y las características clínicas.

Resultados: de 775 reportes de hemocultivos positivos para S. aureus, finalmente se ingresaron 698 pacientes al estudio. La mediana de edad fue de 58 años (RIQ=42-69), 383 eran hombres (54.9%). En 354 pacientes (50.7%) la bacteriemia era de origen nosocomial y el 26.2% (n=183) eran SAMR. En 123 (17.6%) bacteriemias adquiridas en la comunidad, la frecuencia de SAMR fue 33.3% (n=41). El antecedente más frecuente fue tener un catéter vascular en 321 pacientes (46%). Se inició terapia empírica en 67.2% de los casos (n=469). Respecto a la gravedad, la mediana del puntaje SOFA fue de 4 (RIQ=1-5), APACHE II de 15 (RIQ=10-19) y la mortalidad fue del 24.9% (n=174).

Conclusiones: a pesar de que la mayoría de bacteriemias son de origen nosocomial, el reporte más frecuente fue SAMS tanto en el grupo nosocomial como en el de la comunidad. Sin embargo, la mortalidad en el grupo de bacteriemia nosocomial fue inferior comparada con la de la comunidad.
PENGEMBANGAN MINUMAN BERBASIS TEH DAN REMPAH SEBAGAI MINUMAN FUNGSIONAL
Authors: Batubara Siti Chairiyah , Pratiwi Nindia Arum
Published: September 2019

Tujuan dari pembelajaran ini adalah untuk mendapatkan formula minuman fungsional teh dan rempah terbaik. Penelitian ini menggunakan mixture design untuk menentukan formula optimum minuman fungsional terbaik yang terdiri dari gula merah, bubuk kayu manis dan bubuk kapulaga. Berdasarkan input batas atas dan batas bawah dari bahan baku sehingga didapatkan 16 formulasi yang akan diteliti. Untuk batas atas gula merah yaitu 40 dan batas bawah gula merah yaitu 35. Untuk batas atas bubuk kayu manis yaitu 15 dan batas bawah kayu manis yaitu 10. Untuk batas atas bubuk kapulaga yaitu 50 dan batas bawah bubuk kapulaga yaitu 45. Untuk menentukan kualitas minuman fungsional dilakukan uji kimia (uji karbohidrat, gula total dan nilai pH, uji fisik (Uji viskositas), uji organoleptik (uji hedonik untuk warna, aroma, rasa dan kekentalan) dan mutu hedonik yang ditentukan dari kesukaan panelis terhadap warna, aroma, rasa dan kekentalan) dan uji antioksidan. Penelitian ini untuk mendapatkan formula optimum yang terbaik dari hasil pengacakan oleh mixture design. Hasil dari pengolahan mixture design adalah anova, grafik dan duncan. Berdasarkan hasil penelitian formula minuman fungsional yang masih dapat diterima adalah formulasi 11 yang terdiri dari 40% gula merah, 12.67% bubuk kayu manis dan 47.32% bubuk kapulaga. Formula 11 mengandung 0.39% karbohidrat, 15.46% gula total, 5.38% pH 4.98% viskositas dan 255.41 mg antoksidan.
Seed-bank dynamics of native and invasive Impatiens species during a five-year field experiment under various environmental conditions
Authors: Skálová Hana , Moravcová Lenka , Čuda Jan , Pyšek Petr
Published: September 2019

Despite recent evidence on the important role of seed banks associated with plant invasions, and a large body of literature on invasive annual Impatiens species, little is known about the seed bank characteristics of Impatiens species. To bridge this gap, we conducted a five-year field experiment where we buried seeds of two invasive species (I. glandulifera and I. parviflora) and one native species (I. noli-tangere) across four localities in the Czech Republic, harbouring all three Impatiens species and differing in the environmental conditions. We found that the three Impatiens species differed in the characteristics of their seed banks. Both invasive species had a high seed germination rate of almost 100% in the first year after seed burial, while <50% of seeds of the native I. noli-tangere germinated during this year. In I. parviflora all seeds germinated in the first year after seed burial and later decomposed, i.e. the species had a transient seed bank. For I. glandulifera, the most invasive species, the survival of seeds differed among localities. At the first and second localities, the seeds decomposed in the first year after seed burial; in the third locality the seeds germinated in the second year; and in the fourth one, the seeds still germinated in the fourth year. The native I. noli-tangere formed a short-term persistent seed bank across all localities. Germinating or dormant seeds were found in the third year after burial in all localities, and in one locality the seeds persisted until the fifth year. The germination and dormancy in I. noli-tangere were constrained by low minimum temperatures during winter. In addition, germination was highest at intermediate soil moisture, and the most dormant seeds were recorded in soils with intermediate nitrogen concentration. The germination of I. glandulifera was slightly limited by low soil nitrogen. However, no such effect was found in I. parviflora. We suggest that in the invasive Impatiens species seed resistance to environmental factors and high germination at least partly explain their wide distribution.
An updated synopsis of Tanaecium (Bignonieae, Bignoniaceae)
Authors: Frazão Annelise , Lohmann Lúcia G.
Published: September 2019

Tanaecium Sw. emend L.G. Lohmann (Bignonieae, Bignoniaceae) is a genus of Neotropical lianas that is morphologically variable, especially in floral features. The genus is distributed from Mexico and the Antilles to Argentina, and centered in Amazonia. Here, we present an updated overview for Tanaecium that recognizes 21 species within the genus. Species delimitation was based on a detailed analysis of protologues and herbarium specimens, including type collections of all taxa. We present a detailed description for the genus and a key for the identification of all species. For each of the 21 species recognized, we present information on the nomenclature, phenology, habitat, distribution, and taxonomic notes. Furthermore, Spathicalyx kuhlmannii J.C. Gomes is transferred into Tanaecium kuhlmannii (J.C. Gomes) Frazão & L.G. Lohmann. A lectotype is proposed for Tanaecium crucigerum Seem.
To focus on processes, Les Sciences de l’artificiel , cinquante ans après : Essentielle contribution épistémologique et civique à la formation des Sciences de la Cognition et des Sciences d’Ingénierie
Authors: Le Moigne Jean-Louis
Published: September 2019

Lorsque parait en 1969 la première édition de The Science of the Artificial , l’ouvrage embarrassa d’abord les libraires et documentalistes : dans quelle rubrique disciplinaire le classer ? Non seulement il témoignait des compétences réfléchies d’H. A. Simon alors âgé de 53 ans dans la plupart des aires de connaissances reconnues par les académies des sciences mais il argumentait aussi la légitimité gnoséologique et épistémologique de ces ‘nouvelles sciences’ que sont les sciences de l’artificiel, les sciences d’ingénierie, les sciences de conception, se formant sur des ‘projets’ plutôt que sur des ‘objets dits naturels’. L’aventure de ce livre dans nos cultures mérite alors d’être contée puisqu’elle se poursuit cinquante après. Genèse de 1945 à 1968 : éclairée par les élections aux Académies des Arts & Sciences en 1959 et 67. Deuxième phase, celle d’une croissance étonnante de 1969 à 1981 : 3 chapitres de plus pour la deuxième édition, prix Turing de l’ACM (Informatique) 1975, prix Nobel (Economie) 1978 ; Troisième phase 1981-1996-2001, marquée par la parution du manifeste épistémologique Reason in Human Affairs (1983) qui va contribuer au renouvellement paradigmatique de l’épistémologie complexe par les ‘nouvelles sciences’ que sont les sciences de l’artificiel, les sciences d’ingénierie, les sciences des systèmes complexes, les sciences de conception.
All of Us Research
Authors: Jones-Schenk Jan
Published: September 2019

The National Institutes of Health (NIH) has joined the movement of big data by establishing a new research initiative to collect comprehensive health data from over 1 million U.S. citizens to better understand and address the health of the nation. As part of a focus supporting the Precision Medicine Initiative, the NIH aims to accelerate health and medical science and deliver on the promise for more personalized care and treatment.

[
J Contin Educ Nurs.
2019;50(10):442–443.]
Predictors of Hospital Nurses' Cultural Competence: The Value of Diversity Training
Authors: McLennon Susan M. , Rogers Tara L. , Davis Altheria
Published: September 2019

Background:

RNs must be culturally competent to facilitate optimal health outcomes for diverse patients and families. The purpose of this study was to identify factors associated with cultural competence in hospital nurses.

Method:

In this cross-sectional, descriptive study, the Cultural Competence Assessment Tool was administered to RNs (
N
= 74) from a 500-bed urban medical center in the southeastern United States. The mean age of participants averaged 40.6 (
SD
= 11.0) years, and most participants were White (63%) and had encountered more than five (66%) different cultures in their work environment in the prior 12 months. Forty-two percent had received two or more different types of diversity training (
M
= 1.6,
SD
= 1.1).

Results:

Mean score for overall cultural competence was 7.3 (
SD
= 0.8) on a scale of 0 to 10 (10 = highest possible). Years of education was positively associated with diversity training (
r
= 0.31,
p
< .01) and cultural competence (
r
= 0.25,
p
< .05). Only diversity training predicted greater cultural competence (β = 0.40,
p
= .001).

Conclusion:

Results suggest that diversity training is associated with greater cultural competence. Further research is needed to identify optimal types, dose, and frequency of diversity training to enhance overall cultural competence.

[
J Contin Educ Nurs.
2019;50(10):469–474.]
Increasing Nursing Knowledge of ST-Elevated Myocardial Infarction Recognition on 12-Lead Electrocardiograms to Improve Patient Outcomes
Authors: Hernandez Joanna M. , Glembocki Margaret M. , McCoy Mary Anne
Published: September 2019

Background:

Early identification of ST-elevated myocardial infarction (STEMI) on electrocardiograms (ECGs) is vital to patient outcomes. Therefore, nurses need to have the knowledge to quickly recognize this lethal dysrhythmia.

Method:

The purpose of this pretest–posttest study was to increase nursing's knowledge on accurate and timely identification of an STEMI using an online educational intervention delivered via social media.

Results:

This study included a convenience sample of 31 RNs employed in an urban hospital in the Midwest. The mean score on the pretest was 7.53 of 10 (
p
= .028), which improved to 9.11 of 10 (
t
= 6.273;
p
= .000) on the posttest.

Conclusion:

The use of social media to reach adult learners may be an effective means of delivering continuing education. Additional work is needed to further explore the use of educating bedside nurses on the importance of using the 12-lead ECG as a screening tool.

[
J Contin Educ Nurs.
2019;50(10):475–480.]
The Effect of Pulsed Ultrasound in the Treatment of Tibial Stress Fractures
Authors: Rue John-Paul H , Armstrong David W , Frassica Frank J , Deafenbaugh Martin , Wilckens John H
Published: September 2019

abstract

Tibial stress fractures commonly occur in athletes and military recruits. This prospective, randomized, double-blind clinical study sought to determine whether pulsed ultrasound reduces tibial stress fracture healing time. Twenty-six midshipmen (43 tibial stress fractures) were randomized to pulsed ultrasound or placebo treatment. Twenty-minute daily treatments continued until patients were asymptomatic with signs of healing on plain radiographs. The groups were not significantly different in demographics, delay from symptom onset to diagnosis, missed treatment days, total number of treatments, or time to return to duty. Pulsed ultrasound did not significantly reduce the healing time for tibial stress fractures.
A Retrospective Comparison of LASIK Outcomes for Myopia and Myopic Astigmatism With Conventional NIDEK Versus Wavefront-guided VISX and Alcon Platforms
Authors: Dougherty Paul J. , Bains Harkaran S.
Published: September 2019

Purpose

To compare visual, refractive, and safety outcomes among a non-wavefront scanning-slit laser (NIDEK EC-5000) and wavefront-driven lasers (Alcon CustomCornea and VISX CustomVue).

Methods

A retrospective comparison of outcomes for 290 eyes that underwent LASIK for myopia and myopic astigmatism with either a conventional or custom ablation excimer laser system were compared. The preoperative refractive error and age of the patients were matched. Outcomes were tested for statistically significant differences among the conventional laser and each of the custom ablation lasers. A
P
value <.05 was considered statistically significant. Data with 3-month follow-up are reported.

Results

Postoperatively, mean manifest refraction spherical equivalent was −0.12±0.31 diopters (D) (range: −1.50 to 0.75 D) for the NIDEK group, −0.13±0.39 D (range: −1.88 to 0.75 D) for the VISX group, and −0.06±0.26 D (range: −0.75 to 0.75 D) for the Alcon group. Eighty-nine percent of eyes in the NIDEK group, 88% of eyes in the VISX group, and 92% of eyes in the Alcon group were within a half-diopter of intended correction. None of the NIDEK and VISX eyes and 3% of Alcon eyes lost 2 or more lines of best spectacle-corrected visual acuity. No statistically significant differences in any of the outcomes studied between conventional and custom ablation treatments were noted (
P
>.05).

Conclusions

No statistically significant differences were observed in safety, efficacy, or predictability of eyes that underwent conventional ablation with the NIDEK EC-5000 scanning slit laser compared to custom ablation with the VISX CustomVue or Alcon CustomCornea laser systems. [
J Refract Surg.
2008;24:891–896.]
Multifocal Corneal Ablation for Hyperopic Presbyopes
Authors: Jung Seok Won , Kim Min Jung , Park Shin Hae , Joo Choun-Ki
Published: September 2019

Purpose

To investigate the clinical results of multi-focal wavefront-guided corneal ablation with a central near zone in hyperopic presbyopes.

Methods

Twenty-seven patients (54 eyes) were analyzed retrospectively. Monocular near and distance uncorrected visual acuity (UCVA) and binocular near and distance UCVA were measured preoperatively, and the near addition power and the manifest refraction were obtained. Measurements of spherical aberration, coma, total higher order aberration, and contrast sensitivity for high and low photopic conditions were performed. All patients received multifocal corneal ablations with a central near zone using the VISX CustomVue System and were examined at 1 month (48 eyes), 2 months (42 eyes), and 6 months (28 eyes) after surgery.

Results

Of 14 patients, 9 (64.3%) achieved both 0.8 or better in binocular distance UCVA and 0.65 or better in binocular near UCVA, and the spherical equivalent refraction and near addition power decreased from +1.16±0.82 diopters (D) to +0.33±0.45 D and from 2.35±0.44 D to 1.42±0.62 D at 6 months after surgery, respectively. No significant changes were noted in total higher order aberration and contrast sensitivity, whereas spherical aberration coefficients (Z-12) changed from positive to negative.

Conclusions

Multifocal wavefront-guided refractive surgery in presbyopia offered effective correction in hypermetropia and satisfactory near vision without significant increase in corneal total higher order aberration or significant decrease in contrast sensitivity. [
J Refract Surg
. 2008;24:903–910.]
Customized Topography-guided Photorefractive Keratectomy With the MEL-70 Platform and Mitomycin C to Correct Hyperopia After Radial Keratotomy
Authors: Ghanem Ramon C. , Ghanem Vinicius C. , de Souza Denise C. , Kara-José Newton , Ghanem Emir A.
Published: September 2019

Purpose

To evaluate topography-guided photorefractive keratectomy (PRK) for correcting hyperopia and astigmatism after radial keratotomy (RK).

Methods

Prospective study of 12 consecutive patients (19 eyes) who were treated with topography-guided PRK with 0.02% mitomycin C using an Asclepion-Meditec MEL-70 excimer laser with a 9.5-mm ablation zone. All eyes were operated by the same surgeon and followed for 1 year.

Results

Thirteen eyes had complete epithelialization by day 7 and all eyes by day 10. At 1 year, uncorrected visual acuity was 20/25 or better in 42.1% of eyes and 20/40 or better in 68.4%. Preoperative mean spherical equivalent refraction was +3.80±2.47 diopters (D) and +0.24±2.36 D (
P
<.001) 1 year postoperative, with 47.4% of eyes being within ±1.00 D and 73.7% within ±2.00 D. Preoperative mean cylinder was −2.30±1.41 D and −0.62±0.73 D (
P
<.001) 1 year postoperative. At 1 year, 68.4% of eyes gained at least 1 line of best-spectacle corrected visual acuity, 36.8% gained more than 1 line, and only 2 eyes lost 1 line (one due to corneal haze). Three eyes developed central haze. Mean regression from 6 to 12 months in these 3 eyes was +1.83 D and in the remaining 16 eyes was −0.50 D.

Conclusions

Topography-guided PRK with mitomycin C was safe and reasonably effective for the treatment of hyperopia after RK. [
J Refract Surg.
2008;24:911–922.]
Haze Development After Photorefractive Keratectomy: Mechanical vs Ethanol Epithelial Removal in Rabbits
Authors: de Medeiros Fabricio Witzel , Mohan Rajiv R. , Suto Chikako , Sinhá Sunilima , Bonilha Vera L. , Chaurasia Shyam S. , Wilson Steven E.
Published: September 2019

Purpose

To compare mechanical and ethanol epithelial removal with respect to myofibroblast development and haze formation after photorefractive keratectomy (PRK).

Methods

Seventeen rabbits underwent mechanical or ethanol debridement, and the opposite eye of each rabbit served as an unwounded control. In both groups, the epithelium was removed with a spatula and discarded. A −9.00-diopter PRK was performed in each eye. The level of haze in each cornea at 4 weeks was graded at the slit-lamp microscope according to the Fantes scale. Myofibroblast generation was detected with immunocytochemistry for alpha-smooth muscle actin (alpha-SMA) and cells were quantitatively analyzed.

Results

No difference was noted between the two groups in alpha-SMA + myofibroblasts 4 weeks after surgery (43.6±2.0/400× field and 45.7±4.8/400× field in ethanol and mechanical groups, respectively) (
P
=.10). A slight difference was noted but did not reach statistical significance with regard to stromal haze between ethanol and mechanical groups (2.0±0.5 and 2.3±0.4, respectively,
P
=.063). The ethanol and mechanical groups were statistically different when compared to controls regarding stromal haze and alpha-SMA+ cells (
P
<.0001 for all comparisons).

Conclusions

No difference was noted in clinical haze or myofibroblast generation between corneas that had PRK with mechanical or ethanol epithelial debridement. [
J Refract Surg.
2008;24:923–927.]
A Prospective Bilateral Comparison of Epi-LASIK and LASEK for Myopia
Authors: Hondur Ahmet , Bilgihan Kamil , Hasanreisoglu Berati
Published: September 2019

Purpose

To compare the clinical and confocal microscopic results of mechanical (epi-LASIK) versus alcohol-assisted laser epithelial keratomileusis (LASEK) for the correction of myopia.

Methods

Twenty-five patients with myopia received epi-LASIK in one eye and LASEK in the other. The difference of spherical equivalent refraction of myopia and astigmatism was less than 1.00 diopter (D) in two eyes of each case. Mechanical separation of the epithelium was performed with the Lasitome epithelial separator and alcohol-assisted separation with 25 second application of 18% alcohol. Ablation was performed with the ESIRIS laser. Patients were seen daily until epithelial closure, and at 1, 3, 6, and 12 months. Time to epithelial healing, uncorrected visual acuity (UCVA), manifest refraction, haze, and grey scale value in confocal microscopy were recorded.

Results

Preoperative myopic spherical equivalent refraction was −3.95±1.49 D in the epi-LASIK and −3.91±1.39 D in the LASEK-treated eyes. The mean time to epithelial healing was slightly longer after epi-LASIK (4.86±0.64 vs 4.18±0.58 days). Of both epi-LASIK and LASEK-treated eyes, 92% achieved 20/20 or better UCVA and were within ±0.50 D of emmetropia at 12 months. The grade of haze and mean grey scale value in confocal microscopy were similar in epi-LASIK and LASEK-treated eyes at all postoperative periods. One eye treated with epi-LASIK suffered a minor stromal cut.

Conclusions

Epi-LASIK and LASEK offer effective correction of myopia with comparable results at 1 year. [
J Refract Surg
. 2008;24:928–934.]
Corneal Biomechanical Metrics in Eyes With Refraction of −19.00 to +9.00 D in Healthy Brazilian Patients
Authors: Fontes Bruno M. , Ambrósio Renato , Alonso Ruiz S. , Jardim Daniela , Velarde Guillermo C. , Nosé Walton
Published: September 2019

Purpose

To evaluate corneal biomechanical metrics with tomographic parameters (given by the Oculus Pentacam) and refractive data in a population of healthy Brazilian patients.

Methods

Observational, cross-sectional study of 150 consecutive patients (53 men and 97 women; 260 eyes). Age, gender, central keratometric readings (central K), central corneal thickness (CCT), anterior chamber depth (ACD), spherical equivalent refraction, corneal hysteresis, and corneal resistance factor (CRF) were assessed and analyzed.

Results

Mean patient age was 46.5±21.04 years, average central K was 43.59±1.54 diopters (D), CCT was 545.05±35.41 µm, ACD was 2.96±0.52 mm, spherical equivalent refraction was −1.16±3.48 D, corneal hysteresis was 10.17±1.82, and CRF was 10.14±1.8 (range: 5.45 to 15.1). Mean CRF and corneal hysteresis were distinct among gender: CRF 10.326 in women and 9.810 in men (
P
=.0266); corneal hysteresis 10.421 in women and 9.727 in men (
P
=.0031). A negative correlation was found between both CRF and corneal hysteresis with age (r=−0.1255,
P
=.0434; and r=−0.2445,
P
=.0001, respectively). No association was found between CRF and average central K (r=0.0633,
P
=.3086), ACD (r=−0.0474,
P
=.4498), or spherical equivalent refraction (r=0.1028,
P
=.1061). Corneal hysteresis was not associated with age and average central K (r=0.0572,
P
=.3573), ACD (r=0.0060,
P
=.9236), or spherical equivalent refraction (r=0.0975,
P
=.1253). Corneal resistance factor and corneal hysteresis were positively associated with CCT (r=0.5760,
P
=0; and r=0.4655,
P
=0, respectively).

Conclusions

Corneal biomechanical metrics of healthy Brazilian patients were associated with CCT, gender, and age. Corneal steepness, ACD, and spherical equivalent refraction did not affect corneal hysteresis and CRF values in the studied population. [
J Refract Surg
. 2008;24:941–945.]
Tracking Difficulties After Femtosecond Laser Flap Creation With the LADARVision Excimer Laser System
Authors: Ramos-Esteban Jerome C. , Bamba Sonya , Krueger Ronald R.
Published: September 2019

Purpose

To describe a series of myopic patients in whom a LASIK flap was created with the IntraLase femtosecond laser. The LADARVision (Alcon Laboratories Inc) tracking system failed and resulted in postponement of surgery.

Methods

Five myopic Asian patients with darkly pigmented irides underwent bilateral superior hinge flap creation with three different femtosecond laser (IntraLase Corp) pulse frequencies: 15, 30, and 60 kHz. Mean patient age, preoperative best spectacle-corrected visual acuity (BSCVA), and spherical equivalent refraction were 33 years, 20/20, and −6.25 diopters (D), respectively. Despite uncomplicated flap-lift and adequate pharmacologic dilated pupil diameter >7 mm, difficulty was experienced with LADAR-Vision eye tracking in 9 of 10 eyes. Intraoperative manipulations (fluid application, levitation of the laser bed, and tracking through a repositioned flap) were attempted to facilitate eye tracking at the time of femtosecond laser flap creation, but without success.

Results

The flap was repositioned, and patients were asked to return 1 to 5 days later, at which time the flap was relifted, eye tracking was successfully achieved, and the surgery was completed. Mean postoperative uncorrected visual acuity was 20/18 and no eyes lost any lines of BSCVA at 1 year.

Conclusions

Irregularities of the IntraLASIK stromal bed surface induce forward light scatter, and dark ocular pigmentation further reduces retinal reflectance, leading to tracking failure with the Alcon LADARVision platform. Delaying the surgery by 1 to 5 days may aid in reducing the light scatter, so that eye tracking can be achieved. [
J Refract Surg
. 2008;24:953–956.]
The Visian Myopic Implantable Collamer Lens Does Not Significantly Affect Axial Length Measurement With the IOLMaster
Authors: Sanders Donald R. , Bernitsky David A. , Harton Paul J. , Rivera Robert P.
Published: September 2019

Purpose

To compare pre- to postoperative axial length measurements with the IOLMaster (Zeiss Humphrey Systems) to determine whether a correction factor for later intraocular lens (IOL) power calculation is necessary with an Implantable Collamer Lens (ICL; STAAR Surgical) in place.

Methods

The commercially approved Visian ICL was implanted in 60 eyes from 3 separate sites (20 eyes each). Pre- and postoperative axial length measurements were obtained using partial coherence interferometry.

Results

The pre- and postoperative axial lengths were highly correlated with an R
2
value of 0.9963. For all ranges of axial lengths tested, the use of postoperative axial length instead of preoperative axial length resulted in a <0.1-mm error in axial length measurements.

Conclusions

Based on the SRK formula, a 0.1-mm axial length difference would result in a 0.25-diopter (D) change in calculated IOL power; possibly a 0.20-D change in manifest refraction. These differences are so small as to make any correction to IOL power calculation formula based on the presence of an ICL unnecessary. [
J Refract Surg
. 2008;24:957–959.]
Urrets-Zavalia Syndrome Following Iris-claw Phakic Intraocular Lens Implantation
Authors: Park Shin Hae , Kim So Youl , Kim Hyung Il , Yang Suk Woo
Published: September 2019

Purpose

To report a patient who had a fixed and dilated pupil after uneventful iris-claw phakic intraocular lens (IOL) implantation.

Methods

A 27-year-old woman with bilateral high myopia underwent bilateral implantation of iris-claw phakic IOLs.

Results

No specific ocular findings were noted until postoperative week 1. Intraocular pressure (IOP) was within normal range in both eyes after surgery. At postoperative week 2, the right pupil was normal, but the left pupil was fully dilated and non-reactive to light, accommodative effort, and 0.125% and 2% pilocarpine. Best spectacle-corrected visual acuity was 1.0, and IOP was 13 mmHg in the left eye. There was no history of perioperative mydriatic use.

Conclusions

Urrets-Zavalia syndrome, unrelated to IOP elevation, occurred after uneventful phakic IOL implantation. Clinicians performing phakic IOL implantation should be aware of this complication. [
J Refract Surg
. 2008;24:959–961.]
The Advanced Human Eye Model (AHEM): A Personal Binocular Eye Modeling System Inclusive of Refraction, Diffraction, and Scatter
Authors: Donnelly William
Published: September 2019

Purpose

To present a commercially available software tool for creating eye models to assist the development of ophthalmic optics and instrumentation, simulate ailments or surgery-induced changes, explore vision research questions, and provide assistance to clinicians in planning treatment or analyzing clinical outcomes.

Methods

A commercially available eye modeling system was developed, the Advanced Human Eye Model (AHEM). Two mainstream optical software engines, ZEMAX (ZEMAX Development Corp) and ASAP (Breault Research Organization), were used to construct a similar software eye model and compared. The method of using the AHEM is described and various eye modeling scenarios are created. These scenarios consist of retinal imaging of targets and sources; optimization capability; spectacles, contact lens, and intraocular lens insertion and correction; Zernike surface deformation on the cornea; cataract simulation and scattering; a gradient index lens; a binocular mode; a retinal implant; system import/export; and ray path exploration.

Results

Similarity of the two different optical software engines showed validity to the mechanism of the AHEM. Metrics and graphical data are generated from the various modeling scenarios particular to their input specifications.

Conclusions

The AHEM is a user-friendly commercially available software tool from Breault Research Organization, which can assist the design of ophthalmic optics and instrumentation, simulate ailments or refractive surgery–induced changes, answer vision research questions, or assist clinicians in planning treatment or analyzing clinical outcomes. [
J Refract Surg
. 2008;24:976–983.]
In Vivo Application and Imaging of Intralenticular Femtosecond Laser Pulses for the Restoration of Accommodation
Authors: Schumacher Silvia , Fromm Michael , Oberheide Uwe , Gerten Georg , Wegener Alfred , Lubatschowski Holger
Published: September 2019

Purpose

According to the Helmholtz theory of accommodation, one major cause of the development of presbyopia is the increasing sclerosis of the crystalline lens. One concept for regaining the elasticity of the sclerosing lens is intralenticular treatment by femtosecond laser pulses.

Methods

The feasibility of applying and imaging in vivo microincisions by femtosecond laser pulses was evaluated in five rabbit lenses with a new high repetition rate (100 kHz) femtosecond laser unit. The treated eyes were monitored using optical coherence tomography (OCT) and Scheimpflug imaging for localizing and studying the tissue effects of the incisions. The rabbits were investigated preoperatively, immediately postoperatively, and 14 days after treatment.

Results

The procedure, termed femtosecond-lentotomy, was successfully applied to the left lens of each rabbit. The laser microincisions within the crystalline lens were detectable with OCT and Scheimpflug imaging, which emphasizes the integral role these technologies play in targeting and characterizing postoperative tissue effects. The imaging within the lens showed a progressive fading of the incisional opacities generated by the femtosecond laser after 14 days with no detectable cataract formation.

Conclusions

It is possible to create microincisions inside the crystalline lens within an acceptably short treatment time (<30 seconds). The 14-day follow-up did not show undesirable side effects, such as cataract formation, after intralenticular laser treatment. [
J Refract Surg
. 2008;24:991–995.]
Mitomycin C in Photorefractive Keratectomy
Authors: Shalaby Ashraf , Kaye Geoffrey B. , Gimbel Howard V.
Published: September 2019

Purpose:

To evaluate the outcome of primary or retreatment photorefractive keratectomy (PRK) or photo-therapeutic keratectomy (PTK) with mitomycin C (MMC) 0.02% applied prophylactically intraoperatively for the prevention of haze and regression in cases of significant haze and regression after primary PRK, due to previous radial keratotomy (RK), in primary PRK eyes with high myopia, and in corneas with a previous superficial foreign body scar.

Methods:

This was a retrospective evaluation of 34 eyes treated with PRK or PTK and intraoperative MMC. Mitomycin C was applied immediately after laser ablation. Postoperative examinations were conducted 3 and 7 days after surgery and monthly for 6 months. Haze was graded on a standard 0+ (clear cornea) to 4+ (total opacity) scale. Visual acuity was measured as a general baseline indicator.

Results:

Postoperatively, uncorrected visual acuity (UCVA) was 20/20 or better in 21 eyes and 20/25 in 5 eyes with best spectacle-corrected visual acuity (BSCVA) of 20/20 or better. Three eyes achieved UCVA of 20/30 with BSCVA of 20/20 or better; and 5 eyes had UCVA of 20/40 with BSCVA of 20/20 or better. Nineteen (56%) eyes had grade 0+ haze and 15 (44%) eyes had grade 0.5+ haze (trace haze) at 6-month follow-up.

Conclusions:

Mitomycin C 0.02% used prophylactically during PRK or PTK retreatment was effective in preventing significant recurrent haze from developing. In eyes with high myopia or previous RK or scarring, MMC was effective in preventing significant haze formation. [
J Refract Surg
. 2009;25:S93–S97.]
Confocal Microscopy of Corneal Sub-basal Nerve Plexus: A Quantitative and Qualitative Analysis in Healthy and Pathologic Eyes
Authors: Midena Edoardo , Cortese Marta , Miotto Stefania , Gambato Catia , Cavarzeran Fabiano , Ghirlando Alessandra
Published: September 2019

Purpose:

To validate corneal sub-basal nerve plexus examination by in vivo corneal confocal microscopy.

Methods:

Five parameters of corneal sub-basal nerve plexus in 250 human eyes (nerve fiber length, number of fibers, number of beadings, branching pattern, fiber tortuosity) acquired using in vivo corneal confocal microscopy (Confoscan 4.0; NIDEK Co Ltd) were analyzed. The first operator repeated the parameter analysis twice, performing the 2 evaluations 4 weeks apart. The second operator analyzed the cases once.

Results:

Intraoperator reproducibility of nerve fiber length, number of fibers, and number of beadings (intraclass correlation coefficient [ICC] = 0.96, 0.96, and 0.93, respectively) and interoperator reproducibility (ICC = 0.94, 0.95, and 0.87, respectively) were very good. Intraoperator reproducibility for branching pattern was good (ICC = 0.74), whereas interoperator reproducibility was very good (ICC = 0.81). Reproducibility of fiber tortuosity was good both at intra- and interoperator levels (ICC = 0.69 and 0.60, respectively).

Conclusions:

Corneal confocal microscopy with the NIDEK Confoscan 4.0 represents an in vivo, noninvasive, and reproducible diagnostic technique for the analysis of sub-basal corneal nerve plexus. Methods used to analyze quantitative and qualitative variables were highly reproducible. [
J Refract Surg
. 2009;25:S125–S130.]
NIDEK Optimized Prolate Ablation for the Treatment of Myopia With and Without Astigmatism
Authors: El Danasoury Alaa M.
Published: September 2019

Purpose:

To report the ocular and corneal higher order aberrations of a pilot trial of optimized prolate ablations for the treatment of myopia.

Methods:

In this prospective study, patients were treated using optimized prolate ablation or conventional ablation. Five patients underwent bilateral optimized pro-late ablation treatment, and nine patients were randomized to receive optimized prolate ablation (OPA group) in one eye and conventional ablation (control group) in the other eye. The mean preoperative manifest refraction spherical equivalent was −4.13±1.17 diopters (D) (range: −8.00 to −1.50 D), with a mean cylinder of −0.42±0.32 D (range: −1.00 to 0.00 D). Predictability, contrast sensitivity, and corneal and ocular aberrations were analyzed out to 6 months postoperatively.

Results:

Postoperative predictability was similar between the two groups. There was an increase in mesopic contrast sensitivity in the OPA group, and the OPA group had higher mesopic contrast sensitivity postoperatively. At 6 months postoperatively, the root-mean-square (RMS) of the total ocular higher order aberrations was 0.47 µm for the OPA group and 0.75 µm for the control group. Ocular spherical aberration was 0.04 µm for the OPA group and 0.22 µm for the control group. Six-month postoperative RMS of corneal spherical aberration was 0.25 µm for the OPA group and 0.46 µm for the control group.

Conclusions:

The preliminary outcomes in this study indicate that optimized prolate ablation-treated eyes had less induction of higher order aberration and spherical aberrations postoperatively. Better contrast sensitivity was noted in eyes that underwent optimized prolate ablation treatment compared with preoperatively. [
J Refract Surg
. 2009;25:S136–S141.]
Outcomes of NIDEK Optical Path Difference Custom Ablation Treatments (OPDCAT) for Myopia With or Without Astigmatism
Authors: Chen Shihao , Wang Yibo , Wang Qinmei
Published: September 2019

Purpose:

To report refractive and visual acuity outcomes using wavefront-guided optical path difference custom ablation treatments (OPDCAT; NIDEK Co Ltd) for myopia and myopic astigmatism.

Methods:

One hundred eyes of 50 patients with preoperative manifest refraction spherical equivalent (MRSE) of 4.62±1.30 diopters (D) (range: −1.38 to −7.25 D) with mean astigmatism of −0.57±0.37 D (range: 0 to −1.75 D) underwent LASIK with OPDCAT. Eyes that had ⩾5 µm of irregularity preoperatively underwent additional irregularity treatment (irregularity group) and were compared with eyes that did not undergo irregularity ablation (aspheric group). An independent-samples
t
test was used to analyze refractive outcomes at 3 months postoperatively. A
P
value <.05 was considered statistically significant.

Results:

The mean postoperative MRSE was 0.18±0.35 D (range: −0.63 to 1.00 D). Ninety-six (96%) eyes had uncorrected visual acuity of 20/20 or better and 87 (87%) eyes were within ±0.50 D of the intended correction. No eyes lost two or more lines of best spectacle-corrected visual acuity (BSCVA), 1 (1%) eye lost one line of BSCVA, and 99 (99%) eyes maintained gained lines of BSCVA. The MRSE changed 0.02 D between 1 and 3 months postoperatively. A statistically significant increase was noted in higher order aberrations in the entire cohort (
P
<.05) with lower induced higher order aberration and coma aberrations in the irregularity group (
P
<.05).

Conclusions:

LASIK using wavefront-guided OPDCAT ablation with or without irregularity is safe and efficacious for the treatment of myopia with astigmatism. The irregularity treatment induces fewer higher order aberrations than aspheric ablation. [
J Refract Surg
. 2009;25: S142–S147.]
Pseudoaccommodative Cornea Treatment Using the NIDEK EC-5000 CXIII Excimer Laser in Myopic and Hyperopic Presbyopes
Authors: Uy Edward , Go Rory
Published: September 2019

Purpose:

To investigate the refractive outcomes and spherical aberration of multifocal LASIK to create a distant-dominant center and near-dominant periphery in hyperopic, myopic, and emmetropic presbyopia.

Methods:

One hundred ninety-five eyes with myopic presbyopia and 119 eyes with hyperopic or emmetropic presbyopia that underwent LASIK or epithelial LASIK (epi-LASIK) were assessed out to 3 months postoperatively. All eyes underwent the pseudoaccommodative cornea (PAC) treatment using aspheric ablation profiles and wavefront correction with the NIDEK CXIII excimer laser. Mean preoperative spherical equivalent refraction was −3.80±2.10 diopters (D) for myopic presbyopia and +1.00±0.92 D for hyperopic or emmetropic presbyopia.

Results:

Mean postoperative spherical equivalent refraction was −0.40±0.77 D for myopic presbyopia and +0.15±0.62 D for hyperopic or emmetropic presbyopia. Functional vision, defined as 20/30 or better distance uncorrected visual acuity (UCVA) combined with J3 or better near UCVA, was achieved in 162 (83%) eyes with myopic presbyopia and 103 (87%) eyes with hyperopic or emmetropic presbyopia. An induction of 0.312 µm of spherical aberration was noted at 6 mm for myopic presbyopia treatments and 0.016 µm for hyperopic presbyopia treatments.

Conclusions:

The distance-dominant center used for PAC treatments is effective in emmetropic, myopic, and hyperopic presbyopia. The induced spherical aberration allows for depth of focus in patients with presbyopia. [
J Refract Surg
. 2009;25:S148–S155.]
Bioptics With LASIK Flap First for the Treatment of High Ametropia
Authors: Dvali Merab L. , Tsinsadze Nana A. , Sirbiladze Bella V.
Published: September 2019

Purpose:

To report the safety and predictability of an alternate sequence of the bioptics procedure.

Methods:

In this prospective study of 50 eyes, phakic intraocular lenses (IOLs) and pseudophakic IOLs were implanted, followed by LASIK. The corneal flap was created, followed by lens implantation 3 days later. Laser ablation was performed to the stromal bed 3 months later. Fifty eyes with varying degrees of refractive error (range of manifest refraction spherical equivalent [MRSE], −19.50 to +8.50 diopters [D]) were treated. Follow-up ranged from 3 months to 4 years postoperatively.

Results:

No intra- or postoperative complications occurred. Postoperatively, MRSE ranged from −0.75 to +0.50 D. Mean residual refractive astigmatism ranged from +0.25 to +1.50 D postoperatively. Postoperative uncorrected visual acuity was 20/20 or better in 82% (41/50) of eyes and 20/40 or better in 98% (49/50) of eyes. No eyes experienced a loss of best spectacle-corrected visual acuity postoperatively.

Conclusions:

This modification of the sequence of procedures for bioptics provided safe and predictable outcomes. [
J Refract Surg
. 2009;25:S160–S162.]
Acular LS Before and During LASIK for the Control of Pain: A Randomized, Masked Contralateral Eye Trial
Authors: Dougherty Paul J.
Published: September 2019

Purpose:

To assess the effect of ketorolac tromethamine 0.4% (Acular LS; Allergan Inc) drops in controlling LASIK pain.

Methods:

A prospective, randomized, double-masked, placebo-controlled study was performed to evaluate the effect of Acular LS on LASIK pain. Patients were given two unmarked bottles prior to surgery, one containing ketorolac tromethamine 0.4% (ketorolac group) and the other containing Refresh Tears (Tears group). Patients were randomly assigned to instill Acular LS in one eye and Refresh Tears in the fellow eye four times a day beginning 48 hours prior to LASIK, just before the keratome pass, and at the conclusion of surgery. Bilateral simultaneous LASIK was performed on the right eye followed by the left eye. Pain was assessed on a scale of 0 (no pain) to 6 (extreme pain) immediately after surgery on each eye and again 4 to 6 hours after surgery. Patients were evaluated at postoperative day 1 for microstriae and flap slips.

Results:

Sixty eyes of 30 patients were enrolled in the study. No eyes experienced postoperative flap slips or microstriae. The mean postoperative pain score in the Tears group of 1.23±1.33 was significantly higher (
P
=.002) than the postoperative score of 0.53±0.86 in the ketorolac group. The mean intraoperative pain score in the Tears group of 1.43±1.31 was higher (
P
=.085) than the intraoperative score of 0.97±1.16 in the ketorolac group.

Conclusions:

Pre- and intraoperative treatment with Acular LS significantly reduces postoperative LASIK pain. [
J Refract Surg
. 2009;25:210–213.]
Evaluation of the Apparent Change in Posterior Corneal Power in Eyes With LASIK Using Orbscan II With Magnification Compensation
Authors: Cheng Arthur C.K. , Ho Thomas , Lau Silvania , Lam Dennis S.C.
Published: September 2019

Purpose:

To develop a mathematical model for the assessment of the apparent posterior corneal curvature changes after myopic keratorefractive surgery with Orbscan (Bausch & Lomb) and to assess its accuracy with clinical data.

Methods:

Part 1: Postoperative and preoperative magnification ratio of the posterior corneal surface was calculated from a theoretical eye model. Changes of radius and power of the posterior corneal surface were estimated over a wide range of refractive corrections and preoperative anterior corneal power. Part 2: The measured radius of the posterior cornea by Orbscan II 3 months postoperatively was converted to a new value based on the mathematical model. Both the measured radius and corrected radius were compared with preoperative values using paired sample
t
test.

Results:

Myopic correction is associated with apparent steepening of the posterior curvature. The higher the amount of correction, the more the apparent difference. A statistically significant difference was noted between preoperative and measured postoperative radius of the posterior cornea (0.35±0.16 mm,
P
<.01). However, no significant difference was seen between preoperative and corrected postoperative radius of the posterior cornea (0.008±0.11 mm,
P
=.44).

Conclusions:

The change of corneal magnification induced by refractive correction partly explains the apparent steepening of the posterior corneal curvature. The mathematical model effectively compensates for the error in Orbscan II in the assessment of posterior corneal curvature after LASIK. [
J Refract Surg.
2009;25:221–228.]