Hacking away at the identity of indiscernibles: Possible worlds and Einstein's principle of equivalence

Journal of Philosophy 92 (9):455-466 (1995)
Purpose:Ultraviolet (UV) corneal cross-linking is an accepted method for the treatment of corneal ecstatic disorders. The authors evaluated whether a rapid treatment protocol (higher intensity and shorter irradiation time) could achieve the same increase in corneal stiffness as the currently-used standard protocol.Methods:Stress-strain measurements were performed on porcine corneal strips. The corneas (n=72) were cut into three strips, each randomly receiving a different treatment: rapid (10 mW/c(2), 9 minutes), standard (3 mW/c(2), 30 minutes) or no irradiation (control, 0 mW/c(2)). After irradiation, Young's modulus of each strip was determined. The results of the stress-strain measurements were analyzed statistically.Results:Statistical analysis showed that, after irradiation, the median value of Young's modulus from both active treatment groups (rapid: 3.83 N/m(2); standard: 3.88 N/m(2)) was significantly higher (p<0.05) than that of the control group (2.91 N/m(2)). Treatment increased Young's modulus by a factor of 1.3. However, there was no significant difference (p=0.43) in the median of Young's modulus between the rapid and standard groups.Conclusions:Rapid UV cross-linking treatment can be regarded as equivalent to the standard procedure in terms of increase in corneal stiffness. The new rapid protocol shortens the treatment duration by more than two-thirds, from 30 minutes to 9 minutes. The safety of the higher intensities has to be addressed in further clinical studies
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