25,673 research outputs found
Adjuvant corneal crosslinking to prevent hyperopic LASIK regression
No full textIoannis M Aslanides, Achyut N MukherjeeEmmetropia Mediterranean Eye Clinic, Heraklion, Crete, GreecePurpose: To report the long term outcomes, safety, stability, and efficacy in a pilot series of simultaneous hyperopic laser assisted in situ keratomileusis (LASIK) and corneal crosslinking (CXL).Method: A small cohort series of five eyes, with clinically suboptimal topography and/or thickness, underwent LASIK surgery with immediate riboflavin application under the flap, followed by UV light irradiation. Postoperative assessment was performed at 1, 3, 6, and 12 months, with late follow up at 4 years, and results were compared with a matched cohort that received LASIK only.Results: The average age of the LASIK-CXL group was 39 years (26–46), and the average spherical equivalent hyperopic refractive error was +3.45 diopters (standard deviation 0.76; range 2.5 to 4.5). All eyes maintained refractive stability over the 4 years. There were no complications related to CXL, and topographic and clinical outcomes were as expected for standard LASIK.Conclusion: This limited series suggests that simultaneous LASIK and CXL for hyperopia is safe. Outcomes of the small cohort suggest that this technique may be promising for ameliorating hyperopic regression, presumed to be biomechanical in origin, and may also address ectasia risk.Keyword: CX
Correlation between epithelial thickness in normal corneas, untreated ectatic corneas, and ectatic corneas previously treated with CXL; is overall epithelial thickness a very early ectasia prognostic factor?
No full textAnastasios John Kanellopoulos,1,2 Ioannis M Aslanides,3 George Asimellis11Laservision Eye Institute, Athens, 2Emmetropia Mediterranean Eye Clinic, Crete, Greece, 3New York University School of Medicine, NY, USAPurpose: To determine and correlate epithelial corneal thickness (pachymetric) measurements taken with a digital arc scanning very high frequency ultrasound biomicroscopy (HF UBM) imaging system (Artemis-II), and compare mean and central epithelial thickness among normal eyes, untreated keratoconic eyes, and keratoconic eyes previously treated with collagen crosslinking (CXL).Methods: Epithelial pachymetry measurements (topographic mapping) were conducted on 100 subjects via HF UBM. Three groups of patients were included: patients with normal eyes (controls), patients with untreated keratoconic eyes, and patients with keratoconic eyes treated with CXL. Central, mean, and peripheral corneal epithelial thickness was examined for each group, and a statistical study was conducted.Results: Mean, central, and peripheral corneal epithelial thickness was compared between the three groups of patients. Epithelium thickness varied substantially in the keratoconic group, and in some cases there was a difference of up to 20 µm between various points of the same eye, and often a thinner epithelium coincided with a thinner cornea. However, on average, data from the keratoconic group suggested an overall thickening of the epithelium, particularly over the pupil center of the order of +3 µm, while the mean epithelium thickness was on average +1.1 µm, compared to the control population (P = 0.005). This overall thickening was more pronounced in younger patients in the keratoconic group. Keratoconic eyes previously treated with CXL showed, on average, virtually the same average epithelium thickness (mean –0.7 µm, –0.2 µm over the pupil center, –0.9 µm over the peripheral zone) as the control group. This finding further reinforces our novel theory of the “reactive” component of epithelial thickening in corneas that are biomechanically unstable, becoming stable when biomechanical rigidity is accomplished despite persistence of cornea topographic irregularity.Conclusion: A highly irregular epithelium may be suggestive of an ectatic cornea. Our results indicate that the epithelium is thinner over the keratoconic protrusion, but to a much lesser extent than anticipated, and on average epithelium is thicker in this group of patients. This difference appears to be clinically significant and may become a screening tool for eyes suspected for ectasia.Keywords: corneal pachymetry, ectasia, keratoconus screening, cornea epithelial thicknes
A case report of central toxic keratopathy in a patient post TransPRK (followed by corneal collagen cross-linking)
No full textNicholas Davey, Ioannis M Aslanides, Vasilis Selimis Emmetropia Mediterranean Eye Institute, Heraklion, Crete, Greece Purpose: The purpose of this article is to report a case of central toxic keratopathy in a patient post transepithelial photorefractive keratectomy (TransPRK), followed immediately by corneal collagen cross-linking.Methods: This article describes the case of a 26-year-old male after bilateral aberration-free, TransPRK laser (Schwind Amaris 750S). The procedure was performed for compound myopic astigmatism in November 2015, followed immediately by accelerated corneal collagen cross-linking for early keratoconus.Results: From day 3 post-op, tear film debris underneath both contact lenses with corneal haze and early, progressive central anterior stromal opacity formation only in the left eye were noted. At 2 weeks post-op, the left eye was noted to have a significant hyperopic shift with central corneal thinning in the anterior stroma. A central anterior stromal dense opacity had formed in the left eye with the surrounding superficial stromal haze. As of month 2, the opacity gradually started to improve in size and density. The hyperopic shift peaked at 2 months and continued to improve, largely due to epithelial compensation with a gradual recovery of stromal thickness.Conclusion: The question remains as to what provokes the typical central corneal necrosis/thinning in central toxic keratopathy. We hypothesize that the space between the contact lens and the corneal surface post TransPRK is prone to a “pseudo-interface pathology” that could mimic diffuse lamellar keratitis-like pathology. Suboptimal lid hygiene, resulting in tear film combinations of bacteria, inflammatory cells, matrix metalloproteinases and other proteolytic enzymes, contributes to the degradation of vulnerable, exposed collagen stromal tissue post TransPRK or any surface corneal ablation. Refractive surgeons should maintain a healthy lid margin and tear film, especially in contact lens wearers, to prevent potential complications in refractive surgery procedures. Keywords: central toxic keratopathy, laser refractive surgery, PRK, TransPRK, complication
A pharmacological modification of pain and epithelial healing in contemporary transepithelial all-surface laser ablation (ASLA)
No full textIoannis M Aslanides, Vasilis D Selimis, Nikolaos V Bessis, Panagiotis N Georgoudis Emmetropia Mediterranean Eye Institute, Heraklion, Crete, Greece Purpose: We report our experience with the use of the matrix regenerating agent (RGTA) Cacicol® after reverse transepithelial all-surface laser ablation (ASLA)-SCHWIND to assess the safety, efficacy, pain, and epithelial healing.Methods: Forty eyes of 20 myopic patients were prospectively recruited to a randomized fellow eye study. Patients underwent transepithelial ASLA in both eyes, with one of the eyes randomly assigned to the use of the RGTA Cacicol. Postoperative pain and vision were subjectively assessed with the use of a questionnaire on the operative day, at 24 hours, 48 hours and 72 hours. Epithelial defect area size was measured at 24 hours, 48 hours, and 72 hours. Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were assessed at 1 month.Results: Mean UDVA at 1 month was LogMAR 0.028. The epithelial defect area was 10.91 mm2 and 13.28 mm2 at 24 hours and 1.39 mm2 and 1.24 mm2 at 48 hours for treated and nontreated eyes, respectively. Overall, 50% and 65% of treated and nontreated eyes healed by 48 hours. There was no statistically significant difference in the subjective vision between the groups, although vision of patients in the RGTA group was reported to be better. Pain scores were better at 24 hours and 48 hours in the RGTA group but with no statistically significant difference.Conclusion: The use of RGTA Cacicol shows faster epithelial recovery after transepithelial ASLA for myopia. Subjectively reported scores of pain and subjective vision were better in the RGTA group, although the difference was not statistically significant. There seems to be a consensual acceleration of epithelial healing even in eyes that did not receive treatment. There were no adverse events and no incidents of inflammation, delayed healing, or haze. Keywords: matrix regenerating agent, photorefractive keratectomy, PRK, transepithelia
El feminismo de Estado en España: El Instituto de la Mujer, 1983-1994
No full textEste trabajo contiene un análisis del Instituto de la Mujer (IM), el principal organismo público de igualdad de la Administración central en España. Al igual que las instituciones feministas de otros países, el IM fue establecido con el propósito de impulsar el establecimiento de políticas que contribuyeran a mejorar la posición de las mujeres en la sociedad. La primera parte del artículo examina el proceso de creación del IM, prestando especial atención al papel desempeñado por el movimiento asociativo de mujeres, así como a la importancia de las influencias internacionales. Se estudian además las principales características formales de la institución. La segunda parte contiene una evaluación (provisional) del impacto del IM en la formulación y puesta en práctica de las políticas de igualdad. Por último, se examinan el carácter y las consecuencias de las relaciones formales e informales existentes entre los miembros del movimiento feminista y del feminismo institucional.Publicad
Comparison of single-step reverse transepithelial all-surface laser ablation (ASLA) to alcohol-assisted photorefractive keratectomy
No full textIoannis M Aslanides,1 Sara Padroni,1 Samuel Arba Mosquera,2 Antonis Ioannides,1 Achyut Mukherjee11Emmetropia Mediterranean Eye Institute, Heraklion, Crete, Greece; 2Schwind eye-tech-solutions GmbH, Kleinostheim, GermanyPurpose: To evaluate postoperative pain, corneal epithelial healing, development of corneal haze, refractive outcomes, and corneal aberrations in a novel one-step, modified transepithelial photorefractive keratectomy (PRK), termed All-surface laser ablation (ASLA), compared to conventional, alcohol-assisted PRK.Materials and methods: Sixty eyes of 30 myopic patients were prospectively recruited to a randomized fellow eye study. Patients underwent conventional alcohol-assisted PRK in one eye (control group) and ASLA-modified transepithelial PRK in the other (30 eyes in each treatment arm). Primary endpoints were postoperative pain and haze scores at 1 day, 3 days, 1 week, and 1, 3, 6, and 12 months. Secondary endpoints included visual acuity at 1, 3, 6, and 12 months, corneal aberrations at 3, 6, and 12 months, and early and late onset haze. Refractive predictability, safety, and efficacy of the two methods were considered.Results: The average age of the cohort was 29 years (standard deviation [SD]: 9; range: 18–46), and the average spherical equivalent refractive error was -4.18 diopters (SD: 1.9). At 3 days after surgery, the average pain score was 64% lower in the ASLA group (P < 0.0005). At this point, 96% of ASLA eyes had no epithelial defect, whereas 43% in the alcohol-assisted group did not achieve complete epithelial healing, and required replacement of bandage contact lens. The haze level was consistently lower in the ASLA group at all time points from 1 to 6 months.Conclusion: This study shows that the ASLA technique may have a future role in refractive surgery, due to the fact that it offers faster epithelial healing, lower pain scores, and significantly less haze formation.Keywords: cornea, ASLA, PRK, alcohol, transepithelial, epithelium, lase
Tafeln im flexiblen Überfluss : Ambivalenzen sozialen und ökologischen Engagements /
No full textTafeln und ähnliche Initiativen sammeln die systematisch anfallenden Lebensmittelüberschüsse der Überflussgesellschaft, um sie wohltätig zu verteilen. Sie fügen sich damit in einen transnationalen Trend, der eine lokale Charity-Initiative innerhalb von vier Jahrzehnten zu einem global vernetzten Phänomen expandieren ließ. Stephan Lorenz zeigt, dass die Flexibilisierung der Überflussgesellschaft sowohl soziale Ausgrenzung und Polarisierung als auch die Übernutzung von Ressourcen verstärkt. Seine empirische Analyse gewährt Einblicke in die Etablierung eines zivilgesellschaftlichen Engagements, d.Includes bibliographical references.Print version record.Cover Tafeln im flexiblen Überfluss; Inhalt; I Einleitung; 1 Polarisierung im Wohlstand; 2 Die Diskussion der Tafeln; 3 Tafeln als Reaktion auf Hunger und Ernährungsarmut?; 4 Ziel und Aufbau der Studie; II Im flexiblen Überfluss -- eine zeitdiagnostische Perspektive; 1 Überflüsse -- Deutungen, Probleme, Paradoxien; 1.1 Vom Jagen und Sammeln zur Maschine: Umgang mit Überfluss; 1.2 Paradoxien, Legitimation und Kritik der Überflussgesellschaft; 2 Überflussgesellschaft als Konsumgesellschaft; 3 Ungleichheit, Armut und Ausgrenzung; 4 Konsequenzen flexiblen Überflusses; 4.1 Flexibler Überfluss.4.2 Konsequenzen für die TafelstudieIII Prozedurale Methodik; 1 Grundlagen; 2 Excurs über die : inge9 Tatsachen schaffen -- oder wie der Lebensmittelüberfluss durch Tafelarbeit die Leere und Desorientierung der Nachwendezeit füllt; 3 Zur Datenauswahl; IV Empirie I: Die Tafeln; 1 Nomen est Omen : afel9 2 Die "Tafelidee"; 2.1 "Tafelgedanke"; 2.2 "Tafelkonzept"; 2.3 "Tafelgrundsätze"; 2.4 Zwischenfazit zum Selbstverständnis der Tafeln und weitere Datenwahl; 3 Zur Gründungsgeschichte der Tafeln; 4 Jubiläumsausgabe der Verbandszeitschrift FeedBack; 4.1 Die Zeitschrift.4.2 Thematisierungen von Überfluss- und Ausgrenzungsproblemen?4.3 Thematisierung der Tafelnutzenden?; 4.4 Externe Beiträge?; 4.5 Verständnis bürgerschaftlichen Engagements?; 5 Zu Differenzierungen in der Tafelentwicklung; 5.1 Ausgrenzung: Tafel-Modelle der Solidarität; 5.2 Überschüsse: Ökologische Ansprüche; 5.3 Erweitertes Tätigkeitsspektrum und Kooperationen: Nachhaltige Alternativen durch Produzieren, Bilden, Beraten ...?; 5.4 Transnationale Entwicklungen; 6 Fazit zu Selbstverständnis und Engagementpraxis der Tafeln; V Empirie II: Die Tafelnutzenden.1 Frau K.5 -- Tafelnutzung als kalkulierte Option1.1 Eingangssequenz: Lebensmittel oder Kleidung für die Kinder; 1.2 Auf- und Abwertungen: Zur Selbstachtung auf Kosten anderer; 1.3 Die Bedeutung des Kunden-Status; 1.4 Die Arbeitsoption; 1.5 Fazit; 2 Frau G.15 -- Tafelnutzung als aktive Zugehörigkeit; 2.1 Eingangssequenz: Erlangung und Bedeutung von Zugehörigkeit; 2.2 Eingebettete, reproduktive Selbstständigkeit: Zur Bedeutung von Arbeit und Konsum; 2.3 "Helfernatur" und Rechtsansprüche; 2.4 Fazit.3 Kalkulierte Nutzung und aktive Zugehörigkeit: Möglichkeiten und Grenzen des Tafelengagements aus NutzerperspektiveVI Empirie III: Die Sponsoren; 1 Tafelsponsoring -- wohltätige Spende oder Geschäft?; 2 Tafeln als Nachhaltigkeitsprojekt eines Hauptsponsors; 2.1 Nachhaltigkeit; 2.2 Tafelengagement; 3 Zum Nutzen des Tafelsponsorings; VII Schluss; 1 Zusammenwirken von Tafeln, Tafelnutzenden und Sponsoren; 2 Tafeln im flexiblen Überfluss; Literatur; Dank; Anhang: Tafelgrundsätze.Tafeln und ähnliche Initiativen sammeln die systematisch anfallenden Lebensmittelüberschüsse der Überflussgesellschaft, um sie wohltätig zu verteilen. Sie fügen sich damit in einen transnationalen Trend, der eine lokale Charity-Initiative innerhalb von vier Jahrzehnten zu einem global vernetzten Phänomen expandieren ließ. Stephan Lorenz zeigt, dass die Flexibilisierung der Überflussgesellschaft sowohl soziale Ausgrenzung und Polarisierung als auch die Übernutzung von Ressourcen verstärkt. Seine empirische Analyse gewährt Einblicke in die Etablierung eines zivilgesellschaftlichen Engagements, d.JSTO
Whose future? Whose choosing?: Counselling in a context of (im)possible choice.
No full textCritically reflexive practice is at the heart of counselling, and even more so when clients come face to face with (im)possible choices. As counsellor educators, the authors show counselling practice at the edge of uncertainty. This article features a counselling context in a secondary school. It describes a fictional situation where action is called for in the midst of undecidability, at an impasse in the life of a young woman client. The article explores the aporia that confront the young woman and the counsellor, in the context of education, career, families, cultures and communities. The authors show that these explorations produced transformational questions for their teaching practice as counsellor educators
Single-step transepithelial ASLA (SCHWIND) with mitomycin-C for the correction of high myopia: long term follow-up
No full textIoannis M Aslanides, Panagiotis N Georgoudis, Vasilis D Selimis, Achyut N Mukherjee Emmetropia Mediterranean Eye Institute, Heraklion, Crete, Greece Purpose: We wanted to compare the outcomes of single-step modified transepithelial photorefractive keratectomy (tPRK) termed a SCHWIND all surface laser ablation (ASLA) versus conventional alcohol-assisted photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) for the correction of higher myopia of 6.00 diopters (D) or more, in an area with high risk of haze due to high intensity of sunlight.Methods: We used a prospective interventional cohort with matched retrospective control groups. Patients with >6 D myopia and <3.5 D of astigmatism were included. All treatments were performed with the SCHWIND Amaris system using aspheric ablation profiles. Mitomycin C was used in all PRK and ASLA cases. Outcomes were postoperative refraction, visual acuity, stability, and complications. The follow-up period was up to 12 months.Results: In total, 101 eyes were included after exclusions. Mean preoperative spherical equivalent refraction was −7.9 D, −8.2 D, and −7.4 D in the ASLA (n=41), PRK (n=29), and LASIK (n=31) groups. Mean postoperative spherical equivalent at 12 months postoperatively was −0.1 (standard deviation [SD]: 0.34), −0.2 (SD: 0.59), and −0.08 (SD: 0.36) in the ASLA, PRK, and LASIK groups, with 91.4%, 85.7%, and 83.9% within 0.5 D of target, respectively. Refractive outcomes and regression at 12 months did not vary among groups (P>0.05). Mean logMAR (logarithm of the minimum angle of resolution) uncorrected distance visual acuity at 12 months was 0.00 (SD: 0.05), 0.06 (SD: 0.1), and 0.05 (SD: 0.09) in the ASLA, PRK, and LASIK groups, with significantly better vision in the tPRK group versus LASIK (P=0.01) and PRK (P=0.01) groups.Conclusion: ASLA (SCHWIND) tPRK with mitomycin C for high myopia demonstrates comparable refractive outcomes to LASIK and PRK, with relatively favorable visual acuity outcomes. There was no increased incidence of haze in the ASLA group. Keywords: PRK, LASIK, transepithelial PRK, high myopia, ASLA, Mitomycin, epitheliu
Der homme machine des 21. Jahrhunderts : a Von lebendigen Maschinen im 18. Jahrhundert zur humanoiden Robotik der Gegenwart /
No full textWarum werden lebende Organismen, insbesondere der Mensch, als lebendige Maschinen verstanden? Warum hat der Mensch das Bedürfnis, sich selbst als Maschine nachzubauen? Das 18. Jahrhundert stand u.a. mit La Mettries Werk L’homme machine (1747) und den »lebendigen« Automaten eines Vaucansons im Zeichen verschiedener »Maschinentheorien des Lebendigen«. Um bis in die Gegenwart anhaltende Tradierungen und Wandlungen des damals fundierten Mensch-Maschinen-Konstrukts erfahrbar zu machen, rückt der Mensch als Forschungsobjekt der KI und der Robotik ins Blickfeld. Es steht zu beantworten, inwieweit die Rede vom Maschinenmenschen und der Bau künstlicher Maschinen dazu verhelfen, Wissen über den Menschen zu erlangen.Preliminary Material /Warum werden lebende Organismen, insbesondere der Mensch, als lebendige Maschinen verstanden? Warum hat der Mensch das Bedürfnis, sich selbst als Maschine nachzubauen? Das 18. Jahrhundert stand u.a. mit La Mettries Werk L’homme machine (1747) und den »lebendigen« Automaten eines Vaucansons im Zeichen verschiedener »Maschinentheorien des Lebendigen«. Um bis in die Gegenwart anhaltende Tradierungen und Wandlungen des damals fundierten Mensch-Maschinen-Konstrukts erfahrbar zu machen, rückt der Mensch als Forschungsobjekt der KI und der Robotik ins Blickfeld. Es steht zu beantworten, inwieweit die Rede vom Maschinenmenschen und der Bau künstlicher Maschinen dazu verhelfen, Wissen über den Menschen zu erlangen.Description based on print version record
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