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Avi Wallerstein,1,2 Mathieu Gauvin,1,2 Michael Mimouni,3 Louis Racine,4 Ali Salimi,1,2 Mark Cohen2,5 1Department of Ophthalmology and Visual Sciences, McGill University, Montreal, QC, Canada; 2LASIK MD, Montreal, QC, Canada; 3Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; 4Department of Ophthalmology, University of Montreal, Montreal, QC, Canada; 5Department of Surgery, University of Sherbrooke, Sherbrooke, QC, CanadaCorrespondence: Avi Wallerstein 1250 Rene-Levesque Blvd W, MD Level, Montreal, QC, H3B 4W8, CanadaTel +1 514-908-9888, Ext. 2273Email awallerstein@lasikmd.comPurpose: To assess the potential application of corneal higher-order aberration (HOA) excimer ablation map imaging in identifying reproducible keratoconus (KC) features and to explore if newly derived map metrics correlate to Pentacam KC indices.Methods: Case series of 12 eyes with KC ≥ grade 2. Topolyzer Vario corneal imaging with its resultant HOA ablation map islands were analyzed for their centroid, distance from center, angular position, orientation, sphericity, diameter, area, and maximal ablation depth. Correlations to Pentacam indices were studied.Results: All eyes showed recurrent features with an arrangement of two elliptical paracentral ablation islands, one deep inferotemporal and one shallow superonasal, in direct mirror-like opposition to each other. These were always accompanied by superior peripheral ablation crescents. The two paracentral islands had highly reproducible distance from center (1.2 ± 0.1 mm and 1.3 ± 0. 2 mm) and angular positions (246.8 ± 15.9° and 76.7 ± 7.7°), with greater variation in ablation depth (68.3 ± 33.2 μm and 17.6 ± 12.1 μm). Distance from center of the peripheral superior crescents was highly reproducible (3.3 ± 0.1 mm), with a larger range of depth (74.5 ± 37.2 μm). The deep paracentral inferotemporal island “hot spot” was coincident with the topographical apical cone. Strong correlations were found between the depth of the inferotemporal island and Pentacam indices of posterior radius curvature (PRC: R = − 0.74) and Belin/Ambrosio enhanced ectasia total deviation (BAD-D: R = 0.71).Conclusion: The corneal HOA ablation map revealed a recurring, distinct, easily recognizable pattern in KC eyes. There was a strong correlation between the depth of novel HOA ablation map metrics and validated Pentacam KC indices. Novel information can be extracted from the corneal HOA ablation map giving it the potential to be a new modality to diagnose and grade KC.Keywords: topography, Contoura, keratoconus, ectasia, diagnosis, higher-order aberration

Ori Segal,1 Yinon Shapira,2 Assaf Gershoni,1 Igor Vainer,2 Arie Y Nemet,1 Noa Geffen,1 Michael Mimouni2 1Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel and the Sackler School of Medicine, Tel Aviv University, Tel Aviv, 2Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel Purpose: To examine the relationship between signal strength and macular thickness as measured by Stratus optical coherence tomography (OCT)’s fast macular thickness protocol in healthy subjects.Methods: In this prospective cross-sectional study 79 eyes of 42 healthy subjects were enrolled. The age, gender, and eye (right vs left) of each subject were recorded. The Stratus OCT fast macular thickness scan protocol was used and the macular thickness was measured with retinal thickness map analysis. Each eye was imaged at least six times to acquire images with signal strengths of 4, 5, 6, 7, 8, and 9 out of 10 via adjustment of the focusing knob. The OCT parameters included in the analysis were thickness in the central 1 mm and in the different quadrants in the 3-mm area.Results: Overall 79 eyes of 42 patients with a mean age of 38.4±12.4 were included. There was no significant difference between the signal strength measurements obtained with different signal strengths in the central thickness (P=0.20). In the superior, nasal, inferior, and temporal quadrants, a signal strength of 8 demonstrated up to 3 µm thicker measurements than a signal strength of 5 (P

Ori Segal,1,2 Yael Segal-Trivitz,1,3 Arie Y Nemet,1,2 Noa Geffen,1,2 Ronit Nesher,1,2 Michael Mimouni4 1Department of Ophthalmology, Meir Medical Center, Kfar Saba, 2The Sackler School of Medicine, Tel Aviv University, Tel Aviv, 3Department of Psychiatry, Geha Psychiatric Hospital, Petah Tikva, 4Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel Purpose: The purpose of this study was to describe antivascular endothelial growth factor intravitreal injection techniques of retinal specialists in order to establish a cornerstone for future practice guidelines. Methods: All members of the Israeli Retina Society were contacted by email to complete an anonymous, 19-question, Internet-based survey regarding their intravitreal injection techniques. Results: Overall, 66% (52/79) completed the survey. Most (98%) do not instruct patients to discontinue anticoagulant therapy and 92% prescribe treatment for patients in the waiting room. Three quarters wear sterile gloves and prepare the patient in the supine position. A majority (71%) use sterile surgical draping. All respondents apply topical analgesics and a majority (69%) measure the distance from the limbus to the injection site. A minority (21%) displace the conjunctiva prior to injection. A majority of the survey participants use a 30-gauge needle and the most common quadrant for injection is superotemporal (33%). Less than half routinely assess postinjection optic nerve perfusion (44%). A majority (92%) apply prophylactic antibiotics immediately after the injection. Conclusion: The majority of retina specialists perform intravitreal injections similarly. However, a relatively large minority performs this procedure differently. Due to the extremely low percentage of complications, it seems as though such differences do not increase the risk. However, more evidence-based medicine, a cornerstone for practice guidelines, is required in order to identify the intravitreal injection techniques that combine safety and efficacy while causing as little discomfort to the patients as possible. Keywords: retina, intravitreal, injection, practices, techniques, patterns

Eyal Cohen,1,* Amir Zerach,1,* Michael Mimouni,2 Adiel Barak1 1Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 2Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel *These authors contributed equally to this work Background: Pneumatic retinopexy (PR) remains a popular technique for the treatment of rhegmatogenous retinal detachment (RRD). Objective: To evaluate the single operation and final success rate of PR for primary treatment of RRD and to determine factors associated with anatomical and visual outcomes. Methods: This retrospective case review study analyzed the data of patients who underwent PR for primary treatment of RRD. Patients with a follow-up period of

This paper introduces an induction machine-based flywheel energy storage system (FESS) for direct integration with a variable-speed wind generator (VSWG). The aim is to connect the FESS at the DC bus level of a permanent magnet synchronous generator-based VSWG in order to stabilize the DC bus voltage as well as the power flowing into the grid. A rotor flux-oriented control strategy is proposed for the FESS converter based on the actual speed of the flywheel rotor. Since mechanical speed sensors are prone to failure and increase the maintenance cost of the system, a sensorless technique is proposed to estimate the rotor speed through a specially synthesized high-gain observer (HGO). The proposed observer achieves accurate tracking of the flywheel speed and flux and reduces the adverse effects of variations in the rated rotor resistance. Simulation results obtained using the MATLAB-Simulink environment are presented to illustrate the theoretical synthesis and analysis of the proposed FOC and sensorless HGO control strategies. [ABSTRACT FROM AUTHOR]