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Purpose To evaluate the influences of preoperative pupil parameters on the visual outcomes of the SBL-3, a rotationally asymmetric multifocal intraocular lens (IOL) with a surface-embedded near segment. Setting Cathedral Eye Clinic, Belfast, Northern Ireland, United Kingdom. Design Retrospective comparative case series. Methods Postoperatively, patients divided into 4 groups according to their pupil size as follows: Group A: 2.50 to 2.99 mm, Group B: 3.00 to 3.50 mm, Group C: 3.51 to 4.00 mm, and Group D: 4.01 to 4.50 mm. The uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities, IOL centration and tilt, and quality of vision (QoV) questionnaires were compared between the 4 groups for 18 months postoperatively. Results The study comprised 90 patients (180 eyes). The mean preoperative pupil (photopic and mesopic) diameter was 4.3 mm ± 0.3 (SD) and 5.6 ± 1.4 mm, respectively, which decreased to 3.8 ± 0.7 mm and 4.9 ± 1.2 mm, respectively, at 18 months. Eighteen months postoperatively, both photopic and mesopic pupil groups had a statistically significant reduction in size from preoperative levels. No significant differences in UDVA, UIVA, and UNVA were found between the groups (P > .001). Significant differences in the QoV questionnaire day scores and night scores were found between the 4 groups (P Conclusions The rotationally asymmetric multifocal IOL provided excellent optical performance during 18-months follow-up. The preoperative photopic pupil is an important parameter for consideration of this type of IOL because smaller pupils have a significant negative subjective impact on QoV.

Freeform surfaces enable numerous new applications. However, they imply new challenges as well. Due to lots of degrees of freedom, it is possible to compensate some tolerances for each other.

Since late 1980s, the implantation of intraocular lenses became the standard of care. In routine cases, the IOL is implanted in the bag with overlapping capsulorhexis margin to ensure good centration and reduce the rate of secondary cataract. For difficult cases with insufficient or no capsular support over the years, different IOL designs and fixation techniques have been developed [1–21].

This dissertation deals with the notion of centration in the work of Teilhard de Chardin, the notion being examined with regard to two related aims: 1) to illustrate the logical structure of Teilhard's Christian theory of evolution, and 2) to explain the relation between centration carried out by created beings and centration assigned to God as the focal point of evolution. In other words: to explore the connection between fundamental freedom attributed by Teilhard to created beings and culminating in human beings according to him, and God's freedom demonstrating itself in controlling the universe and directing it to a goal being the fullness of being (pleroma). The first part presents Teilhard's life and the contexts of his work. The second part explains the main notions of Teilhard's theory and metaphysics, such as "consciousness", "spirit", "energy", "centro-complexity", and "matter", and relates them to the notion of centration. Centration is presented here as an activity of the consciousness consisting in the unifying formation of multitude by its interconnection with different types of relations around one centre. In such unification, the main law of evolution manifests itself - the Law of Differentiating Unity. This means that parts unified in such way start differentiating again. What is...

Objectives. To evaluate the centration and movement of soft contact lenses and to verify the repeatability of two repeated measurements of the lens centration and movement using ultra-long scan depth optical coherence tomography (UL-OCT). Methods. A 1-day Acuvue® Define™ lens was tested on both eyes of 10 subjects (5 males and 5 females; mean age, 31.6 years). The centration and blink-induced movement of the contact lens were measured using UL-OCT at 5 min and 30 min after insertion. The measurements were repeated once at each checkpoint. Results. Good repeatability was found in the lens centration and movement between the two repeated measurements at either checkpoint. The values of the lens movement were 0.457 ± 0.248 mm and 0.402 ± 0.229 mm at 5 min and decreased to 0.197 ± 0.065 mm and 0.211 ± 0.110 mm at 30 min after insertion for the right and left eyes, respectively (P<0.05). Conclusions. The custom-built UL-OCT presented good repeatability of centration and movement in Define lenses at 5 min and 30 min after insertion. Most of the lenses were centered temporal and inferior to the cornea during the first 30 min wearing period. Compared with 5 min after insertion, the lens was centered better and exhibited less movement at 30 min.

Patients should have been evaluated and deemed appropriate for such surgical intervention. Patient was noted to have a dislocated lens, intraoperative posterior capsular rupture, or traumatic dislocation of lens that was creating visual disturbance and/or affecting activities of daily living that necessitated further surgical intervention. Patients should have been educated about the risks and benefits of the procedure, including alternatives.

OBJECTIVE To evaluate the safety, efficacy, and on-eye performance of KeraSoft 3 contact lenses (UltraVision) in ectatic corneal diseases. METHODS The charts of patients who were fit with KeraSoft 3 were reviewed. The reason for KeraSoft 3 lens fit, the number of trial lenses required for ideal fit, centration, movement, and stabilization of the contact lens, uncorrected, spectacle-corrected, and contact lens-corrected visual acuities, slitlamp biomicroscopy findings, patient comfort, and daily duration of contact lens wear were evaluated. RESULTS Seventy eyes of 40 patients were fit with the KeraSoft 3 lens. Indications included rigid gas permeable (RGP) lens intolerance in 41 eyes of 24 patients (58.5%), patients' desire to use soft contact lenses in 26 eyes of 14 patients (37.1%), and proud nebula in 3 eyes of 2 patients (4.4%). The number of trial lenses required for ideal fit was 1.2±0.4 lenses. Eleven patients (20 eyes, 29%) never purchased the contact lens, 15 patients (26 eyes, 37%) discontinued after purchasing, and 14 patients (24 eyes, 34%) continued successfully wearing their lenses. In the latter group, the visual acuity improved significantly (P

This study examined pulling exercises performed on stable surfaces and unstable suspension straps. Specific questions included: which exercises challenged particular muscles, what was the magnitude of resulting spine load, and did technique coaching influence results. Fourteen males performed pulling tasks while muscle activity, external force, and 3D body segment motion were recorded. These data were processed and input to a sophisticated and anatomically detailed 3D model that used muscle activity and body segment kinematics to estimate muscle force, in this way the model was sensitive to each individual's choice of motor control for each task. Muscle forces and linked segment joint loads were used to calculate spine loads. There were gradations of muscle activity and spine load characteristics to every task. It appears that suspension straps alter muscle activity less in pulling exercises, compared to studies reporting on pushing exercises. The chin-up and pull-up exercises created the highest spine load as they required the highest muscle activation, despite the body "hanging" under tractioning gravitational load. Coaching shoulder centration through retraction increased spine loading but undoubtedly adds proximal stiffness. An exercise atlas of spine compression was constructed to help with the decision making process of exercise choice for an individual.

We present a technique for posterior chamber intraocular lens (IOL) scleral suturing for the management of aphakia, which includes the use of a needleless Gore-Tex CV-8 suture to create a girth hitch around both IOL fixation eyelets using microinstruments. This technique avoids intraocular needle manipulation, provides long-term IOL stability, avoids both passive and torque-induced IOL tilt, and enables fine tuning of the intraoperative IOL centration using the Purkinje reflexes. Financial Disclosure Dr. Snyder is a consultant to Alcon Laboratories, Inc., Microsurgical Technology, Haag-Streit AG, and Humanoptics AG. Dr. Perez has no financial or proprietary interest in any material or method mentioned.

We describe an unusual case which presented with late lateral IOL decentration secondary to bag subluxation in the presence of a posterior capsular defect. Instead of approaching the case with the usual IOL exchange with iris-fixated or anterior chamber IOL or by fixating it to the sclera, a relatively non-invasive sutureless method of IOL re-centration was performed by buttonholing the optic into the posterior capsular defect. It enabled a perfect IOL centration with minimal incidence of astigmatism, inflammation, macular edema, secondary glaucoma, or corneal decompensation.

Multiple-choice-questions are common in medical examinations, but guessing biases assessment results. Confidence-based-testing (CBT) integrates indicated confidence levels. It has been suggested that correctness of and confidence in an answer together indicate knowledge levels thus determining the quality of a resulting decision. We used a CBT approach to investigate whether decision quality improves during undergraduate medical education. 3rd- and 5th-year students attended formative multiple-choice exams on pharmacological issues. Students were asked to indicate their confidence in a given answer. Correctness of answers was scored binary (1-correct; 0-wrong) and confidence levels were transformed to an ordinal scale (guess: 0; rather unsure: 0.33; rather sure: 0.66; very sure: 1). 5th-year students gave more correct answers (73 ± 16 vs. 49 ± 13 %, p < 0.05) and were on average more confident regarding the correctness of their answers (0.61 ± 0.18 vs. 0.46 ± 0.13, p < 0.05). Correlation of these parameters was stronger for 5th-year students (r = 0.81 vs. r = 0.52), but agreement of confidence and correctness ('centration') was lower. By combining the Bland-and-Altman approach with categories of decision-quality we found that 5th-year students were more likely to be 'well-informed' (41 vs. 5 %), while more 3rd-students were 'uninformed' (24 vs. 76 %). Despite a good correlation of exam results and confidence in given answers increased knowledge might be accompanied by a more critical view at the own abilities. Combining the statistical Bland-and-Altman analysis with a theoretical approach to decision-quality, more advanced students are expected to apply correct beliefs, while their younger fellows are rather at risk to hesitate or to act amiss.

PURPOSE: To describe a surgical technique and intraoperative modifications to create a secondary capsulotomy using the femtosecond cataract laser in an eye with traumatic aphakia and aniridia. METHODS: The expanded use of the femtosecond cataract laser (Catalys Precision Laser System; Optimedica, Sunnyvale, CA) for creation of a well-centered and circular secondary capsulotomy in the capsular remnants of an eye with traumatic aphakia and aniridia. RESULTS: Using software modifications based on intraoperative anterior segment spectral-domain optical coherence tomography imaging, and customizing the capsulotomy settings, the femtosecond cataract laser was able to penetrate through most of the fused anterior and posterior capsular leaflets and a circular capsulotomy was achieved. The latter permitted optic capture and excellent centration of a three-piece intraocular lens placed in the sulcus with good postoperative visual rehabilitation. CONCLUSION: The femtosecond cataract laser can be customized to create a well-centered and circular secondary capsulotomy in aniridic and aphakic eyes where optic capture is critical for long-term intraocular lens stability. [ J Refract Surg. 2014;30(6):416–419.]

Purpose To determine if postoperative refractive outcome in cataract surgery relates to centration or circularity of the capsulorrhexis. Design Prospective, observational study. Participants One hundred thirteen eyes from 108 patients undergoing routine phacoemulsification cataract surgery with manual continuous curvilinear capsulorrhexis. Methods Patients underwent refraction, and digital retroillumination photographs were obtained 1 month and 1 year after surgery. Capsulorrhexis parameters were analyzed using computer photographic software. Main Outcome Measures Postoperative spherical equivalent (SE), deviation from predicted refraction, and postoperative spectacle cylinder. Results At 1 month, mean capsulorrhexis circularity index was 0.83±0.01 mm and mean decentration was 0.30±0.14 mm. There was no significant correlation between either circularity or decentration and any of the refractive outcomes of SE, deviation from predicted refraction, or spectacle cylinder at 1 month or at 1 year. In contrast, an association between capsulorrhexis decentration and change in postoperative SE from 1 month to 1 year was observed: 56% of patients with more than 0.4 mm of decentration had a change in SE of more than 0.25 diopter (D) compared with 30% with 0.4 mm or less of decentration ( P = 0.04). In eyes with incomplete capsulorrhexis–optic overlap, 60% had a change in spectacle cylinder of more than 0.50 D from 1 month to 1 year, compared with 15% of eyes with complete overlap ( P = 0.004). Conclusions Postoperative refraction at 1 year was not related to centration or circularity of the capsulorrhexis. However, decentration by more than 0.4 mm was associated with a 0.25-D change in SE and incomplete capsulorrhexis–optic overlap was associated with a 0.50-D change in spectacle cylinder from 1 month to 1 year.

PURPOSE: The aim of the study was to present a novel technique for the assessment of postoperative centration and bending in phakic intraocular lens (PIOL), illustrated through 4 patient examples. DESIGN: This was a prospective observational study. METHODS: Four patients (7 eyes) who presented with complaints of reduced quality of vision after implantation with a Staar Collamer plate haptic PIOL were recruited for assessment. Scheimpflug images were obtained and analyzed with respect to the apical axis and the crystalline lens by means of an in-house-developed algorithm. The program provides an estimate for the PIOL centration and bending through an analysis of the distance between the PIOL and the crystalline lens. RESULTS: The algorithm detected PIOL bending in 5 of the 7 eyes and PIOL decentration in 3 eyes. The PIOL bending or decentration detected corresponded, in all cases, with the axis of the astigmatism-like complaints in the patient. In 2 eyes of the same patient, the analysis could not be performed because the distance between PIOL and crystalline lens was too short for reliable analysis. CONCLUSIONS: This algorithm is a useful tool to objectively assess the postoperative complaints of patients implanted with a posterior chamber PIOL. Bending and decentration due to anatomical variations of the sulcus lens position can be measured and in many cases correlated with patients' complaints.

Pediatric cataract surgery poses a significant challenge for the cataract surgeon, in part because an elastic anterior capsule can make capsulorhexis difficult. With the use of femtosecond laser-assisted cataract surgery (FLACS), however, the continuous curvilinear capsulorhexis can be made with predictable size, circular shape, centration, and accuracy. In addition, topical anesthesia can be used for the FLACS docking procedure in cooperative children above 6 years of age, using transparent adhesive polyurethane film segments.

Lens colobomas extending more than 4 clock hours and causing visual impairment require lens extraction along with capsular support devices with scleral fixation for adequate centration of the capsular bag and for prevention of capsular fornix aspiration with inadvertent extension of zonular dialysis intraoperatively. In this case series, we describe a technique for the management of isolated lens colobomas involving 4-5 clock hours by clear lens extraction and intraocular lens implantation using a combination of a capsular tension ring with a capsular tension segment (CTS) for the centration and stability of the capsular bag. Hoffman's corneoscleral pocket and half-bow sliding knot technique were used for scleral fixation of the CTS.

Purpose: This study was assessed to investigate the change of subjective and/or objective symptoms and the light transmissibility of lens caused by over-usage of daily disposable circle contact lenses (circle lens). Methods: Three daily disposable circle lenses made of etafilcon A, hilafilcon B, and nelfilcon A were applied on 20 normal eyes free from any eye diseases by when subjects complained any kind of discomfort. On the first and the last days of lens wearing, subjective discomfort, blinking rate, non-invasive break-up time, lens centration on corneal surface and visible light transmissibility of lens were recorded at every case and compared. Results: The circle lens wearers complained discomfort when they wore the circle lens more than 15 hours, in excess of 8 hours being the recommended wearing time and the most circle lens wearers quit the lens wearing when they wore more than 30 hours. On the last day of lens wearing, the representative subjective discomforts were stiffness, dryness and tiredness. When the subjects wore circle lens more than the recommended time, a tendency of increased blinking rate and decreased NIBUT was observed when it compared with the values right after lens wearing. On the last day of lens wearing, the lens centration was shown to be decentrated from the pupil center compared with the centration right after the wearing. These changes in lens centration and blinking rate were consistently shown in all cases of lens wearing however, the difference in the degree of subjective and/or objective change was present depending on lens materials and subjects. The visible light transmissibility of circle lens has largely been changed. Conclusions: From these results, it was thought that the decreased NIBUT induced dryness and stiffness and decreased visible light transmissibility caused more blinking when daily disposable circle lens was exceedingly used, which provoked lens decentration and subjective discomfort. However, the difference of subjective and/or objective change was largely varied in accordance with the lens material types and individuality and thus it may occur some unexpected problems by the individual base. Therefore, the education about the necessity to comply with the recommended wearing time and the problem will be essential.

Purpose This study aims to report on the measured in vivo contribution of soft lenses of various powers to the optics of a piggyback system (PBS). Methods This prospective, non-dispensing clinical study was conducted on regular wearers of contact lenses who showed regular corneal profiles. Subjects were masked to the products used. The study involved the use of a spherical soft lens of three different powers in a PBS, used as a carrier for a rigid gas permeable lens. Baseline data were collected and soft lenses were then fitted on both eyes of each subject. Both lenses were assessed for position and movement. Over-refraction was obtained. Soft lens power contribution to the optics (SLPC) of a PBS system was estimated by computing initial ametropia, lacrymal lens, rigid lens powers and over-refraction. A set of data on one eye was kept, for each subject, for statistical analysis. Results Thirty subjects (12 males, 18 females), aged 24.4 (± 4.5) years, were enrolled. The use of plus powered soft lenses enhanced initial RGP lens centration. Once optimal fit was achieved, all lenses showed normal movement. SLPC represented 21.3% of the initial soft lens power when using a −6.00 carrier, and 20.6% for a +6.00. A +0.50 did not contribute to any power induced in the system. These results are generally in accordance with theoretical model developed in the past. Conclusion On average, except for the low-powered carrier, the use of a spherical soft lens provided 20.9% of its marked power. To achieve better results, the use of a plus-powered carrier is recommended.

Purpose: To develop a new schematic scheme for efficiently recording the key parameters of gas permeable contact lens (GP) fits based on current consensus. Methods: Over 100 established GP fitters and educators met to discuss the parameters proposed in educational material for evaluating GP fit and concluded on the key parameters that should be recorded. The accuracy and variability of evaluating the fluorescein pattern of GP fit was determined by having 35 experienced contact lens practitioners from across the world, grading 5 images of a range of fits and the topographer simulation of the same fits, in random, order using the proposed scheme. The accuracy of the grading was compared to objective image analysis of the fluorescein intensity of the same images. Results: The key information to record to adequately describe the fit of an GP was agreed as: the manufacturer, brand and lens parameters; settling time; comfort on a 5 point scale; centration; movement on blink on a ±2 scale; and the Primary Fluorescein Pattern in the central, mid-peripheral and edge regions of the lens averaged along the horizontal and vertical lens axes, on a ±2 scale. On average 50-60% of practitioners selected the median grade when subjectively rating fluorescein intensity and this was correlated to objective quantification (r= 0.602, p< 0.001). Objective grading suggesting horizontal median fluorescein intensity was generally symmetrical, as was the vertical meridian, but this was not the case for subjective grading. Simulated fluorescein patterns were subjectively and objectively graded as being less intense than real photographs (p< 0.01). Conclusion: GP fit recording can be standardised and simplified to enhance GP practice. © 2013 British Contact Lens Association.

The surgical management of ectopia lentis presents the ophthalmic surgeon with numerous challenges and options. From the clinical evaluation to the surgical approach, ectopia lentis patients require additional methodologies, techniques, and devices to ensure the best possible outcome. The continued refinement of surgical techniques and adjunctive prosthetic devices has led to incremental improvements in the ability to achieve successful in-the-bag placement and centration of intraocular lenses while reducing complications. A thorough understanding of the challenges inherent in ectopia lentis cases and the management of intraoperative complications will ensure that surgeons approaching the correction of these eyes will achieve the best possible surgical results.

The prolific work of Jean Piaget (1896–1980) is credited for launching the field of cognitive development and for providing the roots of contemporary developmental inquiry into specific cognitive subfields. Perhaps the most renowned aspect of Piaget's theoretical perspective is his characterization of intellectual development as occurring in a fixed sequence of four qualitatively distinct stages (sensorimotor, preoperational, concrete operational, and formal operational). Research across a wide range of cultures has replicated many of Piaget's observations and claims regarding behavioral features of these proposed stages, particularly those in very early childhood; however, research has also convincingly challenged some of his interpretations and propositions. Following decades of studies that can trace their inspiration back to Piaget, modern scholars have largely abandoned a traditional Piagetian account of comprehensive, stage-based cognitive transformations in favor of domain-specific theories that address conceptual advances in particular knowledge areas. Keywords: child development; cognitive development; Piaget, Jean

We describe the case of a 47-year-old man with bilateral inferiorly subluxated cataractous lenses of idiopathic etiology (≈ 9 clock hours of subluxation). Phacoemulsification and insertion of a single eyelet Cionni ring with a posterior chamber intraocular lens (PC IOL) were performed in the right eye. On the first postoperative day, there was a significant superior decentration of the PC IOL, with the inferior part of the Cionni ring visible in the pupillary axis. This was corrected by implanting a capsular tension segment (CTS) inferiorly. In the fellow eyes, a planned simultaneous Cionni and CTS insertion was performed and achieved adequate centration. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

A technique is described for transscleral suturing of the implantable miniature telescope device for end-stage age-related macular degeneration. It provides stabilization and centration of the implantable miniature telescope device in the case of capsule rupture or severe zonular dialysis. Financial Disclosure The author has no financial or proprietary interest in any material or method mentioned.

The paper deals with the testing of a special target for determining the exact dimensions of steel structures and their descriptions. In most cases, the accuracy required in mechanical engineering is on the order of millimetres, and the location of a point on a steel construction is marked by a centre punch. Due to the segmentation of steel constructions and the impossibility of the vertical placement of a target, it is very difficult to use ordinary prisms because of their size and the linear error from a wrong rotation and a nontrivial conversion of the centre of a prism into a centre punch on a steel construction. For a more accurate determination of spatial coordinates, a special reflective target with a reflective foil and a mechanical collimator, which ensures the correct angle to the target device according to the instructions of the person at the instrument, has been developed. Centration with a high degree of accuracy is achieved by a spike. Its functionality and usability goals have been tested and compared with standard methods of measurements and goals in engineering structures.

Purpose To assess the rotation and centration stability of the new design features of a 1-piece aspheric hydrophobic acrylic intraocular lens (IOL). Setting National Eye Hospital, Cairo, Egypt. Design Randomized clinical trial. Methods Patients in this study had implantation of a 1-piece Tecnis 1 ZCB00 IOL or a 3-piece Sensar AR40e IOL. Decentration and rotation were recorded immediately postoperatively, and 2 to 3 days and 8 weeks postoperatively. This was done using 2 slitlamp eyepieces and referring to constant corneal landmarks (ie, the limbus and the phaco incision). Results Thirty-two 1-piece IOLs and 30 3-piece IOLs were implanted. Although the 1-piece IOLs moved toward the corneal center more than the 3-piece IOLs between 3 days and 8 weeks postoperatively ( P =.054), the difference was not statistically significant between 0 day and 3 days or during the entire follow-up ( P =.546 and P =.367, respectively). There were no statistically significant differences in the horizontal or vertical components of this movement between the 2 groups ( P =.883 and P =.636, respectively). The mean rotation was 2.5 degrees ± 9.1 (SD) in the 1-piece IOL group and 0 ± 6.5 degrees in the 3-piece IOL group, with no statistically significant difference between the groups ( P =.521). Conclusion The new 1-piece design showed relatively good centration and stability in the horizontal, vertical, and rotational aspects. Financial Disclosure Drs. Roshdy, Riad, Morkos, Hassouna, and Wahba receive travel support from Abbott Medical Optics, Inc., Santa Ana, California, USA; Drs. Riad, Morkos, and Hassouna have equipment provided by Abbott Medical Optics, Inc., and Alcon Laboratories, Inc., Fort Worth, Texas, USA. No author has a financial or proprietary interest in any material or method mentioned.

Egocentrism as personal feature is defined by social -psychological conditions of formation of the personality and carries out stabilizing functions in structure of ego-system. Egocentrism is defined by a position occupied with the subject in system social-psychological, first of all — interpersonal relations. The centration and the decentration are the mechanisms allowing during dialogue to support a feedback, not breaking thus integrity and uniqueness of the person. Formation of correct representation about a role of the egocentrizm and value a centration of persons, i. e. concentration of consciousnesses on itself, own experiences, is the important stage of increase of social psychological competence of physicins. Overcoming the centration of contents includes formation of skills of coordination of the points of view with colleagues, with patients in decoding essence of the reasons of disease and ways of struggle against them.

Angle kappa is the difference between the pupillary and visual axis. This measurement is of paramount consideration in refractive surgery, as proper centration is required for optimal results. Angle kappa may contribute to MFIOL decentration and its resultant photic phenomena. Adjusting placement of MFIOLs for angle kappa is not supported by the literature but is likely to help reduce glare and haloes. Centering LASIK in angle kappa patients over the corneal light reflex is safe, efficacious, and recommended. Centering in-between the corneal reflex and the entrance pupil is also safe and efficacious. The literature regarding PRK in patients with an angle kappa is sparse but centering on the corneal reflex is assumed to be similar to centering LASIK on the corneal reflex. Thus, centration of MFIOLs, LASIK, and PRK should be focused on the corneal reflex for patients with a large angle kappa. More research is needed to guide surgeons’ approach to angle kappa.

We report 2 patients implanted with a small-aperture corneal inlay to correct presbyopia. After the surgery, both patients complained of visual symptoms and poor visual acuity. The distances from the center of the inlay to the corneal vertex center were 593 μm nasally and 159 μm superiorly in Case 1 and 72 μm temporally and 17 μm superiorly in Case 2. The 2 inlays were recentered at 2 weeks and 3 weeks postoperatively, resulting in significant improvement in the visual acuity and quality of vision. Accurate centration of a small-aperture corneal inlay seems to be an important factor in obtaining a satisfactory result. Recentration is possible and improves visual acuity if proper centration was not obtained after the first surgery. Financial Disclosure Dr. Saad is a consultant to Acufocus, Inc. Dr. Gatinel is an investigator for a clinical trial conducted with the small-aperture inlay. He does not have any financial interest in relation to this inlay. Neither of the other authors has a financial or proprietary interest in any material or method mentioned.

New method of laser power radiation increasing in-process on a takers-off during the leadthrough of centering works on pumpings aggregates is presented. An optical chart and construction of device are presented.

PURPOSE: To evaluate optical zone centration of hyperopic small incision lenticule extraction (SMILE). METHODS: This prospective study of 60 consecutive hyperopic SMILE procedures used the VisuMax femtosecond laser and matched LASIK procedures with the VisuMax and MEL 80 excimer lasers (Carl Zeiss Meditec AG, Jena, Germany). Inclusion criteria were maximum attempted hyperopic meridian of between +1.00 and +7.00 diopters (D) and astigmatism up to 6.00 D. For SMILE, the optical zone was between 6.3 and 6.7 mm, with a 2-mm transition zone. Two LASIK control groups (6.5- and 7-mm optical zone) were generated matched for spherical equivalent treated. In SMILE, the corneal vertex of the coaxially fixating eye was aligned with the vertex of the curved contact glass. In LASIK, the treatment was centered on the coaxially sighted corneal light reflex (first Purkinje image) with the contralateral eye (Seiler method). A tangential (instantaneous) curvature preoperative to 3 months postoperative difference map was generated for each eye. A fixed grid and set of concentric circles were superimposed on the difference map to measure the offset between the optical zone center and corneal vertex (0,0), and vector analysis was used for comparative analysis. RESULTS: Mean attempted spherical equivalent was +5.61 ± 0.96 D (range: +3.20 to +6.50 D) and mean cylinder was −0.96 ± 0.62 D (range: 0.00 to −2.75 D) in the SMILE group. Mean age was 29 ± 7 years (range: 19 to 52 years) in the SMILE group. Mean centration offset was 0.23 ± 0.15 mm (range: 0 to 0.61 mm) for the SMILE group, 0.33 ± 0.14 mm (range: 0.14 to 0.85 mm) for the 6.5-mm LASIK group, and 0.31 ± 0.19 mm (range: 0.05 to 0.85 mm) for the 7-mm LASIK group. The mean centration offset for SMILE was less than that of both LASIK groups ( P < .05). CONCLUSIONS: Optical zone centration of hyperopic SMILE was found to be similar to eye-tracker–centered hyperopic LASIK with the MEL 80 laser. [ J Refract Surg. 2017;33(3):150–156.]

Experimental and theoretical approaches are used to demonstrate the importance of asymmetries in microtubule arrays and cortical pulling forces mediated by dynein in positioning the pronuclear complex before nuclear envelope breakdown in the early Caenorhabditis elegans embryo., Positioning of microtubule-organizing centers (MTOCs) incorporates biochemical and mechanical cues for proper alignment of the mitotic spindle and cell division site. Current experimental and theoretical studies in the early Caenorhabditis elegans embryo assume remarkable changes in the origin and polarity of forces acting on the MTOCs. These changes must occur over a few minutes, between initial centration and rotation of the pronuclear complex and entry into mitosis, and the models do not replicate in vivo timing of centration and rotation. Here we propose a model that incorporates asymmetry in the microtubule arrays generated by each MTOC, which we demonstrate with in vivo measurements, and a similar asymmetric force profile to that required for posterior-directed spindle displacement during mitosis. We find that these asymmetries are capable of and important for recapitulating the simultaneous centration and rotation of the pronuclear complex observed in vivo. The combination of theoretical and experimental evidence provided here offers a unified framework for the spatial organization and forces needed for pronuclear centration, rotation, and spindle displacement in the early C. elegans embryo.

Purpose To compare the safety and efficacy between femtosecond laser–assisted cataract surgery using the Victus laser system and conventional cataract surgery. Setting Department of Ophthalmology, Kepler University Hospital, Linz, Austria. Design Prospective randomized case series. Methods Both eyes of patients with age-related cataract were randomized to conventional cataract surgery or femtosecond laser–assisted cataract surgery, both with intraocular lens (IOL) implantation. Postoperative follow-up was at 1 day, 1 week, 1 month, 3 months, and 6 months and comprised corrected distance visual acuity, endothelial cell density (ECD), central corneal thickness (CCT), and central retinal thickness. The main outcomes were intraoperative and postoperative complications and the effective phacoemulsification time (EPT). Intraocular lens and capsulotomy centration were evaluated using retroillumination slitlamp photography. Results The study enrolled 50 patients. No intraoperative complications occurred in either group. The ECD, CCT, and central retinal thickness were similar between the groups at all follow-up examinations (P > .05). The EPT was not statistically significantly different between the groups (P = .22). The IOL centration was similar between the groups (P = .93). Conclusion Femtosecond laser–assisted and conventional cataract surgery using the mentioned system were equally safe and effective.

PURPOSE: To compare size, circularity, and centration outcomes of continuous curvilinear capsulorhexis (CCC) performed with or without assistance from the VERUS ophthalmic caliper (Mile High Ophthalmics, Denver, CO). METHODS: This was a multicenter retrospective consecutive case controlled series review. RESULTS: Data from 40 consecutive cases using the VERUS device for CCC were compared to 40 consecutive cases with standard manual CCC. VERUS-assisted CCC size, circularity, and centration were closer to target compared to that of manual only procedures ( P < .05). The average time from initiation to completion of the capsulotomy was shorter with manual (40 ± 11 seconds) compared to VERUS-assisted (71 ± 13 seconds) cases ( P < .0001). CONCLUSIONS: The VERUS ophthalmic caliper is effective at improving size, circularity, and centration of the CCC in a time-efficient manner when compared to manual procedures performed without VERUS guidance. [ J Refract Surg. 2016;32(10):654–658.]

This article focuses on one of the lesser-studied aspects in modern Russian psychology of the problem of personality development of pre-school age children - specific correlation between manifestations of ego-centrism and interpersonality relations with peers as regards a gender subject. The article briefly summarizes some of the existing approaches towards addressing the phenomenon of child’s ego-centrism as well as reveals the results of empirical study that illustrates some of the gender-specific manifestations of ego-centrism in older preschoolers and nature of correlation between the level of ego-centrism and sociometric status of 6-7 year-old girls and boys. A fact of more harmonious development processes of centration and de-centration among girls by the end of pre-school childhood and the prevalence of self-centrism on themselves among boys was found out. The data showing lesser propensity to gender segregation among pre-school girls were obtained. It has been established that sociometric status of pre-school children in the peer group is associated with their level of ego-centrism, namely: low and high levels of ego-centrism consistent with low sociometric status, whereas high sociometric status of a child is mostly observed at medium level of ego-centrism, which is characterized by a more harmonious balance of centration - de-centration.

Purpose To report the clinical performance of the orthokeratology (ortho-k) lens fitted with computer assisted system after 1-month of lens wear, in a group of children undergoing ortho-k treatment in a 2-year randomized myopic control study. Method Children aged 6–11 years old were fitted with the ortho-k lenses using computerized fitting. The initial myopia was 4.00–0.50 D and the initial refractive astigmatism was within 1.25 D. Lens performance, in terms of centration, myopic reduction, vision, ocular health status and lens binding incidence, was evaluated at one night, one week and one month after lens wear. Only data from the right eye was presented. Results The initial spherical equivalent refraction (SER) for the 51 subjects was −2.29 ± 0.81 D. The first fit success rate was 90%. The reduction of SER after one night and one week aftercare visit were 57% and 81%, respectively. At the one month visit, the mean reduction in SER was 89% with unaided logMAR visual acuity of 0.03 ± 0.11. Mild central corneal staining was found in 9–20% of the subjects at the aftercare visits. The incidences of lens binding at one night, one week and one month aftercare visits were 17%, 39% and 30%, respectively. Conclusions Computer assisted system for Menicon Z Night lens fitting gave a high first fit success rate. Menicon Z Night lens was effective in myopic reduction and provided stable vision after one week of lens wear. Ocular health of the subjects after lens wear was generally unremarkable.

Objective. The aim of this study was to test the reproducibility of the Heidelberg Spectralis SD-OCT and to determine if provided software retest function for follow-up exam is superior to manual centration. Design. Prospective, cross-sectional study. Participants. 20 healthy subjects. Methods. All subjects underwent SD-OCT testing to determine retinal nerve fiber layer (RNFL) measurements sequentially on two different days and with two different centration techniques. Within-subject standard deviation, coefficient of variation, and intraclass correlation coefficient were used to assess reproducibility. Results. RNFL measurements showed high reproducibility, low within-subject standard deviation (1.3), low coefficient of variation (0.63%), and low intra-class correlation coefficient (0.98 (95% CI 0.97–0.99)) in the automated centration and manual centration groups for average RNFL Thickness. Quadrants showed slightly higher variability in the manual group compared to the automated group (within-subject standard deviation 2.5–5.3 versus 1.1–2.4, resp.). Conclusions. SD-OCT provides high-resolution RNFL measurements with high reproducibility and low variability. The re-test function allows for easier recentration for longitudinal examinations with similar results in average RNFL, but less variability in quadrant RNFL. SD-OCT high reproducibility and low variability is a promising fact and should be further evaluated in longitudinal studies of RNFL.

Citation information: Pointer JS. The interpupillary distance in adult Caucasian subjects, with reference to ‘readymade’ reading spectacle centration. Ophthalmic Physiol Opt 2012, 32, 324–331. doi: 10.1111/j.1475-1313.2012.00910.x Abstract Purpose: The magnitude of the far interpupillary distance (FIPD) has recognized significance within and beyond clinical optometry. Quantitative information regarding the lesser-reported near parameter (NIPD) would similarly be of interest, and could be of relevance with regard to the visual comfort obtained with ‘readymade’ reading spectacles. Methods: Mensuration statistics relating to the FIPD and NIPD are presented, as collated from the spectacle dispensing records of n = 1354 healthy Caucasian presbyopic subjects. The FIPD data were partitioned across 4 age bands (by decade, 41–80 years of age): the NIPD data were distributed across seven nominal reading powers (in 0.50 D steps, +1.00 to +4.00 D). The results of these analyses are considered here, along with their potential application. Results: Consistent gender (male > female) and classification (far > near) differences in IPD (both of approximately 3 mm) were confirmed throughout these data. The magnitude of the adult FIPD is in accord with previously published results; this dimension is now supplemented by NIPD values, whose relationship with total near power is also described. Conclusions: This new anthropometric survey indicates that inter- and intra-gender interocular facial measurement stability is a characteristic of presbyopic subjects. It is suggested that across the anticipated range of age and total reading power requirement of Caucasian (White Northern European) wearers of ‘readymade’ reading spectacles, adoption of a standard optical centration distance of 61 mm would be universally appropriate.

An assessment of the retinal nerve fiber layer (RNFL) provides important information on the health of the optic nerve. There are several non-invasive technologies, including spectral domain optical coherence tomography (SD OCT), that can be used for in vivo imaging and quantification of the RNFL, but often there is disagreement in RNFL thickness between clinical instruments. The purpose of this study was to investigate the influence of scan centration, ocular magnification, and segmentation on the degree of agreement of RNFL thickness measures by two SD OCT instruments.RNFL scans were acquired from 45 normal eyes using two commercially available SD OCT systems. Agreement between RNFL thickness measures was determined using each instrument's algorithm for segmentation and a custom algorithm for segmentation. The custom algorithm included ocular biometry measures to compute the transverse scaling for each eye. Major retinal vessels were identified and removed from RNFL measures in 1:1 scaled images. Transverse scaling was also used to compute the RNFL area for each scan.Instrument-derived global RNFL thickness measured from the two instruments correlated well (R(2) = 0.70, p0.01) but with significant differences between instruments (mean of 6.7 μm; 95% limits of agreement of 16.0 μm to -2.5 μm, intraclass correlation coefficient = 0.62). For recentered scans with custom RNFL segmentation, the mean difference was reduced to 0.1 μm (95% limits of agreement 6.1 to -5.8 μm, intraclass correlation coefficient = 0.92). Global RNFL thickness was related to axial length (R = 0.24, p0.01), whereas global RNFL area measures were not (R(2) = 0.004, p = 0.66). Major retinal vasculature accounted for 11.3 ± 1.6% (Cirrus) or 11.8 ± 1.4% (Spectralis) of the RNFL thickness/area measures.Sources of disagreement in RNFL measures between SD-OCT instruments can be attributed to the location of the scan path and differences in their retinal layer segmentation algorithms. In normal eyes, the major retinal vasculature accounts for a significant percentage of the RNFL and is similar between instruments. With incorporation of an individual's ocular biometry, RNFL area measures are independent of axial length, with either instrument.

Globe axial length (AL) in children is commonly measured using either contact or immersion technique. Office measurement of AL can be difficult in young children and infants and must often be done under anesthesia in an eye that is unable to cooperate with precise fixation and centration. Contact A-scan measurements yield shorter AL, on average, than immersion A-scan measurements in pediatric eyes. This difference is mainly the result of the anterior chamber depth rather than the lens thickness value. During intraocular lens power calculation, if globe axial length is measured by the contact technique, it will result in the use of an average 1-D stronger IOL power than is actually required. This can lead to induced myopia in the postoperative refraction. In our studied patients, there was a significant difference in prediction error between contact A-scan biometry and immersion A-scan biometry. The immersion A-scan technique is recommended for pediatric IOL power calculation. We also provide a review of biometry in pediatric eyes. The overall mean AL of pediatric cataractous eyes is significantly different than the mean AL of non cataractous eyes. More importantly, the standard deviation is higher in eyes with cataract than in those without. Three phases of eye growth in children have been documented: A rapid, postnatal phase from birth to 6 months of age, followed by a slower, infantile phase from 6 to 18 months of age, and finally a slow, juvenile phase from 18 months forward. In our study, girls had shorter ALs than boys and African-American subjects had longer ALs than Caucasians. Eyes with unilateral cataract had shorter ALs than eyes with bilateral cataract during the earlier years, but had longer ALs during later childhood.

Beginning with Piaget’s concept of egocentrism, we explicate a view of differentiating and coordination perspectives on which language and cognition are based by also drawing on insights from Mead and Wittgenstein. The concept of egocentrism is linked to Piaget’s view of knowledge and development. In overcoming egocentrism, infants differentiate the world from their action. We extend a Piagetian approach to overcoming egocentrism with regard to children’s social knowledge by drawing on Mead’s view that minds and selves emerge from the social process. Children must take the role of others for selves to emerge, a process that is rooted in interaction, requiring sufficient experience with others to be able to anticipate others’ response or attitude to their act. Then the self can respond to one’s own act as the other would. From Piaget’s perspective, these are schemes or patterns of action that develop with repeated experience. From Wittgenstein’s perspective, these patterns are embedded in forms of life; natural ways of reacting to and interacting with others that are characteristic of our species. Overcoming egocentrism or developing perspective taking is required for understanding and for human forms of cognition.

Purpose: To describe the beneficial use of the John Centration Ring (ASICO, Inc, Westmont, Ill) and trypan blue (Vision Blue; Dutch Ophthalmic International, Exeter, NH) in Boston keratoprosthesis surgery. Surgical Technique: The donor cornea is stained with trypan blue and a central 3.0-mm opening is created using a 3.0-mm disposable trephine that is optimally centered using the John Centration Ring (ASICO, Inc). The donor cornea is then sandwiched between the 2 plates of the Boston keratoprosthesis and locked in place with a titanium ring. After host corneal excision, the assembled Boston keratoprosthesis unit is sutured in place to the recipient corneal rim. Conclusions: Use of the John Centration Ring (ASICO, Inc) greatly facilitates the proper centration of the Boston keratoprosthesis on to the donor cornea before the unit being sutured to the recipient corneal rim. Trypan blue staining of the donor cornea greatly enhances visibility, helps in uniform surface alignment of the donor corneal rim to the peripheral recipient corneal rim, and helps in the uniform suture placement in the donor cornea stained with trypan blue.

In this paper, we trace the origin and development of the concept of egocentrism in Piaget’s work. We evaluate a number of criticisms that have been leveled against the concept of egocentrism. Based on our evaluation, we propose a reconceptualization of the concept of egocentrism as a decentering process with different phases that is recapitulated at different stages of development. We provide examples of the decentering process for the sensorimotor, preoperational, concrete-operational, and formal operational stages. Piaget introduced the concept of egocentrism in his early writings in the 1920s to describe general characteristics of the preschool child. Since its introduction, the concept of egocentrism has received considerable theoretical and empirical attention and has drawn numerous criticisms. Piaget attributed these criticisms to serious misunderstandings of the concept of egocentrism. Indeed, Piaget (1945/1962, p. 285, fn) admitted that the choice of the term egocentrism was “unfortunate”, and he apologized ( Piaget & Inhelder, 1948/1967 , p. 220) for having dwelt on this expression for the last twenty-five years. In this paper, we trace the origins of the concept of egocentrism in Piaget’s writings and examine the subsequent changes to this concept. We examine some of the criticisms leveled against the concept of egocentrism and conclude that the concept of egocentrism remained ambiguous in Piaget’s writings. Finally, we suggest a revision of the concept of egocentrism that addresses these ambiguities.

Purpose To assess the effect of intraocular lens (IOL) orientation (vertical versus horizontal) and haptic design (1-piece versus 3-piece) on centration and tilt using a Purkinje meter. Setting Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom. Design Randomized pilot study with intrapatient comparison. Methods In part 1 of this study, patients received plate-haptic IOLs (Akreos Adapt) in both eyes that were positioned vertically in 1 eye and horizontally in the other eye. In part 2, patients received a 1-piece IOL (Acrysof SA60AT) in 1 eye and a 3-piece IOL (Acrysof MA60AC) in the contralateral eye. Decentration and tilt were measured 1 month and 3 months postoperatively with a new Purkinje meter. Results In part 1 (n = 15), the mean decentration of plate-haptic IOLs was 0.4 mm ± 0.2 (SD) with vertical orientation and 0.4 ± 0.2 mm with horizontal orientation and the mean tilt, 1.5 ± 1.1 degrees and 2.9 ± 0.9 degrees, respectively. In part 2 (n = 15), the mean decentration was 0.4 ± 0.3 mm with 1-piece IOLs and 0.6 ± 0.8 mm with 3-piece IOLs and the mean tilt, 2.2 ± 7.2 degrees and 5.3 ± 2.4 degrees, respectively. Conclusions Three-piece IOLs had a greater tendency toward more decentration than 1-piece IOLs, perhaps because of slight deformation of 1 or both haptics during implantation or inaccuracies in production when the haptics are manually placed into the optic. The IOL orientation for plate-haptic IOLs appeared to have no effect on IOL position. The Purkinje meter was useful in assessing the capsule bag performance of the IOLs. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.

PURPOSE: To measure and compare sizing and positioning parameters of femtosecond laser capsulotomy with manual continuous curvilinear capsulorrhexis (CCC). METHODS: Femtosecond capsulotomies (Alcon-LenSx Lasers Inc) and CCC were carried out in 20 eyes of 20 patients, respectively. Intraocular lens (IOL) decentration, circularity, vertical and horizontal diameters of capsulotomies, and capsule overlap were measured with Adobe Photoshop (Adobe Systems Inc) 1 week, 1 month, and 1 year after surgery. Between-group differences of parameters and predictors of IOL decentration were determined with repeated measures analysis of variance, chi-square test, and logistic regression analyses. RESULTS: Vertical diameter of CCC was statistically significantly higher in the first week and month. Significantly higher values of capsule overlap over 1 year and circularity in the first week showed more regular femtosecond capsulotomies. Horizontal IOL decentration was statistically significantly higher in the CCC group over 1 year. A significant difference was noted between the two groups in dichotomized horizontal decentration values at 0.4 mm with chi-square test after 1 week and 1 year ( P =.035 and P =.016, respectively). In univariable general estimating equation models, type of capsulorrhexis ( P P =.002) were significant predictors of horizontal decentration. Vertical diameter showed significant correlation to the overlap in the CCC group (1 week: r=−0.91; 1 month: r=−0.76, P P P >.05). CONCLUSIONS: More precise capsulotomy sizing and centering can be achieved with femtosecond laser. Properly sized, shaped, and centered femtosecond laser capsulotomies resulted in better overlap parameters that help maintain proper positioning of the IOL.

Mohamed Abdel Moneim Hassaballa, Amr Abd el-Latif OsmanDepartment of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, EgyptBackground: The purpose of this study was to evaluate the efficacy and safety of a new instrument to optimize the size, shape, and centration of anterior capsulorhexis.Methods: The study was divided into two parts. The first part was done in 10 goats' eyes. A specially designed capsulorhexis marker was used. The lower edge of the instrument was stained by gentian violet and then applied to the anterior capsule to produce a circular mark of 5.5 mm. In five eyes, the gentian violet was applied to the marker using a corneal marking pen; in the remaining five eyes, the gentian violet was applied using a corneal marking pad. In the second part, the toxicity of gentian violet was tested as follows: ten albino rabbits received a gentian violet injection into the anterior chamber in one eye (experimental group) and an equal volume of balanced salt solution in the fellow eye (control group). Five rabbits were sacrificed one day after surgery and the remaining five rabbits after one week.Results: In the first part, there was no difficulty in the introduction or removal of the instrument from all eyes. In the first two eyes, the circular mark was diffuse due to sliding of the marker on the surface of the anterior capsule. In the remaining eight eyes, there was a well-centered, rounded mark which was adequately stained. In the second part, there was no histopathological evidence of corneal toxicity in either group. There was loss of ganglion cells from the neurosensory retina one day after surgery in one eye from the experimental group. At one week, there was no evidence of retinal toxicity in any of the rabbits.Conclusion: This capsulorhexis marker can guide the surgeon to a better centration and proper sizing of anterior capsulorhexis using gentian violet staining. More refinement of the instrument is needed to be able to use it in human eyes.Keywords: capsulorhexis, gentian violet, marker

Compte tenu des caractéristiques de la perception et de la participation filmique, le documentaire peut avoir des effets radicalement opposés : il peut favoriser tous les « centrismes » (égocentrisme, sociocentrisme, ethno-centrisme); il peut aussi, dans certaines conditions, favoriser la décentration sociale. L’orientation de ces effets possibles dépend largement du type d’énonciation et de l’organisation des points de vue à l’intérieur du film., Depending on the characteristics of perception and of filmic participation, the documentary can have radically divergent effects. It can foster "centrisms" of all sorts — egocentrism, sociocentrism, ethnocentrism — or, under certain conditions, it can foster social decentering. How a film is oriented with respect to these effects depends primarily on the type of enunciation and the organization of points of view in the film.

Corneal refractive therapy is a non-surgical procedure whose main purpose is to improve uncorrected visual acuity during the day, without spectacles or contact lenses. We report an adult woman who shows contact lens intolerance and does not want to wear eyeglasses. We used dual axis contact lens to improve lens centration. We demonstrate a maintained unaided visual acuity during one year of treatment. In conclusion, we can consider refitting with dual axis lens for corneal refractive therapy as a non-surgical option for patients who show contact lens intolerance.

Purpose: To evaluate the safety and efficacy of the AcuFocus Corneal Inlay 7000 (ACI 7000) implanted in emmetropic presbyopic patients for the improvement of near and intermediate vision over 2-year follow-up. Methods: This prospective, non-randomized, non-comparative study included 32 naturally emmetropic presbyopic patients. The intracorneal inlay was implanted in the non-dominant eye over the pupil by creating a superior-hinged flap with the IntraLase 60-kHz femtosecond laser (Abbott Medical Optics). Inlay centration was over the line of sight. Minimum postoperative follow-up was 24 months. Results: After mean follow-up of 24.2±0.8 months (range: 24 to 26 months), 96.9% of patients read J3 or better in the implanted eye. Mean binocular uncorrected near visual acuity improved from J6 preoperatively to J1 after 24 months. Mean binocular uncorrected intermediate visual acuity (UIVA) was 20/20 at 1 month and remained 20/20 throughout 24-month follow-up, with 71.9% of eyes reaching UIVA of 20/20 or better. At 24 months, mean uncorrected distance visual acuity was 20/20 in the implanted eye and 20/16 binocularly. No inlay was explanted during the study. Two decentered inlays were recentered after 6 months because of in-sufficient increase in near and intermediate visual acuity. Both patients’ near and intermediate visual acuity improved significantly after recentration. Conclusions: The ACI 7000 seems to provide a safe and effective treatment for presbyopia over follow-up of 2 years.