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Adolescents of color experiencing chronic environmental stress are at an increased risk for adverse mental health concerns and problems behaviors. Concepts drawn from the Positive Youth Development (PYD) framework identify internal and external assets that suggest positive outcomes for youth and promote resilience. The present study investigated the relationship between the Five Cs and Sixth C models of PYD (represented by youth competence, confidence, connection, caring, character, and contribution) and the likelihood of anxiety/depressive symptoms and behaviors in conflict with the law among urban youth of color residing in high-stress communities. Data were collected during a longitudinal cross-age peer-mentoring program from a sample of 151 adolescents of color (M = 16). Results indicated that, when combined, youth competence, confidence, connection, caring, character, and contribution predicted decreases in behaviors in conflict with the law over time. Internal PYD dimensions were significantly associated with decreased behaviors in conflict with the law over time, whereas external PYD dimensions were significantly associated with decreased anxiety and depressive symptoms over time. In addition, gender and levels of chronic environmental stress were found to moderate the relationship between PYD and psychosocial outcomes. The findings suggest the value of the PYD framework for understanding psychosocial outcomes for urban youth of color. Limitations of the present study and implications for future research are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PURPOSE To evaluate surge volume after occlusion breaks in 3 different phacoemulsification systems. SETTING Alcon Research LLC, Lake Forest, California. DESIGN Experimental study. METHODS A mechanical spring eye model was used to test the Centurion with Active Sentry, WhiteStar Signature Pro, and Stellaris PC. Raw oscilloscope data were converted to volumetric and pressure measurements. Fitted average surge traces were generated for each test condition and used to develop an interpolation algorithm to predict transient occlusion break surge events. Two-dimensional heat maps were generated. RESULTS During occlusion break surge, the Centurion with Active Sentry had smaller aqueous volume losses than the WhiteStar or Stellaris PC. Maximum surge volumes within the mechanical spring eye model displacement limit were 74.7 μL, 157.5 μL, and 151.7 μL using Centurion with Active Sentry, WhiteStar, and Stellaris PC, respectively. In the aphakic state, heat maps showed that Centurion with Active Sentry had less than 20% aqueous volume loss across all vacuum limits and target intraocular pressure; WhiteStar and Stellaris PC systems had up to 35% and 50% aqueous volume losses, respectively, at the higher vacuum limits. In the phakic state, Centurion with Active Sentry had up to 30% aqueous volume loss and WhiteStar and Stellaris PC systems had up to 50% aqueous volume losses. In addition, predicted transient traces demonstrated that Centurion with Active Sentry had the lowest percentage simulated aqueous volume loss compared with WhiteStar or Stellaris PC. CONCLUSIONS Centurion with Active Sentry had lower aqueous volume losses after occlusion break than WhiteStar and Stellaris PC systems at all surgical settings.

Daniel H Chang,1 Jerry Hu,2 Kevin M Miller,3 Srividhya Vilupuru,4 Wuchen Zhao4 1Empire Eye and Laser Center, Bakersfield, CA, USA; 2Texas Eye & Laser Center, Hurst, TX, USA; 3Department of Ophthalmology, David Geffen School of Medicine at the University of California Los Angeles (UCLA), Los Angeles, CA, USA; 4Johnson & Johnson Surgical Vision, Inc., Irvine, CA, USACorrespondence: Daniel H Chang, Empire Eye & Laser Center, 4105 Empire Dr, Bakersfield, CA, 93309, USA, Email dchang@empireeyeandlaser.comPurpose: To evaluate 3-month rotational stability, and visual and refractive outcomes of a toric intraocular lens (IOL) with frosted haptics.Patients and Methods: A post-market, prospective, multi-center, single-arm, open-label study conducted at seven clinical sites in the United States. Two hundred and two eyes of 133 subjects with unilateral or bilateral cataracts and corneal astigmatism were implanted with the Tecnis Toric II IOL, Models ZCU150 to 600 (Johnson & Johnson Surgical Vision, Inc.). Lens axis misalignment/rotation, visual acuity, manifest refraction, and surgeon and patient satisfaction were evaluated 3 months postoperatively. Lens rotation was determined with operative and postoperative visit photographs and was analyzed by two independent masked analysts.Results: Mean absolute lens rotation was 0.82° ± 1.00° and 0.94° ± 0.71° at 1 day (n = 189 eyes) and 3 months (n = 185 eyes), respectively. Absolute lens rotation was ≤ 5° in 98.9% and 100% of eyes at 1 day and 3 months, respectively. At 3 months, postoperative monocular uncorrected and corrected distance visual acuities were 0.004 ± 0.115 LogMAR (20/20) and − 0.066 ± 0.092 LogMAR (20/17), mean spherical equivalent was − 0.25 D ± 0.35 D and residual refractive cylinder was +0.27 D ± 0.33 D. Surgeons were satisfied/very satisfied with overall clinical outcomes and rotational stability in 99% of eyes, and with uncorrected distance vision in 98.5% of eyes.Conclusion: The study results demonstrate that the Tecnis Toric II IOL has excellent rotational stability with a high percentage of study eyes being within 5° of intended orientation. The study lens demonstrated excellent uncorrected distance visual acuity, reduction of cylinder, and exceptional patient and surgeon satisfaction.Keywords: toric IOL, lens rotation, IOL misalignment, residual astigmatism

PURPOSE: To evaluate the outcomes of resident-performed femtosecond laser–assisted in situ keratomileusis (FS-LASIK). METHODS: Records of 138 eyes of 69 patients treated by residents for myopia or myopic astigmatism between March 2018 and June 2020 were reviewed. All preoperative visits, procedures, and postoperative visits were supervised by attending physicians. Follow-up examinations were performed 1 day and 1 month postoperatively. Complications and enhancements were noted. Outcome measures included postoperative uncorrected distance visual acuity (UDVA), refractive accuracy, and complications. RESULTS: Eighteen residents performed FS-LASIK on a median of 8 eyes (interquartile range: 1.75). Fifty-nine patients (118 eyes) returned for a 1-month postoperative examination. UDVA was 20/40 or better in 117 eyes (99%) and 20/20 or better in 108 eyes (92%). The mean preoperative spherical equivalent (SE) refractive error was −4.01 ± 1.82 diopters (D) in 138 eyes, decreasing to −0.12 ± 0.35 D at 1 month after surgery in the 102 eyes that were refracted. The SE was ±1.00 D in 100 eyes (98%) and ±0.50 D in 94 eyes (93%). The CDVA change was within one line in 100% of eyes. Intraoperative complications occurred in 5 eyes (3.62%), enhancements were performed in 3 eyes (2.17%), and postoperative complications developed in 3 eyes (2.17%). CONCLUSIONS: Resident-performed FS-LASIK is relatively safe and effective in comparison to published U.S. Food and Drug Administration premarket approval studies. Early resident experience performing LASIK can improve the training of ophthalmic surgeons while simultaneously increasing patient access to laser vision correction. [ J Refract Surg . 2021;37(8):545–551.]

This autoethnography details the story of my personal experience in the field as a social work MSW and Ph.D. student, working as the facilitator of a human rights-based after-school and summer program at an urban high school set for permanent closure in a structurally oppressed community, and my journey to the realization that I was witnessing genocide in the form of structural violence. One purpose in writing this narrative is to provide a social and cultural context to the ubiquity of structurally violent policies, such as closing public schools. This story also testifies to the wealth of strengths that youth possess to resist even the most severe human rights abuses. I also write to show the inextricable political link between individuals and societal structures and systems and to challenge social workers to actively oppose structural violence and its genocidal effects. As I reflect on the genocidal conditions I witnessed, I will at the same time critically consider the profession of social work’s role in responding to structural violence, as well as the great potential that our profession has to meaningfully address crises like these.

The proximity of the iris to the instruments and currents of cataract surgery makes iatrogenic damage to the iris a common complication of cataract surgery. This article discusses techniques to prevent or minimize this damage. When damage does occur, the surgeon must decide if, when, and how to repair the damage. Principles governing these decisions and techniques for repair are discussed. Figures and videos, included as online Supplemental Data files, illustrate cases of iatrogenic damage and repair techniques.

While the solvating power of ionic liquids (ILs) for a variety of solute types including polymers is well-known, the use of ILs as solvents for ionenes—charged polymers with cationic moieties withi...

A series of 1,2,3-triazolium-functionalized cellulose derivatives were prepared using an azide–alkyne “click” cyclization strategy, followed by quaternization. As cellulose represents an inexpensiv...

Purpose To describe the indications, motivations, and outcomes of artificial iris exchange. Setting Stein Eye Institute. Design Consecutive case series. Methods Review of medical records of patients implanted with an artificial iris device who underwent a subsequent artificial iris exchange. Results Five patients were identified: 4 women and 1 man. Their ages ranged from 19 to 58 years at the time of the exchange. One patient had congenital aniridia; the other 4 had acquired iris defects. Three exchanges were simultaneous; 2 were consecutive. Corneal decompensation was the most common indication for the surgery precipitating the exchange. Explanted iris devices included models from Ophtec, Morcher, BrightOcular, and HumanOptics. Replacement models were from Morcher and HumanOptics. Three of the original irides were passively fixated in the capsular bag or ciliary sulcus. All of the replacement irides were suture-fixated to the sclera, either directly or secondarily by way of an intraocular lens. The motivation for the exchange was improved cosmesis in 4 patients and sustained cosmesis in 1 patient. Final visual acuities were 20/25 for 2 patients, 20/100 for 1 patient, and hand motion for 2 patients. Conclusions No 2 iris exchanges were similar. Clinical indications and outcomes varied considerably from patient to patient. A common thread was each patient's motivation to maintain or improve on the functional and cosmetic benefits of having been previously implanted with an artificial iris device. Final visual acuity results were often poor because of the effects of comorbidities, especially glaucoma and corneal decompensation.

We sought to evaluate the 1- to 9-year safety and efficacy of colored iris reconstruction lens implantation in eyes with visual disturbances caused by partial or complete aniridia.Prospective, interventional case series.Thirty-eight patients were implanted with Ophtec 311 colored iris reconstruction lenses at the University of California, Los Angeles as part of a larger U.S. Food and Drug Administration clinical trial. Patients in group 1 lacked corneal pathology. Patients in group 2 patients had corneal pathology, such as endothelial failure, previous transplants, or scarring. Safety measures included loss of corrected distance visual acuity (CDVA), surgical complications, adverse events, secondary interventions, and corneal endothelial cell loss. Efficacy measures included improvement in uncorrected distance visual acuity (UDVA) and subjective visual disturbances.Groups 1 (n = 8) and 2 (n = 30) showed improvements in CDVA (P = .155 and .038), UDVA (P = .002 and P.001), and subjective visual disturbance scores at year 3. Median CDVA and UDVA declined slightly for both groups after 1-2 years. Group 2 experienced more adverse events, surgical complications, and secondary interventions. Endothelial cell loss was greater for group 2 (19.7%) than group 1 (8.05%), although this difference was not statistically significant (P = .067).Colored iris reconstruction lens implantation improved CDVA, UDVA, and subjective visual disturbances 3 years postoperatively and beyond. Adverse events, complications, and subsequent declines in visual acuity were common, however, in these eyes with complex medical and surgical histories.

Author(s): Bonnet, Clemence; Miller, Kevin M | Abstract: PurposeTo assess the preliminary safety and efficacy of custom silicone artificial iris implantation.SettingStein Eye Institute.DesignProspective consecutive case series.MethodsMedical records of patients implanted with the artificial iris were reviewed and followed for 1 year. Safety measures included corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell count (ECC), surgical complications, secondary interventions, and adverse events (AEs). Efficacy measures included CDVA with glare, subjective daytime and nighttime glare graded from 0 to 10 (very significant), and subjective cosmetic appearance graded from 0 to 10 (very satisfied).ResultsTwenty eyes (19 patients) were implanted. Safety data were mixed. CDVA improved in 13 eyes and worsened in 6. ECC decreased from 1918 ± 870 to 1405 ± 705 cells/mm (P = .02). Eight eyes experienced postoperative complications. There were 4 IOP elevations, 2 corneal decompensations, 1 case of cystoid macular edema, and 1 device dislocation. Four eyes underwent secondary surgical interventions including 2 AEs (1 glaucoma surgery and 1 device dislocation). Efficacy outcomes were excellent. CDVA with glare improved from 1.5 ± 0.6 to 0.7 ± 0.8 logarithm of the minimum angle of resolution (P l .01). Mean subjective daytime glare decreased from 8.9 ± 1.8 to 2.7 ± 2.6 (P l .01) and nighttime glare decreased from 7.9 ± 1.8 to 2.5 ± 2.7 (P l .01). Mean cosmesis improved from 2.2 ± 1.6 to 8.8 ± 2.1 (P l .01).ConclusionsCustom artificial iris implantation was moderately risky but very effective at reducing light and glare sensitivity and in improving ocular cosmesis.

Plastic pollution is one of the most pressing global environmental issues we face today, in part due to the continued rise in production and use of disposable plastic products. Polyolefins and polyesters are two of the most prevalent polymers in the world accounting for ∼80% of total nonfiber plastic production. Recycling, despite being intrinsically environmentally friendly and sometimes economically viable, remains at a surprisingly low level (

Poly(ionic liquid) covalently adaptable networks containing thermoreversible furan–maleimide linkages were prepared and characterized for their thermal, mechanical and conductive properties. Self-healing behaviour was initially evaluated using oscillatory rheology where a G′/G′′ crossover temperature of ∼110 °C was observed. Anhydrous conductivities, as determined by dielectric relaxation spectroscopy, were found to be on the order of 10−8 S cm−1 at 30 °C. Recovery of >70% of the original stress and strain at break was found within 2 hours at 105 °C as determined from tensile testing experiments, with breakage occurring at a new point on the film. Recovery of conductivity was completed utilizing chronoamperometric cycling whereby >75% of the original current was recovered within two hours at 110 °C.

To evaluate safety and efficacy of a custom-manufactured artificial iris device (CustomFlex Artificial Iris; HumanOptics AG) for the treatment of congenital and acquired iris defects.Multicenter, prospective, unmasked, nonrandomized, interventional clinical trial.Patients with photophobia, sensitivity secondary to partial or complete congenital or acquired iris defects, or both.Eyes were implanted from November 26, 2013, to December 1, 2017, with a custom, foldable artificial iris by 1 of 4 different surgical techniques. Patients were evaluated 1 day, 1 week, and 1, 3, 6, and 12 months after surgery. At each examination, slit-lamp findings, intraocular pressure, implant position, subjective visual symptoms, and complications were recorded. Corrected distance visual acuity (CDVA) and endothelial cell density (ECD) were measured at 3, 6, or 12 months as additional safety evaluations. The 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was used to assess health-related quality of life affected by vision. The Global Aesthetic Improvement Scale was used to assess cosmetic results.Photosensitivity, glare, visual symptoms, NEI VFQ-25 score, Global Aesthetic Improvement Scale rating, prosthesis-related adverse events, intraocular lens (IOL)-related adverse events, and surgery-related adverse events 12 months after surgery.At the 12-month postoperative examination, a 59.7% reduction in marked to severe daytime light sensitivity (P0.0001), a 41.5% reduction in marked to severe nighttime light sensitivity (P0.0001), a 53.1% reduction in marked to severe daytime glare (P0.0001), and a 48.5% reduction in severe nighttime glare (P0.0001) were found. A 15.4-point improvement (P0.0001) in the NEI VFQ-25 total score was found, and 93.8% of patients reported an improvement in cosmesis as measured by the Global Aesthetic Improvement Scale 12 months after surgery. No loss of CDVA of2 lines related to the device was found. Median ECD loss was 5.3% at 6 months after surgery and 7.2% at 12 months after surgery.The artificial iris surpassed all key safety end points for adverse events related to the device, IOL, or implant surgery and met all key efficacy end points, including decreased light and glare sensitivity, improved health-related quality of life, and satisfaction with cosmesis. The device is safe and effective for the treatment of symptoms and an unacceptable cosmetic appearance created by congenital or acquired iris defects.

Purpose: To determine the relation between patients’ age and degree of myopia on the risk of postoperative retinal detachment following cataract surgery. Setting: University-based cataract referral practice. Patients and methods: This is a retrospective study. The chart of all patients in the practice of 1 surgeon (K.M.M) who had cataract surgery by the Kelman phacoemulsification technique between 1991 and 2010, were reviewed to identify patients (those who had retinal detachment) was associated with 4-control who didn’t detach but had surgery around the same time. Result: Forty-three cases of retinal detachment were identified, the mean age at time of cataract surgery for the RD cases was 57.3 ± 14.7 years (range: 4 to 96 years) and for the control was 69.8 ± 12.9 years (range: 9 to 75 years), p < 0.0001, mean SE refraction error for the RD cases was -4.8 ± 4.7 diopters of myopia and for the control group was -1.6 ± 4.3 diopters of myopia p < 0.0001. Conclusion: The study shows that risk of retinal detachment and the degree of myopia is linear up to 12.00 diopters of myopia then starting to decline, and the risk of retinal detachment is the highest in age group between 50 to 59 years.

A 27-year-old woman had BrightOcular iris implants placed for cosmetic purposes that changed eye color from brown to blue bilaterally. Of note, BrightOcular implants are not approved by the U.S. Food and Drug Administration (FDA) for use in the United States and have been associated with severe ocular complications. In keeping with their design, they were placed in the anterior chamber (AC) in both eyes of this patient; surgery was performed outside the United States. As has been described previously and tragically in other cases, she developed chronic inflammation, intolerable glare, angle-closure glaucoma, corneal edema, and cataracts in both eyes. For medically unmanageable elevated intraocular pressure (IOP), she underwent diode laser cyclophotocoagulation (CPC) in both eyes, and eventually, an Ahmed tube shunt (New World Medical, Inc.) was placed in the right eye. Although she was advised and urged to have the iris implants removed, despite her ocular issues, she refused removal until intolerable glare and reduced vision ensued. Ultimately, both iris implants were extracted 5 years after implantation by a U.S. surgeon; the procedures resulted in corneal decompensation and progressive cataract development. Subsequent penetrating keratoplasty (PKP) was performed for the right eye, but it failed because of contact with the glaucoma tube shunt. She sought additional consultation and presented with the following findings: corrected distance visual acuity was 20/400 in the right eye and 20/40 in the left eye, IOP of 18 mm Hg in the right eye and 16 mm Hg in the left eye, pupils were nonreactive and fixed, and extraocular muscles and central visual field were normal. Pachymetry was 868 μm in the right eye and 653 μm in the left eye. Anterior segment examination in the right eye revealed a failed corneal graft with 3+ edema, peripheral anterior synechiae (PAS) for 360 degrees, shallow AC, Ahmed tube shunt at the 11 o'clock position and remnant iris adherent to the graft-host junction for 270 degrees, 3+ posterior subcapsular cataract, and 2+ cortical cataract (Figure 1JOURNAL/jcrs/04.03/02158034-202208000-00024/figure1/v/2022-08-01T210317Z/r/image-tiff). The sclera revealed multiple circular and circumferential atrophic blue spots consistent with high-energy transscleral CPC (Figure 2JOURNAL/jcrs/04.03/02158034-202208000-00024/figure2/v/2022-08-01T210317Z/r/image-tiff). In the left eye, she had remnant fixed dilated iris for 270 degrees, missing iris superiorly for 3 clock hours, an adequate AC, and 2+ cortical cataract (Figure 3JOURNAL/jcrs/04.03/02158034-202208000-00024/figure3/v/2022-08-01T210317Z/r/image-tiff). Posterior segment examination revealed a 0.5 cup-to-disc ratio in both eyes with normal vessels, macula, vitreous, and retinal periphery, bilaterally. Given this constellation of findings, how would you proceed?

Purpose To report complications of cosmetic artificial iris implantation and explantation outcomes. Design Retrospective case series. Methods Medical records of 12 patients (24 eyes) who presented to us after being implanted with cosmetic artificial irises elsewhere were reviewed. Data collected included baseline demographics, presenting symptoms, examination findings, and management outcomes. Results Eight eyes had NewColorIris implants and 16 had BrightOcular implants. The mean interval from cosmetic iris implantation to presentation was 61.7 ± 60.0 months. The mean follow-up after explantation was 35.5 ± 38.1 months. Complications at presentation included iris abnormalities (11 eyes, 45.8%), elevated intraocular pressure (8 eyes, 33.3%), corneal edema (6 eyes, 25%), intraocular inflammation (5 eyes, 20.8%), and cataract (4 eyes, 16.7%). Surgical interventions included cosmetic iris removal (19 eyes, 79.2%), cataract extraction (7 eyes, 29.2%), corneal transplantation (7 eyes, 29.2%), and glaucoma surgery (4 eyes, 16.7%). Complications at the last follow-up examination included native iris defects (11 eyes, 45.8%), persistent glaucoma (7 eyes, 29.2%), cataract (5 eyes, 20.8%), corneal edema (4 eyes, 16.7%), and intraocular inflammation (2 eyes, 8.3%). The mean logarithm of the minimum angle of resolution was 0.56 ± 0.47 at presentation and 0.78 ± 0.88 at the last examination (P = .30). The mean intraocular pressure was 22.7 ± 15.8 mm Hg at presentation and 13.4 ± 6.99 mm Hg at the last examination (P = .02). Conclusion Cosmetic iris implantation was associated with serious complications at the time of presentation, and adverse sequelae persisted for years after explantation.

Author(s): Bonnet, Clemence; Vazirnia, Parsia; Deng, Sophie X; Aldave, Anthony J; Miller, Kevin M | Abstract: PurposeTo assess safety and efficacy outcomes of sutured custom silicone artificial iris and intraocular lens implantation combined with penetrating keratoplasty (triple procedure).MethodsProspective consecutive surgical case series of patients who underwent the triple procedure between 2010 and 2019 at Stein Eye Institute, UCLA, followed up for 1 year minimum. Safety outcomes were changes from preoperative to last follow-up in corrected distance visual acuity (CDVA), endothelial cell count, intraocular pressure (IOP), and postoperative complications. Efficacy outcomes included changes in subjective glare (none to severe), cosmetic appearance (worse to very much improved), and visual function as assessed by the Visual Function Questionnaire-25 at 1-year follow-up.ResultsAmong 82 eyes implanted with an artificial iris, 14 eyes (17.1%) underwent the triple procedure. The median follow-up was 18.1 months (range 12.0-54.9 months). The median CDVA improved from 2.0 log of minimum angle of resolution (logMAR) (range 0.9-2.3 logMAR) to 0.7 logMAR (range 0.2-2.6 logMAR) (P = 0.02). Average endothelial cell count decreased 57.6% (P l 0.01). Six eyes (42.9%) experienced IOP elevations, 13 eyes (92.3%) developed iritis, and 11 eyes (78.6%) underwent secondary surgery. Graft rejection or secondary graft failure occurred in 7 eyes each (50.0%). Cosmesis improved in 12 eyes (85.7%; P l 0.01). The Visual Function Questionnaire-25 score improved from 72 to 77 (P l 0.01). Glare symptoms did not change significantly.ConclusionsThe triple procedure was effective at improving CDVA, cosmesis, and quality of life; however, it was associated with frequent postoperative complications, of which iritis, IOP elevation, and secondary graft failure were the most common.

A series of covalently cross-linked poly(ionic liquid) networks were prepared using thiol–ene “click” photopolymerization. In these networks, imidazolium groups are placed in the backbone and pendant to the main chain, creating a “hybrid”-type network architecture. The pendant imidazolium groups were incorporated into the networks from monofunctional “ene” monomers that contained either a terminal alkyl group at the imidazolium N-3 position of variable length (R = C1, C4, C8, C12, C16, or C20) or a variable alkyl tether spacer (n = 6 or 10) between the newly formed sulfide and the imidazolium ring. Thermal characterization of these networks indicated a general decrease in Tg as the length of the terminal alkyl chain length increased from C1 to C8, followed by an abrupt increase in Tg up to C20 due to increased van der Waals interactions between longer chains. X-ray scattering data confirmed the presence of chain-extended crystallites within the network cavities for the C16 and C20 systems, leading to the ...

Azide–alkyne “click” cyclization was used to prepare a series of polymerizable acetoacetate monomers containing a 1,2,3-trizolium ionic liquid group. The monomers were subsequently polymerized using base-catalyzed Michael addition chemistry, producing a series of covalently crosslinked 1,2,3-triazolium poly(ionic liquid) (TPIL) networks. Structure–activity relationships were conducted to gauge how synthetic variables, such as counteranion ([Br], [NO3], [BF4], [OTf], and [NTf2]), and crosslink density (acrylate/acetoacetate ratio) effected thermal, mechanical, and conductive properties. TPIL networks were found to exhibit ionic conductivities in the range of 10–6–10–9 S/cm (30 °C, 30% relative humidity), as determined from dielectric relaxation spectroscopy, despite their highly crosslinked nature. Temperature-dependent conductivities demonstrate a dependence on polymer glass transition, with free-ion concentrations impacted by various ions’ Lewis acidity/basicity and ion mobilities impacted by freely mobile anion size.

To assess the safety and efficacy of Morcher 67B black iris diaphragm intraocular lens (IOL) implantation for managing large iris defects and aphakia.Stein Eye Institute, UCLA, Los Angeles, California, USA.Prospective case series.The demographic, preoperative, and postoperative data on patients implanted with a black iris diaphragm IOL and followed to 1 year were reviewed. Safety measures included loss of corrected distance visual acuity (CDVA), perioperative complications, adverse events, and secondary surgical interventions. Efficacy measures included CDVA with glare, daytime and nighttime glare symptom scores, and subjective cosmesis scores.Thirty-one eyes of 31 patients were implanted. There was a 7-line improvement in median Snellen CDVA (P .001). Four eyes worsened more than 1 line. There was 1 minor intraoperative complication. Twenty-one eyes experienced postoperative complications, most of which were related to preexisting ocular comorbidities. Three adverse events included cystoid macular edema, corneal graft dehiscence, and uveitis with ocular hypertension. There were 12 secondary surgical interventions. The CDVA with glare improved 6 Snellen lines (P .0001). The mean subjective glare symptoms improved 4.94 points on a 0 to 10 scale during the day (P .0001) and 3.61 points at night (P .0001). The mean cosmesis score improved 2.23 points (P .0001) on the same scale.Black iris diaphragm IOL implantation in aphakic eyes with large iris defects and significant ocular comorbidity was found to be relatively safe and very effective at improving CDVA and reducing light and glare sensitivity.

A thermoreversible thiol-Michael bond was incorporated into a series of covalently crosslinked polyester networks using base-catalyzed Michael addition polymerization. Variations in acrylate:acetoacetate ratio (crosslink density), thiol-Michael bond content and cure temperature were employed in order to gauge dynamic and rehealing properties. All of the networks investigated in this study were found to display rehealing behavior after being cut at 100 °C within 48 h. Increasing the curing temperature to 120 °C led to a decrease in time to reheal (≤8 h), however the network which employed the highest thiol-Michael bond content, coupled with the lower acrylate:acetoacetate monomer ratio, did not recuperate the original crosslink density upon cooling as evidenced by strain recovery values in excess of 100% and a steady decrease in DSC Tg and TGA weight % as a functional of exposure time.

Objective: The current study examined the extent of gun exposure, referring to the mere presence of guns in youth’s lives, in a sample of Black American adolescents residing in low-income urban neighborhoods. The relationship of gun exposure to internalizing and externalizing outcomes was also explored. Method: Data were collected from a sample of 185 Black American eighth-grade students ( M = 13.58 years old, 59% female). Results: Just under half of the youth reported some type of gun exposure with youth most often exposed to guns outside of the home. Overall gun exposure was related to externalizing but not internalizing symptoms, while knowing someone who owns a gun was related to both externalizing and internalizing symptoms. However, the majority of youth reported exposure to guns in a safe manner (stored locked and unloaded). Conclusions: In addition to gun violence and gun carrying, general gun exposure is a factor that should be accounted for when attempting to address consequences associated with guns.

Purpose To develop a mechanical model of human eye compliance for volumetric studies. Setting Alcon Research, Ltd., Lake Forest, California, USA. Design Experimental study. Methods Enucleated human eyes underwent pressurization and depressurization cycles with peak intraocular pressures (IOPs) of 60 to 100 mm Hg; anterior chamber pressure and volume changes were measured. Average net volume change curves were calculated as a function of IOP for each eye. Overall mean volumes were computed from each eye's average results at pressure points extrapolated over the range of 5 to 90 mm Hg. A 2-term exponential function was fit to these results. A fluid chamber with a displaceable piston was created as a mechanical model of this equation. A laser confocal displacement meter was used to measure piston displacement. A test bed incorporated the mechanical model with a mounted phacoemulsification probe and allowed for simulated occlusion breaks. Surge volume was calculated from piston displacement. Results An exponential function, V = C1 × exp(C2 × IOP) + C3 × exp(C4 × IOP) − V0, where V, the volume, was fit to the final depressurization curve obtained from 15 enucleated human eyes. The C1 through C4 values were −0.07141, −0.23055, −0.14972, and −0.02006, respectively. The equation was modeled using a piston system with 3 parallel springs that engaged serially. The mechanical model mimicked depressurization curves observed in human cadaver eyes. Conclusion The resulting mechanical compliance model measured ocular volumetric changes and thus would be helpful in characterizing the postocclusion break surge response.

Purpose: To discuss problems associated with the implantation of two Morcher iris diaphragm models. Methods: We describe the history, intraoperative complications, and postoperative complications of 5 patients with specific Morcher iris implants. Results: We implanted Morcher 50D devices in 1 patient and Morcher 96S devices in 4 patients. Complications included postoperative rotation, device mis-sizing, difficult intraoperative rotation, zonular dehiscence, and intraoperative hemorrhage. Conclusion: Artificial iris implantation has a steep learning curve. With widespread availability on the horizon in the United States, the sharing of surgical experiences is key to achieving the best outcomes for patients.

Purpose To expand understanding of presentation, diagnosis, and outcomes of hemorrhagic occlusive retinal vasculitis (HORV). Design Retrospective case series. Participants Thirty-six eyes of 23 patients. Methods The American Society of Cataract and Refractive Surgery (ASCRS) and the American Society of Retina Specialists (ASRS) formed a joint task force to define clinical characteristics of HORV and to study its prevalence, cause, treatment, and outcomes. An online registry was established on both societies' web sites. Surveys were e-mailed to members of both societies soliciting cases of suspected HORV. A literature search was performed to uncover additional cases. Main Outcome Measures Historical data including intraoperative characteristics, images, treatment regimens, and visual and anatomic outcomes. Results Characteristic findings of HORV included unremarkable postoperative day 1 undilated examination, delayed-onset painless vision loss, mild anterior chamber and vitreous inflammation, sectoral retinal hemorrhages in areas of ischemia, and predilection for venules and peripheral involvement. Based on predetermined diagnostic criteria, 36 eyes of 23 patients were diagnosed with HORV. All eyes received intraocular vancomycin via intracameral bolus (33/36), via intravitreal injection (1/36), or through the irrigation bottle (2/36). Patients sought treatment with HORV 1 to 21 days after surgery or intravitreal injection. Visual results usually were poor: 22 of 36 eyes (61%) had 20/200 or worse visual acuity and 8 of 36 eyes (22%) had no light perception (NLP). Neovascular glaucoma developed in 20 of 36 eyes (56%). Seven eyes received additional intravitreal vancomycin after surgery; 5 of these 7 eyes had NLP visual acuity at the most recent examination. Three eyes received intravitreal corticosteroids and had final visual acuities of 20/40, 20/70, and hand movements. Conclusions Hemorrhagic occlusive retinal vasculitis is a rare, potentially devastating condition that can develop after cataract surgery or intraocular injection. All cases in this series were associated with intraocular vancomycin. Disease course and findings suggest that HORV is caused by a delayed hypersensitivity reaction to vancomycin. Early treatment with corticosteroids likely is beneficial. Subsequently, anti–vascular endothelial growth factor injections and panretinal photocoagulation are important to prevent neovascular glaucoma, a common complication. Avoidance of additional intravitreal vancomycin is recommended if HORV is suspected.

Purpose: To determine the effect of anterior capsule polishing (APC) on the rate of posterior capsule opacification (PCO) as assessed by the need for laser posterior capsulotomy. Setting: University-based clinical practice, Jules Stein Eye Institute, Los Angles, California, USA. Methods: This study involved a retrospective review of eyes that underwent phacoemulsification and intraocular lens implantation between September 1991 and June 1999. Lens epithelial cells in the 763 study eyes were mechanically debrided or polished from the inside surface of the anterior capsules using a pair of Shepherd-Rentsch (Morning STAAR Inc.) capsule polishers. The 484 control eyes that had surgery earlier in the series were not polished. The rate of laser capsulotomy in the ACP and the non-ACP groups was compared using a Kaplan-Meier survival analysis. Multivariate regression was performed to determine if variables other than ACP influenced the need for laser posterior capsulotomy. Results: We identified 763 eyes that had ACP and 484 that did not. At the 24-month follow-up interval, 26.6% of the eyes in the ACP group had received a capsulotomy versus 19.50% in the non-APC. Next, a separate study was done using only one eye per patient, taking the patient as the unit of analysis. Again the capsulotomy rate was higher in the ACP group compared to the non-ACP (1.02 per 100 person-months of follow-up vs. 0.74 per 100 person-months of follow-up). Finally, a third Kaplan-Meier analysis was done on 52 patients that had one eye treated with the ACP procedure and the other eye with the non-ACP procedure. Although the log-rank test showed the statistical significant of this analysis to be borderline, the results again favored the non-ACP group with a lower capsulotomy rate. Multivariate analysis showed very similar results to the above univariate studies. The mean time to capsulotomy was 46 months for the polished group and 70 months for the unpolished group. The severity of cataract (p = 0.46) and the type of haptics (p = 0.86) did not influence the rate of capsulotomy. Plate haptic IOLS had a higher rate of capsulotomy than loop haptic IOLS (p = 0.001). Conclusions: Polishing of the anterior capsule with Shepherd-Rentsch polishers may unexpectedly increase the rate of posterior capsule opacification in eyes with round-edge silicone lenses.

Thiol-ene photopolymerization was used to generate a series of covalently crosslinked, imidazolium-containing ionene networks. A variety of counteranions were chosen so as to investigate the influence of size and basicity on the thermal, mechanical and conductive properties of the resulting networks. Anhydrous conductivities at 20 °C were found to be on the order of 10−6 to 10−10 S/cm and correlated to some degree with Tg; however, Tg-normalization of the curves indicated that this relationship between polymer structure and conductivity was more complex. VFT fitting, along with free ion concentration and ion mobility data, were investigated in order to provide additional insight. Also of interest in this study was the influence of humidity on ionic conductivity. Hydrophilic networks with anions such as [Cl], [NO3] or [OMs] were found to exhibit 3- to 5-orders of magnitude enhancement in ionic conductivity (up to 10−3 S/cm) when the relative humidity was increased to 70% while the more hydrophobic networks ([PF6] and [NTf2]) were not influenced. Further experimentation (water uptake, DSC) indicated that the observed enhancements in conductivity were likely due to a combination of plasticization and water-assisted ion transport.

Despite the modified Brostrom Procedure (MBP) being the gold standard for surgical treatment of chronic ankle instability (CAI), there is little data regarding factors that impact rehabilitation time. This retrospective analysis includes 67 consecutive Modified Brostrom Procedures (MBPs). Records were reviewed to define patient factors associated with increased time to return to activity (RTA). Of the 67 cases reviewed, 23 patients underwent reconstruction of the calcaneofibular (CFL) with a semimembranosus allograft in addition to repair of the anterior talofibular ligament (ATFL) with a suture tape. There were no significant demographic or clinical differences between these two groups. All patients had a minimum follow-up of 12 months. The mean age and body mass index (BMI) of the cohort was 44.7 years and 33.7 kg*m2, respectively, with a ratio of females to males of 2.35:1. Males began weight bearing as tolerated (WBAT) in a walking boot 1.08 weeks earlier than females (p = 0.053). Those with a BMI ≥ 35 kg/m2 RTA in normal shoe gear 0.50 weeks later (p = 0.443). Workers’ compensation cases were correlated with RTA (+0.431, p

Exposure to violence (ETV) poses a serious threat to adolescents’ safety and well-being; however, some adolescents who grow up in such toxic environments are able to thrive due to a combination of internal and external characteristics. The current study examines the role of cohesion across contexts (i.e., family, school, and community) as moderating the relation between ETV and positive internal outcomes characteristic of resilient youth (i.e., ethnic identity, positive affect, and self-esteem) in a sample of low-income, urban, African American adolescents ( N = 269, 60% female) from seventh grade to eighth grade. Results indicated that greater cohesion in each context was directly related to more positive outcomes. Family and neighborhood cohesion additionally served as protective enhancing factors for males exposed to high levels of violence. These findings expand the current research on positive youth development and help locate potential environmental targets for prevention and intervention research.

The Marangoni effect describes fluid flow near an interface in response to a surface tension gradient. Here, we demonstrate that the Marangoni effect is the underlying mechanism for flow driven feature formation in an azobenzene-containing polymer film; features formed in azobenzene-containing polymers are often referred to as surface relief gratings or SRGs. An amorphous poly(4-(acryloyloxyhexyloxy)-4′-pentylazobenzene) was synthesized and studied as a model polymer. To isolate the surface tension driven flow from the surface tension pattern inscription step, the surface tension gradient was preprogrammed via photoisomerization of azobenzene in a glassy polymer film without forming topographical features. Subsequently, the latent image was developed in the absence of light by annealing above the glass transition temperature where the polymer is a liquid. The polymer flow direction was controlled with precision by inducing different surface tension changes in the exposed regions, in accordance with expect...

A series of imidazolium-based bis(trifluoromethylsulfonyl)imide [NTf2] poly(ionic liquid)s (PILs) were prepared by conducting the solventless thiol-ene ‘click’ photopolymerization of bisallylimidazolium [NTf2] and pentaerythritol tetrakis(3-mercaptopropionate) (PTMP). The thiol:ene molar ratio was varied in order to examine changes in the thermal, mechanical and conductive properties of the resulting polymer networks. The 1.0:2.0 thiol-ene PIL network exhibited the highest glass transition temperature (Tg of −5.0 °C) and storage modulus (E′ of 9.24 MPa at 100 °C) values. Temperature-dependent ionic conductivities were found to rely on both the Tg/crosslink density as well as the IL content, with the highest ionic conductivity observed for the 1.0:3.0 thiol-ene PIL network (1.42 × 10−5 S/cm at 25 °C). Application of Vogel-Fulcher-Tammann and Williams-Landel-Ferry theories revealed the impact of both Tg/crosslink density and free ion concentration on temperature-dependent conductivity data, and indicated lower free volumes and fragilities for the thiol-ene networks relative to other non-network PILs.

A series of 1-alkyl-3-methyl-1,2,3-triazolium bis(trifluoromethylsulfonyl)imide [NTf2] ionic liquids were prepared synthetically using azide–alkyne ‘click’ cyclization chemistry and their physicochemical and thermal properties were determined. Increasing the alkyl chain length resulted in increased viscosities and higher thermal transitions (Tg or Tm) with depressed molar conductivities. Walden plot analysis indicated that the ionicity of 1-butyl-3-methyl-1,2,3-triazolium [NTf2] was comparable to the analogous imidazolium system and higher than the 1,2,4-triazolium equivalent.

Purpose To evaluate aqueous volume losses associated with occlusion breaks at varying vacuum limits in phacoemulsification systems from 4 different manufacturers. Setting Alcon Research Ltd., Lake Forest, California, USA. Design Experimental study. Methods The anterior chamber was modeled using the spring eye model. Systems tested included the Centurion, Whitestar Signature, Stellaris PC, and EVA. Occlusion breaks were actuated at vacuum limits of 200, 300, 400, 500, and 600 mm Hg and a target intraocular pressure of 55 mm Hg. Results The model eye piston reached its measurement limit just below 600 mm Hg on the EVA and just above 400 mm Hg on the Stellaris PC. Higher vacuum limits could not be tested on these 2 units. Surge volumes varied from 17 to 77 μL on the Centurion, 30 to 103 μL on the Whitestar Signature, 67 μL to 163 μL on the Stellaris PC, and 47 to 165 μL on the EVA. Assuming an average phakic eye aqueous volume of 250 μL, these μL values correspond to percent aqueous volume losses of 7% to 31% on the Centurion, 12% to 41% on the Whitestar Signature, 27% to 65% on the Stellaris PC, and 19% to 66% on the EVA. Surge responses increased on all machines with each increment in vacuum limit. The Centurion had the lowest surge volumes across all vacuum limits. Conclusions Occlusion break surge volumes vary considerably across phacoemulsification platforms. Severe chamber shallowing might occur if an occlusion break occurs under high vacuum on some systems.