Sidewall angle tuning in focused electron beam-induced processing.

Structures fabricated using focused electron beam-induced deposition (FEBID) have sloped sidewalls because of the very nature of the deposition process. For applications this is highly undesirable, especially when neighboring structures are interconnected. A new technique combining FEBID and focused electron beam-induced etching (FEBIE) has been developed to fabricate structures with vertical sidewalls. The sidewalls of carbon FEBID structures have been modified by etching with water and it is shown, using transmission electron microscopy imaging, that the sidewall angle can be tuned from outward to inward by controlling the etch position on the sidewall. A surprising under-etching due to the emission of secondary electrons from the deposit was observed, which was not indicated by a simple model based on etching. An analytical model was developed to include continued etching once the deposit has been removed at the exposed pixel. At this stage the secondary electrons from the substrate then cause the adsorbed water molecules to become effective in etching the deposit from below, resulting in under-etched structures. The evolution of the sidewall angle during etching has also been experimentally observed in a scanning electron microscope by continuously monitoring the secondary electron detector signal.

A new approach for fast field calculation in electrostatic electron lens design and optimization.

In electron optics, calculation of the electric field plays a major role in all computations and simulations. Accurate field calculation methods such as the finite element method (FEM), boundary element method and finite difference method, have been used for years. However, such methods are computationally very expensive and make the computer simulation challenging or even infeasible when trying to apply automated design of electrostatic lens systems with many free parameters. Hence, for years, electron optics scientists have been searching for a fast and accurate method of field calculation to tackle the aforementioned problem in the design and optimization of electrostatic electron lens systems. This paper presents a novel method for fast electric field calculation in electrostatic electron lens systems with reasonably high accuracy to enable the electron-optical designers to design and optimize an electrostatic lens system with many free parameters in a reasonably short time. The essence of the method is to express the off-axis potential in an axially symmetrical coordinate system in terms of derivatives of the axial potential up to the fourth order, and equate this to the potential of the electrode at that axial position. Doing this for a limited number of axial positions, we get a set of equations that can be solved to obtain the axial potential, necessary for calculating the lens properties. We name this method the fourth-order electrode method because we take the axial derivatives up to the fourth order. To solve the equations, a quintic spline approximation of the axial potential is calculated by solving three sets of linear equations simultaneously. The sets of equations are extracted from the Laplace equation and the fundamental equations that describe a quintic spline. The accuracy and speed of this method is compared with other field calculation methods, such as the FEM and second order electrode method (SOEM). The new field calculation method is implemented in design/optimization of electrostatic lens systems by using a genetic algorithm based optimization program for electrostatic lens systems developed by the authors. The effectiveness of this new field calculation method in optimizing optical parameters of electrostatic lens systems is compared with FEM and SOEM and the results are presented. It should be noted that the formulation is derived for general axis symmetrical electrostatic electron lens systems, however the examples shown in this paper are with cylindrical electrodes due to the simplicity of the implementation in the software.

Rebubbling and graft failure in Descemet membrane endothelial keratoplasty: a prospective Dutch registry study.

AIMS: To identify risk factors for rebubbling, and early graft failure after Descemet membrane endothelial keratoplasty (DMEK). METHODS: In this prospective registry study, all consecutive DMEK procedures registered in the Netherlands Organ Transplant Registry were assessed (n=752). Univariable and multivariable analysis was performed using logistic regression. The effect of rebubbling on endothelial cell density was analysed using a linear mixed model. RESULTS: 144 of 752 (19%) eyes underwent rebubbling. Rebubbling was successful in 101 eyes (70%). In eyes that underwent rebubbling, the graft failure rate was significantly higher than eyes that did not undergo rebubbling (30% vs 9%, respectively; OR: 4.28, 95% CI 2.72 to 6.73, p<0.001). In multivariable analysis, independent risk factors for rebubbling were surgical complication (OR: 2.28, 95% CI 1.20 to 4.33, p=0.012) and older recipient age (OR: 1.04 (per increase of 1 year), 95% CI 1.01 to 1.07, p=0.003). Risk factors for developing graft failure within 3 months were transplant before 2016 (OR: 3.32, 95% CI 1.87 to 5.90, p<0.001), and surgical complication (OR: 2.93, 95% CI 1.42 to 6.04, p=0.004). Throughout the study period, rebubbling and early graft failure were inversely related. Eyes that underwent rebubbling showed significantly lower endothelial cell densities at 3, 6 and 12 months compared with eyes that did not undergo rebubbling (all p<0.001). CONCLUSIONS: This Dutch registry study identified independent risk factors for DMEK graft detachment leading to rebubbling, namely recipient age and surgical complication, and early graft failure, namely transplantation before 2016 and surgical complication. Rebubbling was associated with significantly higher endothelial cell loss in the first year after surgery.

Imaging resonant micro-cantilever movement with ultrafast scanning electron microscopy.

Here, we demonstrate ultrafast scanning electron microscopy (SEM) for making ultrafast movies of mechanical oscillators at resonance with nanoscale spatiotemporal resolution. Locking the laser excitation pulse sequence to the electron probe pulses allows for video framerates over 50 MHz, well above the detector bandwidth, while maintaining the electron beam resolution and depth of focus. The pulsed laser excitation is tuned to the oscillator resonance with a pulse frequency modulation scheme. We use an atomic force microscope cantilever as a model resonator, for which we show ultrafast real-space imaging of the first and even the 2 MHz second harmonic oscillation as well as verification of power and frequency response via the ultrafast movies series. We detect oscillation amplitudes as small as 20 nm and as large as 9 µm. Our implementation of ultrafast SEM for visualizing nanoscale oscillatory dynamics adds temporal resolution to the domain of SEM, providing new avenues for the characterization and development of devices based on micro- and nanoscale resonant motion.

Interaction-Free Measurement with Electrons.

Here, we experimentally demonstrate interaction-free measurements with electrons using a novel electron Mach-Zehnder interferometer. The flexible two-grating electron interferometer is constructed in a conventional transmission electron microscope and achieves high contrast in discrete output detectors, tunable alignment with independently movable beam splitters, and scanning capabilities for imaging. With this path-separated electron interferometer, which closely matches theoretical expectations, we demonstrate electron interaction-free measurements with an efficiency of 14±1%. Implementing this quantum protocol in electron imaging opens a path toward interaction-free electron microscopy.

Electrostatic electron mirror in SEM for simultaneous imaging of top and bottom surfaces of a sample.

The use of electron mirrors in aberration correction and surface-sensitive microscopy techniques such as low-energy electron microscopy has been established. However, in this work, by implementing an easy to construct, fully electrostatic electron mirror system under a sample in a conventional scanning electron microscope (SEM), we present a new imaging scheme which allows us to form scanned images of the top and bottom surfaces of the sample simultaneously. We believe that this imaging scheme could be of great value to the field of in-situ SEM which has been limited to observation of dynamic changes such as crack propagation and other surface phenomena on one side of samples at a time. We analyze the image properties when using a flat versus a concave electron mirror system and discuss two different regimes of operation. In addition to in-situ SEM, we foresee that our imaging scheme could open up avenues towards spherical aberration correction by the use of electron mirrors in SEMs without the need for complex beam separators.

Trajectory displacement in a multi beam scanning electron microscope.

The analytical theory of statistical Coulomb interactions allows to determine the trajectory displacement in a single rotationally symmetrical beam with well-behaved spatial and angular particle distributions. This can be used to estimate the trajectory displacement in a multi-beam system using the so called fully-filled segment approximation. This approach predicts full compensation of trajectory displacement for a specific setup of the system. We show that this prediction is not consistent with Monte Carlo simulations and we develop a new approach to the calculation, showing that two independent trajectory displacement contributions are present in a multi-beam system. We support this calculation with Monte Carlo simulations as well as with experimental data from a multi-beam system.

Quality of vision and vision-related quality of life after Descemet membrane endothelial keratoplasty: a randomized clinical trial.

PURPOSE: To compare quality of vision and vision-related quality of life (QOL) in patients undergoing Descemet membrane endothelial keratoplasty (DMEK) or ultrathin Descemet stripping automated endothelial keratoplasty (DSAEK). METHODS: Fifty-four eyes of 54 patients with Fuchs' dystrophy from six corneal clinics in the Netherlands were randomized to DMEK or ultrathin DSAEK and examined preoperatively, and 3, 6 and 12 months postoperatively. Main outcome measures were corneal higher-order aberrations (HOAs), contrast sensitivity, straylight and vision-related QOL. RESULTS: Posterior corneal HOAs decreased after DMEK and increased after ultrathin DSAEK (p ≤ 0.001) 3 months after surgery and correlated positively with best spectacle-corrected visual acuity (12 months: r = 0.29, p = 0.04). Anterior and total corneal HOAs did not differ significantly between both techniques at any time point. Contrast sensitivity was better (p = 0.01), and straylight was lower (p = 0.01) 3 months after DMEK compared with ultrathin DSAEK; 95% confidence interval [CI] of log(cs) 1.10-1.35 versus 95% CI: 0.84 to 1.12, and 95% CI: log(s) 1.18 to 1.43 versus 95% CI: 1.41 to 1.66, respectively. Both were comparable at later time points. Vision-related QOL (scale 0-100) did not differ significantly between both groups at any time point and improved significantly at 3 months (ß = 12 [95% CI: 7 to 16]; p < 0.001), and subsequently between 3 and 12 months (ß = 5 [95% CI: 0 to 9]; p = 0.06). CONCLUSIONS: Descemet membrane endothelial keratoplasty (DMEK) results in lower posterior corneal HOAs compared with ultrathin DSAEK. Contrast sensitivity and straylight recover faster after DMEK but reach similar levels with both techniques at 1 year. Vision-related QOL improved significantly after surgery, but did not differ between both techniques.

Real-World Outcomes of DMEK: A Prospective Dutch registry study.

PURPOSE: This study analyzed real-world practice patterns, graft survival, and outcomes of Descemet membrane endothelial keratoplasty (DMEK) in the Netherlands. DESIGN: Population-based interventional clinical study. METHODS: In this prospective registry study, all consecutive primary DMEK procedures registered in the Netherlands Organ Transplant Registry were identified. Short-term graft survival and outcomes of primary transplants for Fuchs' endothelial dystrophy (FED) were analyzed using Kaplan-Meier survival curves with log-rank test and Cox regression. Linear mixed model analyses were used for best spectacle-corrected visual acuity (BSCVA), spherical equivalent, hyperopic shift, and endothelial cell density. RESULTS: 752 DMEKs were identified between 2011 and 2018. In 90% of cases, the indication for DMEK was FED. Graft survival measured 87% at 3 months, 85% at 6 months, 85% at 1 year, and 78% at 2 years. DMEK procedures after 2015 showed better survival compared to previous years (Hazard ratio = 0.4; P < .001). Baseline BSCVA in primary transplants with FED measured on average 0.45 logarithm of the minimum angle of resolution (logMAR) (95% confidence interval [CI], 0.41-0.49), and significantly improved (overall P < .001) to 0.17 logMAR (95% CI, 0.14-0.21) at 3 months, 0.15 logMAR (95% CI, 0.11-0.18) at 6 months, 0.12 logMAR (95% CI, 0.08-0.16) at 1 year, and 0.08 (95% CI, 0.05-0.12) at 2 years. At 3 months, a hyperopic shift of +0.36 diopters (P < .001) was observed and endothelial cell loss measured 33%. CONCLUSION: Our findings provide real-world support that DMEK is an effective treatment for FED with respect to vision restoration, inducing a small hyperopic shift with an acceptable endothelial cell loss. Graft survival improved over time, suggesting a learning curve on a national level.

Combined Focused Electron Beam-Induced Deposition and Etching for the Patterning of Dense Lines without Interconnecting Material.

High resolution dense lines patterned by focused electron beam-induced deposition (FEBID) have been demonstrated to be promising for lithography. One of the challenges is the presence of interconnecting material, which is often carbonaceous, between the lines as a result of the Gaussian line profile. We demonstrate the use of focused electron beam-induced etching (FEBIE) as a scanning electron microscope (SEM)-based direct-write technique for the removal of this interconnecting material, which can be implemented without removing the sample from the SEM for post processing. Secondary electron (SE) imaging has been used to monitor the FEBIE process, and atomic force microscopy (AFM) measurements confirm the fabrication of well separated FEBID lines. We further demonstrate the application of this technique for removing interconnecting material in high resolution dense lines using backscattered electron (BSE) imaging to monitor the process.

Lock-in Ultrafast Electron Microscopy Simultaneously Visualizes Carrier Recombination and Interface-Mediated Trapping.

Visualizing charge carrier flow over interfaces or near surfaces meets great challenges concerning resolution and vastly different time scales of bulk and surface dynamics. Ultrafast or four-dimensional scanning electron microscopy (USEM) using a laser pump electron probe scheme circumvents the optical diffraction limit, but disentangling surface-mediated trapping and ultrafast carrier dynamics in a single measurement scheme has not yet been demonstrated. Here, we present lock-in USEM, which simultaneously visualizes fast bulk recombination and slow trapping. As a proof of concept, we show that the surface termination on GaAs, i.e., Ga or As, profoundly influences ultrafast movies. We demonstrate the differences can be attributed to trapping-induced surface voltages of approximately 100-200 mV, which is further supported by secondary electron particle tracing calculations. The simultaneous visualization of both competing processes opens new perspectives for studying carrier transport in layered, nanostructured, and two-dimensional semiconductors, where carrier trapping constitutes a major bottleneck for device efficiency.

Transmission imaging on a scintillator in a scanning electron microscope.

Large area electron microscopy (EM) imaging has long been difficult due to fundamental limits in throughput for conventional electron microscopes. New developments in transmission electron microscopy and multi-beam scanning electron microscopy (MBSEM) imaging have however made it possible to generate large EM datasets [1,2,3]. This article describes a transmission imaging technique that is suitable for a MBSEM as it allows for a relatively straightforward way of separating the signals generated by each beam. The technique places a thin (50nm-200nm) tissue section directly on top of a coated scintillator. The electrons that are transmitted through the section generate light in the scintillator which is collected by a high NA objective and imaged onto a photon detector. This article gives a model for the contrast-to-noise (CNR) and signal-to-noise (SNR) ratio that is to be expected for this imaging technique. These parameters were calculated using Monte-Carlo simulations. It was found that the CNR increases when decreasing landing energy and SNR increases with increasing landing energy. These two trends cause that there is an intermediate energy where imaging performance is best. The energy of this optimum was calculated for various levels of heavy metal staining, section thickness, coating material, coating thickness and light collection efficiency. The model was verified experimentally on a synthetic sample.

Descemet Membrane Endothelial Keratoplasty versus Ultrathin Descemet Stripping Automated Endothelial Keratoplasty: A Multicenter Randomized Controlled Clinical Trial.

PURPOSE: To compare best spectacle-corrected visual acuity (BSCVA), endothelial cell density (ECD), refractive astigmatism, and complications after Descemet membrane endothelial keratoplasty (DMEK) and ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK). DESIGN: Prospective, multicenter randomized controlled trial. PARTICIPANTS: Fifty-four pseudophakic eyes of 54 patients with corneal endothelial dysfunction resulting from Fuchs endothelial corneal dystrophy were enrolled in 6 corneal centers in The Netherlands. METHODS: Participants were allocated to DMEK (n = 29) or UT-DSAEK (n = 25) using minimization randomization based on preoperative BSCVA, recipient central corneal thickness, gender, age, and institution. Donor corneas were prestripped and precut for DMEK and UT-DSAEK, respectively. Six corneal surgeons participated in this study. MAIN OUTCOME MEASURES: The primary outcome measure was BSCVA at 12 months after surgery. RESULTS: Central graft thickness of UT-DSAEK lamellae measured 101 µm (95% confidence interval [CI], 90-112 µm). Best spectacle-corrected visual acuity did not differ significantly between DMEK and UT-DSAEK groups at 3 months (0.15 logarithm of the minimum angle of resolution [logMAR] [95% CI 0.08-0.22 logMAR] vs. 0.22 logMAR [95% CI 0.16-0.27 logMAR]; P = 0.15), 6 months (0.11 logMAR [95% CI 0.05-0.17 logMAR] vs. 0.16 logMAR [95% CI 0.12-0.21 logMAR]; P = 0.20), and 12 months (0.08 logMAR [95% CI 0.03-0.14 logMAR] vs. 0.15 logMAR [95% CI 0.10-0.19 logMAR]; P = 0.06). Twelve months after surgery, the percentage of eyes reaching 20/25 Snellen BSCVA was higher in DMEK compared with UT-DSAEK (66% vs. 33%; P = 0.02). Endothelial cell density did not differ significantly 12 months after DMEK and UT-DSAEK (1870 cells/mm2 [95% CI 1670-2069 cells/mm2] vs. 1612 cells/mm2 [95% CI 1326-1898 cells/mm2]; P = 0.12). Both techniques induced a mild hyperopic shift (12 months: +0.22 diopter [D; 95% CI -0.23 to 0.68 D] for DMEK vs. +0.58 D [95% CI 0.13-1.03 D] for UT-DSAEK; P = 0.34). CONCLUSIONS: Descemet membrane endothelial keratoplasty and UT-DSAEK did not differ significantly in mean BSCVA, but the percentage of eyes achieving 20/25 Snellen vision was significantly higher with DMEK. Endothelial cell loss did not differ significantly between the treatment groups, and both techniques induced a minimal hyperopic shift.

Beam displacement and blur caused by fast electron beam deflection.

Electrostatic beam blankers are an alternative to photo-emission sources for generating pulsed electron beams for Time-resolved Cathodoluminescence and Ultrafast Electron Microscopy. While the properties of beam blankers have been extensively investigated in the past for applications in lithography, characteristics such as the influence of blanking on imaging resolution have not been fully addressed. We derive general analytical expressions for the spot displacement and loss in resolution induced by deflecting the electron beam in a blanker. In particular, we analyze the sensitivity of both measures to how precise the conjugate focus is aligned in between the deflector plates. We then work out the specific case of a beam blanker driven by a linear voltage ramp as was used in recent studies by others and by us. The result shows that the spot displacement and focus blur can be reduced to the same order as the electron beam probe size, even when using a beam blanker of millimeter or larger scale dimensions. An interesting result is that, by the right choice of the focus position in the deflector, either the spot displacement from the stationary position can be minimized, or the blur can be made zero but not both at the same time. Our results can be used both to characterize existing beam blanker setups and to design novel blankers. This can further develop the field of time-resolved electron microscopy by making it easier to generate pulses with a typical duration of tens of picoseconds in a regular scanning electron microscope at high spatial resolution.

Photoemission sources and beam blankers for ultrafast electron microscopy.

Observing atomic motions as they occur is the dream goal of ultrafast electron microscopy (UEM). Great progress has been made so far thanks to the efforts of many scientists in developing the photoemission sources and beam blankers needed to create short pulses of electrons for the UEM experiments. While details on these setups have typically been reported, a systematic overview of methods used to obtain a pulsed beam and a comparison of relevant source parameters have not yet been conducted. In this report, we outline the basic requirements and parameters that are important for UEM. Different types of imaging modes in UEM are analyzed and summarized. After reviewing and analyzing the different kinds of photoemission sources and beam blankers that have been reported in the literature, we estimate the reduced brightness for all the photoemission sources reviewed and compare this to the brightness in the continuous and blanked beams. As for the problem of pulse broadening caused by the repulsive forces between electrons, four main methods available to mitigate the dispersion are summarized. We anticipate that the analysis and conclusions provided in this manuscript will be instructive for designing an UEM setup and could thus push the further development of UEM.

Estimating Step Heights from Top-Down SEM Images.

Scanning electron microscopy (SEM) is one of the most common inspection methods in the semiconductor industry and in research labs. To extract the height of structures using SEM images, various techniques have been used, such as tilting a sample, or modifying the SEM tool with extra sources and/or detectors. However, none of these techniques focused on extraction of height information directly from top-down images. In this work, using Monte Carlo simulations, we studied the relation between step height and the emission of secondary electrons (SEs) resulting from exposure with primary electrons at different energies. It is found that part of the SE signal, when scanning over a step edge, is determined by the step height rather than the geometry of the step edge. We present a way to quantify this, arriving at a method to determine the height of structures from top-down SEM images. The method is demonstrated on three different samples using two different SEM tools, and atomic force microscopy is used to measure the step height of the samples. The results obtained are in qualitative agreement with the results from the Monte Carlo simulations.

Trial-based cost-effectiveness analysis of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) versus DSAEK.

PURPOSE: To evaluate the cost-effectiveness of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) versus standard DSAEK. METHODS: A cost-effectiveness analysis using data from a multicentre randomized clinical trial was performed. The time horizon was 12 months postoperatively. Sixty-four eyes of 64 patients with Fuchs' endothelial dystrophy were included and randomized to UT-DSAEK (n = 33) or DSAEK (n = 31). Relevant resources from healthcare and societal perspectives were included in the cost analysis. Quality-adjusted life years (QALYs) were determined using the Health Utilities Index Mark 3 questionnaire. The main outcome was the incremental cost-effectiveness ratio (ICER; incremental societal costs per QALY). RESULTS: Societal costs were €9431 (US$11 586) for UT-DSAEK and €9110 (US$11 192) for DSAEK. Quality-adjusted life years (QALYs) were 0.74 in both groups. The ICER indicated inferiority of UT-DSAEK. The cost-effectiveness probability ranged from 37% to 42%, assuming the maximum acceptable ICER ranged from €2500-€80 000 (US$3071-US$98 280) per QALY. Additional analyses were performed omitting one UT-DSAEK patient who required a regraft [ICER €9057 (US$11 127) per QALY, cost-effectiveness probability: 44-62%] and correcting QALYs for an imbalance in baseline utilities [ICER €23 827 (US$29 271) per QALY, cost-effectiveness probability: 36-59%]. Furthermore, the ICER was €2101 (US$2581) per patient with clinical improvement in best spectacle-corrected visual acuity (≥0.2 logMAR) and €3274 (US$4022) per patient with clinical improvement in National Eye Institute Visual Functioning Questionnaire-25 composite score (≥10 points). CONCLUSION: The base case analysis favoured DSAEK, since costs of UT-DSAEK were higher while QALYs were comparable. However, additional analyses revealed no preference for UT-DSAEK or DSAEK. Further cost-effectiveness studies are required to reduce uncertainty.

Design and simulation of a linear electron cavity for quantum electron microscopy.

Quantum electron microscopy (QEM) is a measurement approach that could reduce sample radiation damage, which represents the main obstacle to sub-nanometer direct imaging of molecules in conventional electron microscopes. This method is based on the exploitation of interaction-free measurements in an electron resonator. In this work, we present the design of a linear resonant electron cavity, which is at the core of QEM. We assess its stability and optical properties during resonance using ray-tracing electron optical simulations. Moreover, we analyze the issue of spherical aberrations inside the cavity and we propose and verify through simulation two possible approaches to the problem. Finally, we discuss some of the important design parameters and constraints, such as conservation of temporal coherence and effect of alignment fields.

Long-term Outcomes of Repeated Corneal Transplantations: A Prospective Dutch Registry Study.

PURPOSE: To compare long-term outcomes of repeated corneal transplantations (CT), based on primary indication (Fuchs endothelial dystrophy [FED] vs pseudophakic bullous keratoplasty [PBK]), surgical technique (penetrating keratoplasty [PK] vs endothelial keratoplasty [EK]), and indication for repeated grafting. METHODS: In this nonrandomized treatment comparison with national registry data (Netherlands Organ Transplantation Registry, NOTR), data on all consecutive repeated CT following primary PK or EK for FED and PBK between 1994 and 2015 were analyzed, with a maximal follow-up of 5 years. Regraft survival was analyzed using Kaplan-Meier survival curves and univariable and multivariable Cox regression analysis. Secondary outcomes best-corrected visual acuity, spherical equivalent, and refractive astigmatism were compared using linear mixed-model analysis. RESULTS: A total of 332 repeated CT were analyzed. The number of regrafts increased significantly between 2007 and 2015 (P = .001). Overall 5-year regraft survival was 60% and was higher for FED vs PBK (77% vs 45%, HR = 0.40, P = .001), and re-EK vs re-PK (81% vs 55%, HR = 0.51, P = .041). However, multivariable analysis showed no significant difference in survival based on primary indication, surgical technique, and indication for regrafting. Corrected for baseline, secondary outcomes also did not differ between groups. CONCLUSIONS: We found a significant increase in repeated CT, coinciding with the introduction of EK in the Netherlands. While univariable analysis suggested better overall regraft survival for FED and (re-)EK, multivariable analysis showed no such difference. This may be owing to allocation of favorable cases to undergo (re-)EK. Similarly, secondary outcomes were determined by the primary CT technique.