Haptic curing with endolaser after lens tilt in the Yamane technique.

Purpose: To describe a case of intraocular lens (IOL) tilt following transscleral IOL fixation with the Yamane technique and subsequent correction of tilt using 810-nm endoscopic diode laser.

Observations: Our patient required lens exchange and secondary IOL implantation due to a dislocated 1-piece IOL in the bag causing iris chafe. After routine IOL fixation with the Yamane technique and a Zeiss CT Lucia 602 lens, the IOL tilted significantly in the immediate postoperative period.

Assessing the Clinical Requirement of 2.5% Phenylephrine for Diagnostic Pupil Examination.

To evaluate whether the standard dilating drop regimen consisting of phenylephrine, tropicamide, and proparacaine produces clinically significant improvement in pupil size compared to tropicamide and proparacaine during diagnostic eye examination. Sixty-three adult patients at Washington University School of Medicine Eye Clinic were enrolled in this prospective, randomized trial. Each patient received one of two dilating drop regimens: phenylephrine + tropicamide + proparacaine (PE+T+PP), which is considered the standard therapy, or tropicamide + proparacaine (T+PP).

Five-Year Cost-Effectiveness Modeling of Primary Care-Based, Nonmydriatic Automated Retinal Image Analysis Screening Among Low-Income Patients With Diabetes.

Background: Artificial intelligence-based technology systems offer an alternative solution for diabetic retinopathy (DR) screening compared with standard, in-office dilated eye examinations. We performed a cost-effectiveness analysis of Automated Retinal Image Analysis System (ARIAS)-based DR screening in a primary care medicine clinic that serves a low-income patient population.

Methods: A model-based, cost-effectiveness analysis of two DR screening systems was created utilizing data from a recent study comparing adherence rates to follow-up eye care among adults ages 18 or older with a clinical diagnosis of diabetes.

Factors Associated with Adherence to Screening Guidelines for Diabetic Retinopathy Among Low-Income Metropolitan Patients.

In this retrospective analysis of patients with diabetes in an academic primary care clinic in St. Louis, attendance at ophthalmic screening appointments was recorded over a two-year observation window. Factors associated with adherence were analyzed by multivariable regression.

Intraoperative suprachoroidal hemorrhage during Xen gel stent implantation.

Purpose: To report a rare case of intraoperative suprachoroidal hemorrhage during Xen gel stent implantation with accompanying surgical video and subsequent 6-month follow-up.

Observations: Our patient required incisional glaucoma surgery after inadequate pressure reduction with four classes of topical medication, methazolamide, and selective laser trabeculoplasty. The patient underwent Xen gel stent implantation and developed an intraoperative suprachoroidal hemorrhage, which was managed in the operating room.

Evaluation of Skyshine from an Accelerator Facility: Dependence on Distance and Angle.

Neutron skyshine from Linac Coherent Light Source II 4 GeV electron beam operation at SLAC National Accelerator Laboratory can contribute to prompt radiation exposure to the public at distances far beyond the accelerator tunnel housing. One of the shielding design requirements at SLAC is that the annual dose to a member of the public is no more than 0.05 mSv y.

Depsipeptide Aspergillicins Revealed by Chromatin Reader Protein Deletion.

Expression of biosynthetic gene clusters (BGCs) in filamentous fungi is highly regulated by epigenetic remodeling of chromatin structure. Two classes of histone modifying proteins, writers (which place modifications on histone tails) and erasers (which remove the modifications), have been used extensively to activate cryptic BGCs in fungi. Here, for the first time, we present activation of a cryptic BGC by a third category of histone modifying proteins, reader proteins that recognize histone tail modifications and commonly mediate writer and eraser activity.

Radiation Protection Around High-intensity Laser Interactions with Solid Targets.

Interaction of a high-intensity optical laser with a solid target can generate an ionizing radiation hazard in the form of high-energy "hot" electrons and bremsstrahlung, resulting from hot electrons interacting with the target itself and the surrounding target chamber. Previous studies have characterized the bremsstrahlung dose yields generated by such interactions for lasers in the range of 10 to 10 W cm using particle-in-cell code EPOCH and Monte Carlo code FLUKA. In this paper, electron measurements based on a depth-dose approach are presented for two laser intensities, which indicate a Maxwellian distribution is more suitable for estimating the hot electrons' energy distribution.

Intranasal Corticosteroids Do Not Lead to Ocular Changes: A Systematic Review and Meta-analysis.

Objectives: The safety and efficacy of intranasal corticosteroids (INCS) are well established, but there remains apprehension that INCS could lead to systemic side effects, as with oral steroids. The objective of this systematic review was to assess whether the use of INCS lead to increased intraocular pressure (IOP) above 20 mm Hg, glaucoma, or formation of posterior subcapsular cataracts in adult patients with rhinitis.

Methods: Two medical librarians searched the published literature for records discussing the use of "nasal steroids" in "rhinitis" and their effect on "intraocular pressure," "cataracts," or "glaucoma.

Assessing the utility of 2.5% phenylephrine for diagnostic pupillary dilation.

Objective: To evaluate whether the addition of phenylephrine to tropicamide produces any clinically significant change in pupil size during diagnostic eye examination.

Methods: Twenty healthy adults at the Washington University School of Medicine Eye Clinic were enrolled in this prospective, nonrandomized, crossover trial. Each had 3 dilating eye drop regimens administered to the left eye on separate days.

Bremsstrahlung Dose Yield for High-Intensity Short-Pulse Laser-Solid Experiments.

A bremsstrahlung source term has been developed by the Radiation Protection (RP) group at SLAC National Accelerator Laboratory for high-intensity short-pulse laser-solid experiments between 1017 and 1022 W cm-2. This source term couples the particle-in-cell plasma code EPOCH and the radiation transport code FLUKA to estimate the bremsstrahlung dose yield from laser-solid interactions. EPOCH characterizes the energy distribution, angular distribution, and laser-to-electron conversion efficiency of the hot electrons from laser-solid interactions, and FLUKA utilizes this hot electron source term to calculate a bremsstrahlung dose yield (mSv per J of laser energy on target).

Long-chain omega-3 fatty acids and blood pressure.

Background: High dose fish oil supplementation reduces blood pressure (BP) in hypertensive patients. The current study examines how modest variations in omega-3 fatty acid intake may affect BP in a healthy community sample.

Methods: Study participants included 265 Pittsburgh-area adults 30-54 years of age (11% black, 51% female) not taking omega-3 fatty acid supplements or antihypertensive medications.

Radiation safety system.

The goal of this work is to provide an overview of a Radiation safety system (RSS) designed for protection from prompt radiation hazard at accelerator facilities. RSS design parameters, functional requirements and constraints are derived from hazard analysis and risk assessment undertaken in the design phase of the facility. The two main subsystems of a RSS are access control system (ACS) and radiation control system (RCS).