論文 - 鳥居　秀成

Accuracy of recent intraocular lens power calculation methods in post-myopic LASIK eyes.

Gettinger K, Masui S, Omoto M, Torii H, Yotsukura E, Nishi Y, Ayaki M, Hayashi K, Negishi K

Scientific reports 14 （ 1 ） 26560 2024年11月

筆頭著者, 最終著者, 責任著者,  ISSN  2045-2322

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This retrospective study compared postoperative prediction errors of recent formulas using standard- or total keratometry (K or TK) for intraocular lens (IOL) power calculation in post-myopic LASIK patients. It included 56 eyes of 56 patients who underwent uncomplicated cataract surgery, with at least 1-month follow-up at Keio University Hospital in Tokyo or Hayashi Eye Hospital in Yokohama, Japan. Prediction errors, absolute errors, and percentage of eyes with prediction errors within ± 0.25 D, ± 0.50 D, and ± 1.00 D were calculated using nine formulas: Barrett True-K, Barrett True-K TK, Haigis-L, Haigis TK, Pearl-DGS, Hoffer QST, Hoffer QST PK, EVO K, and EVO PK. Statistical comparisons utilized Friedman test, Conover’s all-pairs post-hoc, Cochran’s Q, and McNemar post-hoc testing. Root-Mean-Square Error (RMSE) was compared with heteroscedastic testing. Barrett True-K TK had the lowest median predicted refractive error (-0.01). EVO PK had the smallest median absolute error (0.20). EVO PK had the highest percentage of eyes within ± 0.25 D of the predicted value (58.9%), significantly better than Haigis-L (p = 0.047). EVO PK had the lowest mean RMSE value (0.499). The EVO PK formula yielded the most accurate IOL power calculation in post-myopic LASIK eyes, with TK/PK values enhancing accuracy.

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Changes in cataract and refractive surgery practice patterns among JSCRS members over the past 20 years(タイトル和訳中)

Sato Masaki, Kamiya Kazutaka, Hayashi Ken, Tabuchi Hitoshi, Kojima Takashi, Goto Norihito, Hatsusaka Natsuko, Torii Hidemasa, Nagata Mayumi, Miyata Kazunori

Japanese Journal of Ophthalmology （シュプリンガー・ジャパン(株)）  68 （ 5 ） 443 - 462 2024年09月

筆頭著者, 最終著者, 責任著者,  ISSN  0021-5155

Slowing of Greater Axial Length Elongation Stemming from the Coronavirus Disease 2019 Pandemic with Increasing Time Outdoors: The Tokyo Myopia Study.

Yotsukura E, Torii H, Mori K, Ogawa M, Hanyuda A, Negishi K, Kurihara T, Tsubota K

Ophthalmology science 4 （ 5 ） 100491 2024年09月

筆頭著者, 最終著者, 責任著者,  ISSN  2666-9145

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Purpose: To investigate the changes in axial length (AL) elongation and other ocular parameters before and during the coronavirus disease 2019 pandemic. Design: A longitudinal school-based study. Participants: Public elementary schoolchildren in Tokyo (grades 1–6; age, 6–12 years) participated in this study from 2018 to 2021. Methods: All participants underwent eye examinations and provided written consent to measurements of the noncycloplegic refraction and ocular biometry including AL, among others. The students’ parents also completed a questionnaire about the students’ lifestyles. We included the right eye in our analysis and compared the changes in the ocular parameters among the periods using a linear mixed-effects model for repeated measures and examined the univariate and step-wise multiple regression analyses to evaluate the associations between myopia and other covariates. Main Outcome Measures: Changes in AL elongation and other ocular parameters from 2018 to 2019 (prepandemic), that of 2019 to 2020 (immediately after the pandemic onset), and that of 2020 to 2021 (during the pandemic). Results: A total of 578 students before the pandemic period, 432 immediately after the pandemic onset, and 457 during the pandemic period were evaluated. The changes in the ALs and spherical equivalents (SEs) a year before, immediately after onset, and during the pandemic were 0.31 mm/−0.20 diopter, 0.38 mm/−0.27 diopter, and 0.28 mm/−0.47 diopter, respectively (ALs, P < 0.001; SEs, P = 0.014). The results of the questionnaire showed that time spent outdoors daily had changed during the 3 years to 79, 63, and 77 minutes/day, respectively (P < 0.001). Time spent using smartphones or tablets increased year by year to 41, 52, and 62 minutes/day (P < 0.001). The greatest AL elongation occurred during the period when the shortest amount of time was spent outdoors during the 3 years. Conclusions: These results suggested that the school closures and decreasing time spent outdoors might have caused greater AL elongation among schoolchildren in Tokyo; however, it is possible that, although the time spent in near work still increased, the return to the time spent outdoors to the prepandemic levels may have affected the slowing of AL elongation after lockdown. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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Changes in cataract and refractive surgery practice patterns among JSCRS members over the past 20 years.

Sato M, Kamiya K, Hayashi K, Tabuchi H, Kojima T, Goto N, Hatsusaka N, Torii H, Nagata M, Miyata K, on the Data Analysis Committee of the Japanese Society of Cataract, Refractive Surgery

Japanese journal of ophthalmology 68 （ 5 ） 443 - 462 2024年09月

筆頭著者, 最終著者, 責任著者,  ISSN  0021-5155

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Purpose: To evaluate changes in cataract and refractive surgery practice patterns among members of the Japanese Society of Cataract and Refractive Surgery (JSCRS) over the past 20 years. Study design: Questionnaire survey study. Subjects and methods: Clinical surveys were conducted annually between February and April from 2004 to 2023. Survey questions covered various areas, including cataract surgical techniques, anesthesia, endophthalmitis prophylaxis, toric and presbyopia-correcting intraocular lenses (IOLs), complications, and refractive surgery. Results: The highest (n=554 [36.8%]) and lowest (n=316 [19.1%]) numbers of responses were collected in 2012 and 2016, respectively. In perioperative management, the intraoperative use of polyvinyl alcohol-iodine solution and topical antibiotic prescription 3 days before surgery has increased. The use of intracameral injection at the end of surgery has also significantly increased, although it has not been established as common practice. In anesthesia, there is a clear polarization between the use of topical drops and tenon injection. The use of toric IOLs and presbyopia-correcting IOLs has significantly increased from 2010 to 2023. In the latter, the use of trifocal IOLs has particularly increased. Regarding IOL power calculations, the Barrett True K and the Barrett Universal II formulas are rapidly gaining popularity for application with and without post-laser vision correction, respectively. In refractive surgery, phakic IOLs and corneal refractive therapy have attracted considerable interest, followed by laser in situ keratomileusis. Conclusions: Evaluation of annual clinical survey data over the past two decades provided valuable insights into the shifting practice patterns and clinical opinions among JSCRS members.

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Choroidal thinning in myopia is associated with axial elongation and severity of myopic maculopathy.

Midorikawa M, Mori K, Torii H, Tomita Y, Zhang Y, Tsubota K, Kurihara T, Negishi K

Scientific reports 14 （ 1 ） 17600 2024年07月

筆頭著者, 最終著者, 責任著者,  ISSN  2045-2322

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High myopia can lead to pathologic myopia and visual impairment, whereas its causes are unclear. We retrospectively researched high myopia cases from patient records to investigate the association between axial elongation and myopic maculopathy. Sixty-four eyes were examined in patients who visited the department between July 2017 and June 2018, had an axial length of 26 mm or more, underwent fundus photography, and had their axial length measured twice or more. The average axial length was 28.29 ± 1.69 mm (mean ± standard deviation). The average age was 58.3 ± 14.4 years old. Myopic maculopathy was categorized as mild (grades 0 and 1) and severe (grades 2, 3, and 4). The severe group had longer axial lengths than the mild group (P < 0.05). Moreover, the severe group exhibited thinner choroidal thickness than the mild group (P < 0.05). When subjects were grouped by axial elongation over median value within a year, the elongation group showed thinner central choroidal thickness than the non-elongation group (142.1 ± 91.9 vs. 82.9 ± 69.8, P < 0.05). In conclusion, in patients with high myopia, the severity of maculopathy correlated with choroidal thickness and axial length. Thinner choroidal thickness was associated with axial elongation based on the baseline axial length.

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To receive violet light indoors, human should look directly outdoors through an open window

Kondo, S; Torii, H; Jiang, X; Hou, J; Negishi, K; Kurihara, T; Tsubota, K

INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE 65 （ 7 ）  2024年06月

筆頭著者, 最終著者, 責任著者,  ISSN  0146-0404

Accuracy of intraocular lens power formulas in eyes with keratoconus: Multi-center study in Japan.

Yokogawa T, Mori Y, Torii H, Goto S, Hasegawa Y, Kojima T, Kamiya K, Shiba T, Miyata K

Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie 262 （ 6 ） 1839 - 1845 2024年06月

筆頭著者, 最終著者, 責任著者,  ISSN  0721-832X

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Purpose: To assess the accuracy of intraocular lens (IOL) power formulas, namely, SRK/T, Haigis, Barrett Universal II, Barrett True-K for keratoconus, Kane formula, and Kane formula for keratoconus, for cataract with keratoconus in Japanese eyes. Setting: Five surgical sites in Japan. Design: A retrospective case series. Methods: Eyes with keratoconus undergoing cataract surgery were included. Postoperative refraction was compared with the prediction by the formulas. Visual acuity, manifest spherical equivalent, prediction error (PE), and mean absolute errors (MAEs) were determined 1 month postoperatively. The PE within 0.50 diopter (D), 1.00 D, and 2.00 D were compared between IOL formulas. Subgroup analysis based on the steepest keratometry (stage 1, ≤ 48 D; stage 2, > 48 D and ≤ 53 D; and stage 3, > 53 D) was performed. The relationship between PE and preoperative biometric data were assessed. Results: Fifty eyes were included. The MAE of the Barrett True-K for keratoconus, Kane keratoconus, and Kane formulas were significantly lower than that of Haigis. A statistically significant difference in the prediction accuracy within ± 0.50 D was found between Kane keratoconus and Haigis. The prediction accuracy of the Barrett True-K for keratoconus, SRK/T, and Kane within ± 1.00 D was statistically significant compared with that of Haigis. In stage 3, the Barrett True-K for keratoconus had a significantly lower MAE than SRK/T and Haigis. Conclusion: Keratoconus-specific formulas were more accurate than existing formulas in Japanese eyes. The Barrett True-K formula for keratoconus had higher prediction accuracy in severe keratoconus.

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Myopia Is an Ischemic Eye Condition: A Review from the Perspective of Choroidal Blood Flow.

Baksh J, Lee D, Mori K, Zhang Y, Torii H, Jeong H, Hou J, Negishi K, Tsubota K, Kurihara T

Journal of clinical medicine 13 （ 10 ）  2024年05月

筆頭著者, 最終著者, 責任著者,  ISSN  2077-0383

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Myopia is a common refractive error that affects a large proportion of the population. Recent studies have revealed that alterations in choroidal thickness (ChT) and choroidal blood flow (ChBF) play important roles in the progression of myopia. Reduced ChBF could affect scleral cellular matrix remodeling, which leads to axial elongation and further myopia progression. As ChT and ChBF could be used as potential biomarkers for the progression of myopia, several recent myopia treatments have targeted alterations in ChT and ChBF. Our review provides a comprehensive overview of the recent literature review on the relationship between ChBF and myopia. We also highlight the importance of ChT and ChBF in the progression of myopia and the potential of ChT as an important biomarker for myopia progression. This summary has significant implications for the development of novel strategies for preventing and treating myopia.

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特集 屈折異常の進行評価 １　学童の近視進行

四倉 絵里沙, 鳥居 秀成

眼科 （金原出版）  66 （ 3 ） 217 - 227 2024年03月

筆頭著者, 最終著者, 責任著者,  ISSN  00164488

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A Possible Reciprocal Relationship Between Myopia and Dry Eye Disease in Japanese Teenagers.

Ibrahim OMA, Ayaki M, Yotsukura E, Torii H, Negishi K

Clinical ophthalmology (Auckland, N.Z.) 18   1991 - 1998 2024年

筆頭著者, 最終著者, 責任著者,  ISSN  1177-5467

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Purpose: To investigate the relationship between dry eye disease (DED) and myopia in Japanese teenagers. Methods: This clinic-based, retrospective, cross-sectional study assessed DED condition in 10-to 19-year-old teenagers presenting at Japanese eye clinics. They included 106 high myopic patients (HM; mean age, 16.4 ± 2.2 years), 494 mild myopic patients (15.0 ± 2.6 years) and 82 non-myopic teenagers (NM; 13.8 ± 2.6 years). Subjective refraction and anisometropia were measured. Myopia grade was classified as HM (≤ −6.00 D), MM (> −6.00 D, < −0.50 D), or NM (≥ −0.5 D). The presence of DED-related symptoms including dryness, irritation, pain, fatigue, blurring and photophobia were assessed through a questionnaire. Tear film break-up time (BUT) and fluorescein corneal staining were investigated. Comparison among three groups and regression analysis of myopic error and other variables were conducted. Results: Anisometropia and astigmatic error were greatest in the HM group compared with the other groups (p < 0.001). The HM group reported less photophobia (p < 0.001) and less pain (p = 0.039) compared with the NM group. Regression analysis revealed that myopic error was correlated with astigmatic error (β = −0.231, p <0.001), anisometropia (β = −0.191, p <0.001), short BUT (β = −0.086, p = 0.028) and the presence of diagnosed DED (β = −0.112, p = 0.003). Dryness (β = −0.127 p = 0.004), photophobia (β = 0.117, p = 0.002) and pain (β = 0.084, p = 0.034) correlated with myopic error. Conclusion: This study associated clinical findings of DED in HM teenagers. The present results suggest DED might be associated with myopia, possibly in a reciprocal relationship.

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Effect of Eyelid Hygiene on Functional Visual Acuity After Cataract Surgery: A Randomized Controlled Study.

Yokobori K, Ayaki M, Kawashima M, Torii H, Yotsukura E, Masui S, Negishi K

Clinical ophthalmology (Auckland, N.Z.) 18   1207 - 1216 2024年

筆頭著者, 最終著者, 責任著者,  ISSN  1177-5467

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Purpose: To evaluate the effect of eyelid hygiene after cataract surgery on eyelid and ocular surface findings, subjective symptoms and visual function, including functional visual acuity (FVA) and higher order aberration, in a randomized controlled study. Methods: Fifty patients who underwent cataract surgery at a single institution were involved. Twenty-five patients were instructed to wipe their eyelids twice a day from one to four weeks postoperatively, whereas the other 25 patients did not perform any eyelid hygiene. Optical measurement, FVA, meibomian glands, the grade of meibum, lid margin findings, fluorescein corneal staining findings, dry eye-related subjective symptoms and surgical satisfaction were assessed both preoperatively and one month postoperatively. Results: In the eyelid hygiene group, the visual maintenance ratio of FVA improved significantly (p = 0.048) and the higher order aberration of the 4th + 6th order deteriorated less (p = 0.027) compared with the control group. Multiple regression analyses showed that the change in visual maintenance ratio was associated with surgical satisfaction (p = 0.003), change in corneal staining score (p = 0.007), history of eye diseases (p = 0.029) and eyelid hygiene (p = 0.048). Conclusions: Eyelid hygiene after cataract surgery may be effective for visual function measured with an FVA test.

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Correction to: Vascular endothelial growth factor from retinal pigment epithelium is essential in choriocapillaris and axial length maintenance

Z Ma, X Jiang, H Torii, Y Kubota, K Negishi, T Kurihara, K Tsubota

PNAS 3, 1 2024年

筆頭著者, 最終著者, 責任著者

特集 知って得する白内障と屈折矯正の最新情報 トーリック眼内レンズの現状と課題

西 恭代, 鳥居 秀成

臨床眼科 （株式会社医学書院）  77 （ 13 ） 1549 - 1556 2023年12月

筆頭著者, 最終著者, 責任著者,  ISSN  03705579

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Implantation of a toric intraocular lens after repeated radial keratotomy procedures: A case report.

Chen SSW, Torii H, Yotsukura E, Nishi Y, Negishi K

Heliyon 9 （ 12 ） e22500 2023年12月

筆頭著者, 最終著者, 責任著者,  ISSN  2405-8440

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Corneal alterations due to radial keratotomy (RK) complicate intraocular lens calculations, which may explain why there have been few reports of toric intraocular lens (TIOL) implantation after excessive or multiple operations. A 71-year-old male with a history of repeated RKs and at least 30 corneal incisions in each eye was referred for cataract surgery. Preoperatively, the best-corrected distance visual acuity was 0.7 decimal (0.15 logMAR) in the right eye and 0.9 decimal (0.05 logMAR) in the left eye. The refractive errors were −8.00 −3.00 × 80 and −6.00 −3.50 × 80, respectively. The total corneal cylindrical powers (real power; anterior and posterior) were, respectively, −0.90 D and −3.60 D at 9 a.m., compared to −1.60 D and −3.80 D at 1 p.m. Corneal astigmatism in the left eye was considered symmetric and diurnally stable; therefore, an XY1AT6 TIOL (Hoya, Tokyo, Japan; cylindrical power at the plane, +3.75 D) was implanted. A non-toric intraocular lens, the XY1 (Hoya), was implanted in the right eye. Six-month postoperative best-corrected distance visual acuities were 1.2 decimal (−0.08 logMAR) and 1.0 decimal (0.00 logMAR) in the right and left eyes, respectively. Post-operative manifest refractions were +0.00 −3.00 × 70 and −1.00 −2.00 × 85, respectively. The TIOL reduced refractive astigmatism in the left eye; therefore, we believe that even after multiple RKs, the TIOL can be a suitable candidate to correct astigmatism if the corneal astigmatism is diurnally stable and symmetric.

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日本人の学童における0.01%アトロピン点眼剤中止後の近視リバウンドの評価(Assessment of myopic rebound effect after discontinuation of treatment with 0.01% atropine eye drops in Japanese school-age children)

Hieda Osamu, Hiraoka Takahiro, Fujikado Takashi, Ishiko Satoshi, Hasebe Satoshi, Torii Hidemasa, Takahashi Hiroshi, Tanaka Shiro, Kinoshita Shigeru

Japanese Journal of Ophthalmology （シュプリンガー・ジャパン(株)）  67 （ 5 ） 602 - 611 2023年09月

筆頭著者, 最終著者, 責任著者,  ISSN  0021-5155

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日本人の学童にみられる0.01%アトロピン点眼剤治療完遂後の近視進行の有無を検討した。近視を呈する小児167例を対象とした無作為化対照試験のデータを解析し、2年間のアトロピン点眼剤終了後1ヵ月、12ヵ月における等価球面度数(SE)と軸長を測定した。アトロピン投与群が84例(男児38例、女児46例、平均8.99±1.44歳)、プラセボ投与群が83例(男児35例、女児48例、平均9.00±1.49歳)であり、投与中止1ヵ月後の評価が可能であったのは計149例、12ヵ月後の評価が可能であったのは計51例であった。1ヵ月後におけるSEの最小2乗(LS)平均差は0.18D、軸長のLS平均差は-0.10mmであり、アトロピンによる近視進行抑制効果は維持されていた。12ヵ月後の評価では、SEのLS平均差は0.11Dとアトロピン群とプラセボ群との間に有意差はみられなかったが、軸長のLS平均差は-0.14mmを示しており有意差が認められた。アトロピン投与中止の12ヵ月後における軸延長はプラセボ投与群と比較して少なく、近視進行抑制効果が維持されているものと考えられた。

Assessment of myopic rebound effect after discontinuation of treatment with 0.01% atropine eye drops in Japanese school-age children.

Hieda O, Hiraoka T, Fujikado T, Ishiko S, Hasebe S, Torii H, Takahashi H, Tanaka S, Kinoshita S, ATOM-J Study Group

Japanese journal of ophthalmology 2023年08月

筆頭著者, 最終著者, 責任著者,  ISSN  0021-5155

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房水内代謝産物計測のためのレーザー透過機構とその安全性

栗原 俊英, 篠島 亜里, 木下 卓, 西崎 早織, 白川 佳則, 木村 翔, 李 徳鎬, 日高 悠葵, 西 恭代, 常吉 由佳里, 鳥居 秀成, 坪田 一男, 根岸 一乃

日本眼科学会雑誌 （(公財)日本眼科学会）  127 （ 7 ） 672 - 679 2023年07月

筆頭著者, 最終著者, 責任著者,  ISSN  0029-0203

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目的:房水内代謝産物を非侵襲的に測定するための足掛かりとして,可視光域のレーザー光を網膜側へ直接入らないように,前房内へ横向きに透過させる機構を構築すること.また,臨床的に房水透過レーザーのシグナル検出と安全性を検討すること.方法:光学シミュレータLightTools(Synopsys社)を用いて,角膜屈折率や非球面形状を考慮したヒトの眼球モデルを独自に作成し,光線追跡シミュレーションを行った.シミュレーションの結果をもとに測定装置を開発し,健常男性3名3眼(平均年齢28.3歳)を対象に,前房内の透過レーザー光を検出した.複数回測定し,断続的に6秒間27点で透過光を得た.結果:独自の眼球モデルで光線追跡のシミュレーションを実施したところ,空気・角膜間では安定した光路の確立がほとんど不可能で,房水に近い屈折率である生理食塩液で角膜周囲を満たす必要性を明らかにした.生理食塩液格納容器と光透過機構,研究対象者の顔を固定する独自の装置を開発し,臨床的に房水透過レーザー光シグナル(n=2,322)を得た.変動係数が0.15未満の累積相対度数は67%であり,変動係数の最頻値は最小階級の0～0.05であることから,システムとして妥当であると考えられた.また,研究対象者に有害事象は認められなかった.結論:本研究では,可視光域のレーザー光を前房内へ横向きに透過させ,非侵襲的にシグナルを概ね検出できた.また,first-in-human試験として安全性を確認でき,臨床応用の可能性を見出すことができた.(著者抄録)

Ginkgo biloba extracts improve choroidal circulation leading to suppression of myopia in mice.

Hou J, Mori K, Ikeda SI, Jeong H, Torii H, Negishi K, Kurihara T, Tsubota K

Scientific reports 13 （ 1 ） 3772 2023年03月

筆頭著者, 最終著者, 責任著者,  ISSN  2045-2322

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Suppressive effects of violet light transmission on myopia progression in a mouse model of lens-induced myopia.

Jeong H, Kurihara T, Jiang X, Kondo S, Ueno Y, Hayashi Y, Lee D, Ikeda SI, Mori K, Torii H, Negishi K, Tsubota K

Experimental eye research 228   109414 2023年03月

筆頭著者, 最終著者, 責任著者,  ISSN  0014-4835

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臨床：白内障手術関連3編

木澤 純也, 鳥居 秀成, 永田 万由美

日本白内障学会誌 （日本白内障学会）  35 （ 1 ） 94 - 95 2023年

筆頭著者, 最終著者, 責任著者,  ISSN  09154302

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