1) Toric IOLs are used to correct corneal astigmatism during cataract surgery. They have a cylindrical optic to neutralize corneal astigmatism.
2) The material and design of toric IOLs affect their postoperative rotational stability, with acrylic IOLs showing the highest stability. Larger diameter and loop haptic designs also increase stability.
3) Proper patient selection, preoperative measurements, surgical technique, and IOL alignment are important for achieving optimal visual outcomes with toric IOL implantation. Accurate axis alignment is critical to achieve the intended astigmatic correction.
This is a power point presentation prepared by Dr Robin Goh Chon Han. He is a Ophthalmology Postgraduate Student from University Malaya, Malaysia.
This presentation reviewed the challenges and overcome measures for cataract surgery in silicone oil filled post-vitrectomized eye.
This is a power point presentation prepared by Dr Robin Goh Chon Han. He is a Ophthalmology Postgraduate Student from University Malaya, Malaysia.
This presentation reviewed the challenges and overcome measures for cataract surgery in silicone oil filled post-vitrectomized eye.
A case of dense nuclear cataract has undergone phacoemulsificaton by horizontal chop technique. the pupil was small so Iris retractor was utilized. Intraocular lens was implanted.
Update knowledge about Muntifocal IOL made by Asaduzzaman
Working as Associate Optometrist in Ispahani Islamia Eye Institute &Hospita, Dhaka 1215
Email:asad.optom92@yaho. com
Accommodative and multifocal intraocular lensesBijan Farpour
New generation premium lenses. Accommodative and multifocal intraocular lenses used for cataract surgery and presbyopic lens exchange in modern eye surgery.
A case of dense nuclear cataract has undergone phacoemulsificaton by horizontal chop technique. the pupil was small so Iris retractor was utilized. Intraocular lens was implanted.
Update knowledge about Muntifocal IOL made by Asaduzzaman
Working as Associate Optometrist in Ispahani Islamia Eye Institute &Hospita, Dhaka 1215
Email:asad.optom92@yaho. com
Accommodative and multifocal intraocular lensesBijan Farpour
New generation premium lenses. Accommodative and multifocal intraocular lenses used for cataract surgery and presbyopic lens exchange in modern eye surgery.
Advances in IOL Technology -Muliti-Focal ImpantsRonan Conlon
A slideshow presentation reviewing the features of multi-focal implants. Pertinent information is presented to help eye care providers to help them guide their patients, on the selection of multi-focal implant. Co-management pearls are provided regarding the post operative care of these patients.
The branch of optics that addresses the limiting case λ0 → 0, is known as Geometrical Optics, since in this approximation the optical laws may be formulated in the language of geometry.
For comments please contact me at solo.hermelin@gmail.com.
For more presentations on different subjects visit my website at http://www.solohermelin.com.
This presentation is in the Optics Folder.
Cataract surgery and refractive surgery are now seen as a surgical spectrum
Significant advances in safety, technology, techniques and results
2006 200,000 Cataract operations
2006 50,000 Refractive operations
>10% of >60yo have IOLs
Cataract surgery is very cost effective surgery
LASIK or Lasik (laser-assisted in situ keratomileusis), commonly referred to as laser eye surgery or laser vision correction, is a type of refractive surgery for the correction of myopia, hyperopia, and an actual cure for astigmatism, since it is in the cornea. LASIK surgery is performed by an ophthalmologist who uses a laser or microkeratome to reshape the eye's cornea in order to improve visual acuity. For most people, LASIK provides a long-lasting alternative to eyeglasses or contact lenses.
The planning and analysis of corneal reshaping techniques such as LASIK have been standardized by the American National Standards Institute, an approach based on the Alpins method of astigmatism analysis. The FDA website on LASIK states,
"Before undergoing a refractive procedure, you should carefully weigh the risks and benefits based on your own personal value system, and try to avoid being influenced by friends that have had the procedure or doctors encouraging you to do so."
The procedure involves creating a thin flap on the eye, folding it to enable remodeling of the tissue beneath with a laser and repositioning the flap.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
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Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
3. TORIC INTRAOCULAR LENSES
• First – Shimizu et al in 1994 , non-foldable 3
piece toric iol made from PMMA with oval
optic and loop haptics.
• Postoperative rotational stability of toric iol
also depends on the iol material and iol
design.
4. IOL MATERIAL
• IOL biomaterial is of great influence on the
postoperative rotation.
• STAAR toric IOL and the MicroSil toric IOL
were made from silicone material and showed
relatively high postoperative misalignment
rates.
• Currently available toric IOLs are usually made
of acrylic material.
5. • After implantation of the toric IOL in the
capsular bag, the anterior and posterior
capsules fuse with the IOL which prevents IOL
rotation.
• Hydrophobic acrylic IOLs showed the highest
adhesive properties, followed by hydrophilic
acrylic IOL, PMMA IOLs and finally silicone IOLs.
6. IOL DESIGN
• The overall IOL diameter has been shown to be a
major factor in the prevention of IOL rotation.
• Chang compared two different sizes of the same
toric IOL: the STAAR model with a diameter of
10.8 mm and the STAAR model with a diameter
of 11.2 mm. The longer STAAR model was found
to have a much better rotational stability
compared to the shorter STAAR model.
7. • Currently available toric IOLs however have a
total IOL diameter ranging from 11.0 mm to
13.0 mm.
• Regarding the IOL haptics design, two
different IOL designs are available: plate
haptic IOLs and loop haptic IOLs.
8. • Buckhurst et al. hypothesize that loop haptic
IOLs have a better early rotational stability
compared to plate haptic IOLs due to the
longer haptics and consequently more contact
between haptics and capsular bag.
9. • Prinz et al. recently compared plate-haptic
and loop-haptic acrylic IOLs and did not find a
significant difference in rotation.
• This indicates that for acrylic IOLs, plate and
loop haptics demonstrate equally good
rotational stability.
10.
11.
12. SUCCESSFUL OUTCOME
• Good patient selection
• Preoperative workup
• IOL calculation
• Good surgery with centered IOL.
13. PATIENT SELECTION FOR TORIC IOL
• Ideal patient – with regular corneal
astigmatism between 1 to 3D.
• Toric IOLS have been successfully implanted in
cases with post keratoplasty astigmatism after
complete suture removal.
14. RELATIVE EXCLUSION CRITERIA
• Irregular astigmatism
• Post refractive surgery
• Corneal dystrophies
• Corneal edema
• Problems encountered during surgery
(including pupil damage, posterior capsule
integrity , vitreous loss ,poor iol centration
and discovery of zonular instability)
16. KERATOMETRY
• Various methods of keratometry: IOLMaster
automated keratometry, manual keratometry,
autokeratorefractometry, corneal topography,
or a combination of these techniques.
• Keratometry measurements obtained by
automated keratometry, manual keratometry
and corneal topography have been shown to
have a high repeatability and are generally
well comparable between Devices.
17. SURGICALLY INDUCED ASTIGMATISM
• Surgeon specific criteria
• Total astigmatism should include the SIA.
• SIA may be calculated with the help of online
calculators (www.doctor-hill.com)
18. BIOMETRY
1. Axial length measurement should ideally be done
with IOL master or lenstar however immersion
scan may also be used
2. Only corneal astigmatism should be used for IOL
calculation.
3. Various companies providing toric IOLs have their
online IOL calculators which calculate power
according to surgeons comfort and also suggest
the steepest axis for incision making thereby
giving least residual astigmatism.
19. MARKING TECHNIQUE
• Accurate marking of the alignment axis should
be performed with the patient in an upright
position in order to prevent cyclotorision in the
supine position.
• Firstly the horizontal axis is marked
preoperatively at the slit lamp with the coaxial
thin slit turned to 0-180 degrees. Marking is
done with either sterile ink or a needle or a
bubble marker.
21. • Intraoperatively, the preoperative horizontal
marks are used to position an angular
graduation instrument. The actual alignment
axis is marked using a toric axis marker.
23. NEWER TECHNIQUES
• Newer techniques have become available for
intraoperative toric IOL alignmen :-
1. Iris finger printing technique
2. Intraoperative wavefront aberrometry
3. Real time eye tracking
24. SURGERY
• Phacoemulsification technique with 1.5 to 3.4
mm limbal incision depending on the toric iol.
• A well centered capsulorrhexis with 360
degree overlap of the IOL optics should be
achieved.
• After the phacoemulsification is completed
and the foldable toric IOL is inserted through
the limbal incision.
25. ALLIGNMENT OF TORIC IOL
• First, gross alignment is achieved by rotating
the IOL while it is unfolding, until
approximately 20 to 30 degrees short of the
desired position.
• Final alignment of the toric iol is done after
the removal of the viscoelastic substance.
26. • In the event of a complication during surgery
which may affect the stability of the toric IOL,
such as zonular damage, vitreous loss,
capsulorrhexis tear, or capsular rupture,
conversion to a standard non-toric IOL may be
required.
27. POST OPERATIVE AXIS MEASUREMENT
• Clinically – using a slit lamp with a rotating slit.
Since the IOL marks are located at the
periphery , full mydriasis is required.
• Objective method – wave front aberrometry
combined with corneal topography.
28. DISADVANTAGES OF TORIC IOLs
• Improper alignment or rotation of the iol after
surgery may result in more residual
astigmatism than predicted.
• For every 1 degree the toric iol axis is off from
the true postoperative axis of astigmatism,
there will be a 3.3% loss of toric correction.
• Astigmatism more than 4D at corneal plane
still remains dificult to correct with toric iol.