Color contrast perimetry.

A method for color perimetry is proposed in which colored test objects are presented in a white surround, so that the luminance of the object and its surround are identical. The color of the test object then may be varied in its degree of saturation, while maintaining a constant luminance. A color video instrument controlled by a microcomputer is used as a tangent screen. Foveally viewed, colored test objects are adjusted initially in luminance by heterochromatic flicker photometry to match the luminance of a white background at 100 apostilb. The relative foveal scotoma for blue light requires that test objects large enough to include the perifoveal retina be used for flicker photometry of blue test objects. Due to the progressively increasing threshold for luminance contrast detection in extrafoveal retina, differences in luminance between the colored objects and the white surrounding, as the test objects are moved into the extrafoveal visual field, appear to remain subthreshold. Test object detection can thus be expected to be a perimetric measure of color contrast detection, relatively unaffected by luminance contrast detection. This strategy should simplify the use of colored objects for clinical perimetric testing and should provide a specific test of color vision in the extrafoveal visual field.

Durability of prosthetic heart valves.

Accelerated fatigue testing of clinical heart valves has been performed at cyclic rates of 33 to 35 cycles per second at 37 degrees C using water for non-biological valves and glutaraldehyde solutions for tissue valves. Flows were in the physiological range, and the pressure difference across each valve during closure was 100 +/- 25 mm Hg. The results showed that major fatigue occurred for the Starr-Edwards 2320 at 150 million cycles, the Hufnagel trileaflet at 124 million cycles, the Björk-Shiley Delrin disc at 140, the Björk-Shiley Pyrolite disc at 973, the Beall 103 at 60, the Hancock porcine at 62, the Carpentier-Edwards porcine at 34, and the Ionescu-Shiley porcine pericardial prosthesis at 65 million cycles. The Lillehei-Kaster was removed after 762 million cycles without discernible wear. Three facts emerged from the testing data: (1) the component worn in vitro wears in vivo; (2) the sites of in vitro fatigue on the component are identical to clinical specimens; and (3) those valves that have high durability in vitro have given similar performance in patients. The in vitro and clinical data for tissue valves do not correlate. The possible reasons for the discrepancy are discussed, and a note of caution is made regarding realistic expectations of clinical durability of tissue valves.