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This article discusses a gap in planning estates relating to the failure to consider the needs of wives of male trust beneficiaries. He outlines the sociological and legal basis for the gap and demonstrates it through a specific case. The article concludes that the estate planning gap is not chargeable to the professional deficiencies of those who practice the art of estate planning but suggests that every client be asked to make a conscious choice regarding the problem. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the clinical and biometric features of pediatric eyes with extreme hyperopia and report baseline biometric values., Methods: In this prospective case-control study, the biometric parameters of eyes in children with extreme hyperopia were compared to those of an emmetropic cohort of similar age. Comprehensive eye examinations were conducted for new patients. Anterior OCT (CASIA-2, Tomey) and ocular biometry imaging (IOL Master 700, Zeiss) were performed for all participants., Results: A total of 19 children (mean age, 12.3 ± 2.3 years) with extreme hyperopia (+8.84 ± 0.77) were compared with 17 emmetropic (+0.53 ± 0.43) controls of similar age (mean age, 12.4 ± 2.2 years [P = 0.864]). Extreme hyperopic eyes exhibited significantly shorter axial length, normal spherical equivalent corneal keratometry, higher astigmatism, lower anterior chamber area and volume, and narrower iridotrabecular angle optical coherence tomography (OCT) parameters. Lens thickness and curvature were similar, with a slightly anterior and tilted position., Conclusions: In our study cohort, extreme hyperopia was associated with shorter axial length, reduction in anterior chamber size, with well-formed, regular-sized lens positioned anteriorly, and a narrower iridotrabecular angle., (Copyright © 2024. Published by Elsevier Inc.)

NIMO-TEMPO is a metrology device that measures all types of intraocular lenses available in the ophthalmic market. Its technology, based on interferometry, captures the wavefront of the lens to compute optical results essential to evaluate its quality and understand its characteristics. This study aims to demonstrate the reliability of this device and its associated software, TEMPO-MENTOR, in measuring intraocular lenses. The analysis is based on comparing the theoretical results of the optical design and data computed by the device algorithm. Results provided with NIMO-TEMPO are also validated using another metrology device., Competing Interests: The authors declare no conflicts of interest., (© 2024 Optica Publishing Group.)

In this study, an in vitro comparison of the optical performances of three models (spherical, aberration-neutral, and aberration-correcting) of monofocal intraocular lenses (IOLs) is proposed. A comprehensive model is employed, encompassing a wide range of corneal models and aperture sizes, reflecting the high variability of corneal spherical aberrations (SA) and pupil sizes in both normal and postoperative refractive corneal surgery populations. Analysis of average through-focus modulation transfer function (MTF) curves reveals significant differences in optical performance attributable to pupil size and corneal SA. These differences depend on the IOL model and affects MTFmax (representing contrast at best focus), depth of focus, refractive error tolerance, and the effective power of the lens., Competing Interests: Dr. Gatinel serves as a consultant for BVI Company, whereas the remaining authors have no disclosures to declare., (© 2024 Optica Publishing Group.)

Background and Aims: GI tract perforations and anastomotic dehiscence are increasingly effectively being repaired endoscopically; however, well-known and long-held surgical principles must still be honored. One important principle is that significant extraluminal contamination must be washed out, debrided, and drained in conjunction with repair of the defect if the wound is to effectively heal and resolve. Here we describe the use of endoscopic washout and debridement of extraluminal contamination at the time of luminal defect closure in a 7-patient series at our institution, with video demonstration of 2 patients in the series., Methods: We reviewed a series of 7 patients at our institution and provide a video demonstration of the described technique in 2 patients. A 50-year-old man with decompensated liver cirrhosis presented with a large distal esophageal disruption secondary to a severe Minnesota tube injury. Extensive thoracic and mediastinal contamination of solid and liquid debris was removed and washed out endoscopically, followed by esophageal defect repair. Closure of the defect with overlapping, fully covered, esophageal stents sutured in place was successful after attempts at repairing the primary disruption with suturing alone failed. A 49-year-old man with multiple endocrine neoplasia type 1 and multiple prior surgeries presented with an acute abdomen and sepsis secondary to a fully perforated duodenal ulcer. Extensive endoscopic washout and lavage of the purulent liquid and semiliquid debris covering the liver, stomach, and adjacent structures was performed, followed by closure of the perforation by endoscopic suturing. A percutaneous pigtailed drainage catheter was placed in the extraluminal cavity to facilitate postoperative drainage, followed by placement of a PEG with jejunal extension for enteric exclusion and nutrition., Results: The results for all 7 patients were reviewed. The overall rate of technical success, defined as effective repair of the luminal defect and drainage of extraluminal contamination, was 100%. The overall rate of clinical success, defined as clinical recovery and return to the patient's previous state of health, was 86% because 1 patient died because of severe concomitant disease. The length of time from the described procedure to hospital discharge ranged from 8 to 52 days (mean, 27 days)., Conclusion: Endoscopic washout and debridement can effectively and immediately address extraluminal contamination at the time of endoscopic luminal defect repair in appropriately selected patients. Therefore, it may represent a valuable option to address this clinical situation when a more conventional surgical approach is problematic. A more structured study should be considered for the development and validation of this approach.