Details of a Researcher - Torii, Hidemasa

Papers - Torii, Hidemasa

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Ray tracing software for intraocular lens power calculation after corneal excimer laser surgery

Saiki Megumi, Negishi Kazuno, Kato Naoko, Torii Hidemasa, Dogru Murat, Tsubota Kazuo

Japanese Journal of Ophthalmology (Japanese Journal of Ophthalmology) 58 ( 3 ) 276 - 281 2014

ISSN 0021-5155

Purpose: To evaluate the accuracy of intraocular lens (IOL) power calculations using ray tracing software in eyes after myopic laser in situ keratomileusis (LASIK). Methods: Twenty-four eyes of 17 cataract patients who underwent phacoemulsification and IOL implantation after myopic LASIK were analyzed retrospectively. The IOL power calculation was performed using OKULIX ray tracing software. The axial length was measured using the IOLMaster and keratometry data using TMS2N. The accuracy of the IOL power calculation using OKULIX was compared with those using the Camellin-Calossi, Shammas-PL, Haigis-L formulas and the double-K SRK/T formula using 43.5 diopters (D) for the Kpre. Results: The mean values of the arithmetic and absolute prediction errors were 0.63 ± 0.85 and 0.80 ± 0.68 D, respectively. The arithmetic prediction error by OKULIX was a significant hyperopic shift of the distribution of the postoperative refractive errors compared to the Camellin-Calossi, Shammas-PL and Haigis-L formulas (P < 0.05), and the absolute prediction error showed no significant difference with other formulas. The prediction errors using OKULIX were within ±0.5 D in 10 eyes (41.7 %) and within ±1.0 D in 18 eyes (75.0 %). The percentages of eyes within ±1.0 D using OKULIX were comparable to those obtained using the Camellin-Calossi, the Shammas-PL formulas and the double-K SRK/T formula using 43.5 D for the Kpre, and significantly (P < 0.05) higher than that obtained using the Haigis-L formula. Conclusions: IOL power calculations using OKULIX provided predictable outcomes in eyes that had undergone a previous myopic LASIK. © 2014 Japanese Ophthalmological Society.

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Clinical results of toric intraocular lens implantation for cataract with high astigmatism

Tominaga Takashi, Torii Hidemasa, Watanabe Kazuhiro, Shimizu Tsutomu, Saiki Megumi, Negishi Kazuno, Tsubota Kazuo

Japanese Journal of Clinical Ophthalmology (Japanese Journal of Clinical Ophthalmology) 68 ( 9 ) 1279 - 1283 2014

ISSN 0370-5579

Purpose: To evaluate the postoperative outcome of toric intraocular lens (TIOL) implantation for cataract patients with high corneal astigmatism. Methods: This retrospective study included 24 eyes of 22 patients with high corneal astigmatism exceeded-1.50 D who underwent cataract surgery and implantation of TIOL (SN6AT6:12 eyes, SN6AT7:8 eyes, SN6AT8:3 eyes, SN6AT9:1 eye). The mean age of all cases was 68.1 years. Visual acuity, corneal astigmatism, subjective refraction, and rotation error were recorded preoperatively and 1 month postoperatively. Results: The uncorrected and correted distance visual acuities and subjective refraction were significantly (p<0.001) improved after TIOL implantation. There was no significant difference in corneal astigmatism between preoperatively and postoperatively. The mean rotation error was 2.8°. Conclusion: TIOL was effective for cataract patients with high corneal astigmatism.

Myopic regression after phakic intraocular lens implantation and LASIK

Torii Hidemasa, Negishi Kazuno, Watanabe Kazuhiro, Arai Hiroyuki, Kato Naoko, Tsubota Kazuo

Optometry and Vision Science (Optometry and Vision Science) 91 ( 2 ) 231 - 239 2014.02

ISSN 1040-5488

PURPOSE: In myopia, biometry including the axial length is important, along with the refractive data. We compared the rates of myopic regression 3 years after phakic intraocular lens (pIOL) implantation and laser in situ keratomileusis (LASIK) after matching the preoperative axial length in highly myopic eyes of Japanese patients. METHODS: This retrospective nonrandomized study included 133 eyes of 84 patients with myopia exceeding -6.00 diopters (D) who underwent implantation of two iris-fixated pIOLs (pIOL group, 66 eyes/46 patients) or myopic LASIK (LASIK group, 67 eyes/38 patients) who were followed for more than 3 years postoperatively. The patient age, preoperative refraction, and preoperative axial length were matched between the study groups. RESULTS: There were no significant differences preoperatively between the groups in age, intraocular pressure, refraction, keratometry, or axial length. The mean regression values after 3 years compared with the 1-month postoperative refractions were -0.12 ± 0.47 (SD) D in the pIOL group and -0.82 ± 0.69 D in the LASIK group (p < 0.001). The differences in the mean regression rates between 1 and 12 months, 12 and 24 months, and 24 and 36 months of follow-up were, respectively, 0.09 ± 0.38 D, -0.11 ± 0.35 D, and -0.11 ± 0.30 D in the pIOL group and -0.57 ± 0.84 D, -0.24 ± 0.47 D, and 0.00 ± 0.53 D in the LASIK group (p < 0.001, p = 0.07, p = 0.15, respectively). CONCLUSIONS: There was a significant difference in myopic regression 3 years postoperatively between the groups matched for preoperative axial length in Japanese patients. This result has the potential to elucidate myopia in the future. Copyright © 2014 American Academy of Optometry.

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Secondary implantation of piggyback intraocular lens for residual refractive error after cataract surgery

Kobayashi Fumitaka, Torii Hidemasa, Negishi Kazuno, Watanabe Kazuhiro, Saiki Megumi, Tsubota Kazuo

Japanese Journal of Clinical Ophthalmology (Japanese Journal of Clinical Ophthalmology) 67 ( 10 ) 1679 - 1684 2013.10

ISSN 0370-5579

Purpose: To report a case who received implantation of piggyback intraocular lens (IOL) for residual refractive error after cataract surgery. Case: A 70-year-old man presented to our clinic complaining of decreased visual acuity in his both eyes. Both eyes had received radial keratotomy 23 years before and photorefractive keratectomy 12 years before. Findings: Visual acuity was 0.5 right and 0.4 left without correction, and 0.9 right and 1.0 left with correction. Under diagnosis of age-related cataract, both eyes received phacoemulsification-aspiration with IOL implantation. Visual acuity was 0.5 in either eye without correction and 1.2 right and 1.0 left with correction one year later. The left eye had refraction of +3.00D()cyl-2.00D 65°. By request of the patient, monofocal piggyback IOL was implanted into the left eye. Six months after surgery, left visual acuity was 0.63 without and 1.0 with correction. There has been no complication throughout. Conclusion: Implantation of piggyback IOL can be a therapeutic option for residual refractive error after cataract surgery.

Changes in higher-order aberrations after iris-fixated phakic intraocular lens implantation

Torii Hidemasa, Negishi Kazuno, Watanabe Kazuhiro, Saiki Megumi, Kato Naoko, Tsubota Kazuo

Journal of Refractive Surgery (Journal of Refractive Surgery) 29 ( 10 ) 693 - 700 2013.10

ISSN 1081-597X

PURPOSE: To evaluate surgically induced changes in corneal, internal, and ocular higher-order aberrations (HOAs) after phakic intraocular lens (PIOL) implantation and compare them between two PIOLs with different pupillary diameters. METHODS: Twenty-three eyes with an Artisan PIOL (Ophtec BV, Groningen, The Netherlands) (Artisan group) and 30 eyes with an Artiflex PIOL (Ophtec BV) (Artiflex group) were retrospectively evaluated. The corneal, internal, and ocular HOAs and refractive data were recorded preoperatively and 6 months postoperatively. The root mean squares (RMSs) of the total HOAs from the third- to sixth-order Zernike coefficients were calculated. The RMSs of the third- and fourth-order coefficients represented coma-like aberrations (S3) and spherical-like aberrations (S4), respectively. The main outcome measures were the differences in the parameters among the groups with different pupillary diameters. RESULTS: The mean postoperative spherical equivalents decreased from -11.84 ± 4.90 to -0.16 ± 0.40 diopters and -9.78 ± 3.20 to -0.09 ± 0.26 diopters in the Artisan and Artiflex groups, respectively. With the 4- and 5-mm pupillary diameters, the postoperative internal and ocular spherical aberrations (Z₄⁰) were significantly lower in the Artiflex group than in the Artisan group (4 mm, P = .002, .024; 5 mm, P = .004, .022, respectively). With the 6-mm pupillary diameter, there were no significant postoperative differences in any parameter measured between groups; both groups had positive spherical aberration values. CONCLUSIONS: The postoperative ocular spherical aberrations were positive after Artisan and Artiflex implantation. The postoperative ocular spherical aberration was greater in the Artisan group, possibly due to differences in the SAs of both PIOLs. Copyright © SLACK Incorporated.

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A new central - Peripheral corneal curvature method for intraocular lens power calculation after excimer laser refractive surgery

Saiki Megumi, Negishi Kazuno, Kato Naoko, Arai Hiroyuki, Toda Ikuko, Torii Hidemasa, Dogru Murat, Tsubota Kazuo

Acta Ophthalmologica (Acta Ophthalmologica) 91 ( 2 ) e133 - e139 2013.03

ISSN 1755-375X

Purpose: To propose the central-peripheral (C-P) method, which requires no data history to calculate intraocular lens (IOL) powers for eyes that underwent laser in situ keratomileusis (LASIK), and compare the accuracy of the C-P method with other IOL formulas for eyes after LASIK. Methods: Sixteen patients with cataract (25 eyes) who underwent myopic LASIK were analysed retrospectively. The C-P method is a modified double-K method using the SRK/T formula, in which the estimated pre-LASIK keratometric power calculated from the post-LASIK peripheral anterior sagittal power (also called the axial power) is used for the Kpre in the double-K method using the SRK/T formula, and the post-LASIK anterior sagittal power is used for the Kpost. We compared the accuracy of the C-P method with other popular IOL calculation formulas for use in eyes after LASIK. Results: The median values of the arithmetic and absolute prediction errors with the C-P method were 0.11 diopter (D) (range, -1.67 to 1.97 D) and 0.55 D (range, 0.02-1.97 D), respectively. The prediction error using the C-P method was within ±0.5 D in 48% of eyes, within -1.0 to +0.5 D in 60% of eyes, and within ±1.0 D in 68% of eyes. The C-P method resulted in a significantly higher percentage of eyes within ±0.5 D than the BESSt formula, Shammas-PL formula, true net power method, double-K method using 43.5 D for Kpre, and Feiz-Mannis method. Conclusion: The C-P method may be a good option for calculating IOL powers in eyes undergoing cataract surgery after LASIK when the preoperative LASIK data are unavailable. © 2013 The Authors Acta Ophthalmologica © 2013 Acta Ophthalmologica Scandinavica Foundation.

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A case of impaired vision due to glistening and whitening of hydrophobic acrylic intraocular lens

Hidaka Yuki, Negishi Kazuno, Matsushima Hiroyuki, Torii Hidemasa, Saiki Megumi, Watanabe Kazuhiro, Inafuku Saori, Tsubota Kazuo

Japanese Journal of Clinical Ophthalmology (Japanese Journal of Clinical Ophthalmology) 67 ( 2 ) 199 - 202 2013.02

ISSN 0370-5579

To report a case who received exchange of intraocular lens (IOP) for impaired vision due to glistening and whitening. Case: A 78-year-old woman presented with impaired vision in her right eye. She had received cataract surgery with implantation of IOL 6 years before. She had had reportedly visual acuity of 0.8 immediately after surgery. Findings: Corrected visual acuity was 0.4 in the right eye. Slitlamp examination showed glistening and whitening of IOP. Funduscopy showed slight chorioretinal atrophy which was the same as immediately after surgery. She received exchange of IOL resulting in corrected visual acuity of 0.8. Conclusion: This case illustrates that glistening and whitening of IOL may result in impaired visual function. Exchange of IOL may be useful in such a situation.

Effect of pupil size on uncorrected visual acuity in pseudophakic eyes with astigmatism

Watanabe Kazuhiro, Negishi Kazuno, Dogru Murat, Yamaguchi Takefumi, Torii Hidemasa, Tsubota Kazuo

Journal of Refractive Surgery (Journal of Refractive Surgery) 29 ( 1 ) 25 - 29 2013.01

ISSN 1081-597X

PURPOSE: To study the effect of pupil size on the relationship between refractive astigmatism and uncorrected distance visual acuity (UDVA) and pseudoaccommodation in pseudophakic eyes. METHODS: Thirty-six eyes from 36 patients who underwent phacoemulsifi cation and intraocular lens (IOL) implantation were included. All eyes were divided into two groups based on the presence of postoperative with-therule astigmatism or against-the-rule astigmatism. Uncorrected and corrected distance visual acuity (CDVA), refractive astigmatism, subjective accommodation amplitude, and pupil sizes under photopic and mesopic conditions were measured 1 month postoperatively. The effects of pupil size on the relationship between refractive astigmatism and UDVA were investigated. RESULTS: Against-the-rule astigmatism had a moderate but signifi cant negative linear correlation with UDVA irrespective of the pupil size (R²=0.60, P<.01). A moderate but signifi cant negative linear correlation was found when the pupil diameter exceeded 2.9 mm in eyes with with-the-rule astigmatism (R²=0.46, P=.04). Refractive astigmatism was not signifi cantly correlated with pseudoaccommodation regardless of the pupil diameter in either group. CONCLUSIONS: The results of the current study suggest that pupil size may have an impact on postoperative UDVA in eyes having against the-rule astigmatism and in eyes with a large pupil diameter and with-the-rule astigmatism. Copyright © SLACK Incorporated.

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Effect of experimentally induced astigmatism on functional, conventional, and low-contrast visual acuity

Watanabe Kazuhiro, Negishi Kazuno, Kawai Miho, Torii Hidemasa, Kaido Minako, Tsubota Kazuo

Journal of Refractive Surgery (Journal of Refractive Surgery) 29 ( 1 ) 19 - 24 2013.01

ISSN 1081-597X

PURPOSE: To report the changes in functional visual acuity (FVA) in eyes with experimentally induced astigmatism. METHODS: This study included 26 right eyes from 26 healthy participants (mean age: 27.0±4.4 years). After confi rming best correction under cycloplegia, the cylinder power ×90° and ×180° (against-the-rule [ATR] and with-the-rule [WTR] astigmatism, respectively) were added with 0.50-diopter (D) steps, from 0.50 to 2.50 D. Conventional visual acuity (VA), FVA as measured by the FVA Measurement System (NIDEK Co Ltd), and 10% low-contrast visual acuity (LCVA) were measured with 3-mm artifi cial pupil under each condition. RESULTS: The mean corrected logMAR VA, FVA, LCVA were -0.18±0.00 (20/13), -0.10±0.08 (20/16), and 0.06±0.06 (20/23), respectively. The VA, FVA, and LCVA had a signifi cant linear negative correlation with the addition of cylinder irrespective of the axes. A significant decrease in FVA was noted on addition of ≥0.50 D WTR astigmatism and ≥1.00 D ATR astigmatism. With the addition of 1.00 D of cylindrical lens, 96% of eyes with WTR and ATR astigmatism could maintain 20/20 in VA testing, whereas only 50% and 62% of eyes with WTR and ATR astigmatism, respectively, could maintain 20/20 in FVA testing. CONCLUSIONS: Astigmatism may be associated with deterioration of visual function even when conventional VA of 20/20 is attained. Functional VA testing seems to be useful in evaluating the masked astigmatic visual impairment that cannot be detected by conventional VA testing. Copyright © SLACK Incorporated.

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Simple and accurate alignment of toric intraocular lenses and evaluation of their rotation errors using anterior segment optical coherence tomography

Watanabe Kazuhiro, Negishi Kazuno, Torii Hidemasa, Saiki Megumi, Dogru Murat, Tsubota Kazuo

Japanese Journal of Ophthalmology (Japanese Journal of Ophthalmology) 56 ( 1 ) 31 - 37 2012.01

ISSN 0021-5155

Purpose: To describe a new method of alignment of toric intraocular lenses (IOLs) and evaluation of their rotation errors using anterior segment optical coherence tomography (AS-OCT). Methods: Twenty-nine eyes of 22 patients who had cataract extraction and implantation of an acrylic toric IOL were included. The new AS-OCT method was used for the alignment of toric IOLs and evaluation of their rotation errors. These rotation errors were evaluated and compared with those measured using the internal map of a wavefront aberrometer. Results: The mean rotation error ± standard deviation (SD) of the toric IOLs evaluated by AS-OCT was 3.2 ± 2.2° and 3.2 ± 2.4° at 1 week and 1 month after surgery, respectively. The mean difference in the reference axis between the visits was 1.8 ± 2.1°. The mean difference between the rotation errors of the alignment axes measured by AS-OCT and the internal map was 2.5 ± 1.9° (P = 0.037). Conclusion: The current method is clinically useful not only for the accurate alignment of toric IOLs but also for evaluating their rotation errors. © Japanese Ophthalmological Society 2011.

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Inflammation after phakic implants

Torii Hidemasa, Negishi Kazuno, Dogru Murat, Saiki Megumi, Yamaguchi Takefumi, Watanabe Kazuhiro, Kato Naoko, Tsubota Kazuo

Ophthalmology 118 ( 12 ) 2011.12

ISSN 0161-6420

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Implantation of multifocal intraocular lens in two cases after LASIK

Shirahata Reiko, Negishi Kazuno, Torii Hidemasa, Dogru Murat, Tsubota Kazuo

Japanese Journal of Clinical Ophthalmology (Japanese Journal of Clinical Ophthalmology) 64 ( 6 ) 881 - 884 2010.06

ISSN 0370-5579

Purpose : To report two cases who had received LASIK previously and who underwent cataract surgery with implantation of multifocal intraocular lens (IOL). Cases and Findings : Both were males aged 47 and 55 years respectively. LASIK had been performed 6 years and 2 years before respectively. Both cases were diagnosed with cataract in the right eye. Corrected visual acuity was 1.2 and 0.7 respectively. The affected eye was treated by cataract surgery and implantation of diffractive multifocal IOL. After surgery, near and far visual acuity with the naked eye was 1.2 and 1.0 in one case and 1.0 each in the other. Both patients expressed satisfaction with the outcome. Contrast sensitivity was at the lower limit of normal range in both cases. Conclusion : These two cases illustrate that refractive error and impaired visual function may result following implantation of multifocal IOL after LASIK. We advocate due explanation to obtain informed consent in such cases.

Predictability of ocular spherical aberration after cataract surgery determined using preoperative corneal spherical aberration

Negishi Kazuno, Kodama Chiyo, Yamaguchi Takefumi, Torii Hidemasa, Saiki Megumi, Dogru Murat, Ohnuma Kazuhiko, Tsubota Kazuo

Journal of Cataract and Refractive Surgery (Journal of Cataract and Refractive Surgery) 36 ( 5 ) 756 - 761 2010.05

ISSN 0886-3350

Purpose: To evaluate the predictability of total postoperative spherical aberration after aspheric intraocular lens (IOL) implantation using preoperative corneal spherical aberration. Setting: Keio University Hospital, Tokyo, Japan. Methods: Corneal and ocular higher-order aberrations (HOAs) were analyzed preoperatively and postoperatively in eyes having cataract extraction with aspheric IOL implantation. The predicted postoperative total spherical aberration Z(4,0) was calculated by adding the preoperative corneal spherical aberration and the labeled spherical aberration of the IOL. The prediction error of the postoperative total spherical aberration was calculated by subtracting the predicted postoperative total spherical aberration from the postoperative total spherical aberration. Surgically induced corneal spherical aberration was calculated by subtracting the postoperative from the preoperative corneal spherical aberration. Results: There were no statistically significant differences between preoperative and postoperative corneal spherical aberration, 3rd-order aberration, or HOAs. The prediction error of the postoperative total spherical aberration was within ±0.05 μm in 9 (24.3%) of the 37 eyes evaluated and within ±0.10 μm in 18 eyes (48.6%). Statistically significantly correlations were found between the surgically induced corneal spherical aberration and prediction error of postoperative total spherical aberration, the preoperative corneal spherical aberration and surgically induced corneal spherical aberration, and the preoperative corneal spherical aberration and prediction error of postoperative total spherical aberration. Conclusions: Predictability of postoperative ocular spherical aberration after cataract surgery with aspheric IOL implantation was insufficient because of the surgically induced corneal spherical aberration. Considering surgically induced corneal spherical aberration could improve the predictability of postoperative ocular spherical aberration. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2010 ASCRS and ESCRS.

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Replacement of multifocal by monofocal intraocular lens in two cases for asthenopia and photophobia

Torii Hidemasa, Negishi Kazuno, Dogru Murato, Tsubota Kazuo

Japanese Journal of Clinical Ophthalmology (Japanese Journal of Clinical Ophthalmology) 64 ( 4 ) 459 - 463 2010.04

ISSN 0370-5579

Purpose : To report two cases who received replacement of multifocal intraocular lens (IOL) by monofocal IOL due to postoperative dissatisfaction. Cases : A 75-year-old male received bilateral cataract surgery with implantation of diffractive multifocal IOL. Asthenopia and photophobia became worse after surgery. In accordance to his wish, the multifocal IOL was replaced by monofocal IOL 4 months later. His subjective complaints persisted but improved after treatment for essential blepharospasm. Another 52-year-old female received similar bilateral cataract surgery with implantation of refractive multifocal IOL. The lens was replaced by monofocal one due to photophobia 4 months later. Her subjective complaints persisted. Conclusion : These cases illustrate that replacement of multifocal by monofocal IOL due to dissatisfaction of patients need careful considerations.

Feasibility of spherical aberration correction with aspheric intraocular lenses in cataract surgery based on individual pupil diameter

Yamaguchi Takefumi, Negishi Kazuno, Ono Takeshi, Torii Hidemasa, Dogru Murat, Yamaguchi Kazuko, Ohnuma Kazuhiko, Tsubota Kazuo

Journal of Cataract and Refractive Surgery (Journal of Cataract and Refractive Surgery) 35 ( 10 ) 1725 - 1733 2009.10

ISSN 0886-3350

Purpose: To evaluate the feasibility of correcting spherical aberration with aspheric intraocular lenses (IOLs) in cataract surgery based on individual pupil diameter. Setting: Keio University Hospital, Tokyo, Japan. Methods: In this prospective study, eyes having cataract surgery were divided into 4 groups based on IOL type: aspheric SN (AcrySof SN60WF), aspheric ZA (Tecnis ZA9003), aspheric PY (Hoya PY-60 AD), and spherical (AcrySof Natural SN60AT). Postoperative higher-order aberrations (HOAs) of the cornea and whole eye and the pupil diameter under photopic and mesopic conditions were measured. The HOA was calculated using the individual pupil diameter. The correlation between corneal and ocular spherical aberrations and pupil diameter was evaluated. Results: Each group comprised 30 eyes. Ocular spherical aberrations were significantly lower than corneal spherical aberrations under mesopic conditions in the aspheric SN group, the aspheric ZA group, and the aspheric PY group (P<.05); there was no significant difference between the aberrations in the spherical group. Linear regression showed significant correlations between postoperative corneal and ocular spherical aberrations (β = 0.39, aspheric SN; β = 0.38, aspheric ZA; β = 0.58, aspheric PY; β = 0.79, spherical). The differences in corneal and ocular spherical aberrations were significantly correlated with pupil diameter in the aspheric IOL groups but not in the spherical IOL group. Conclusions: The amount of spherical aberration correction by aspheric IOLs varied depending on IOL type and individual pupil diameter. The linear regression equation in this study may make it possible to customize postoperative ocular spherical aberration after cataract surgery. © 2009 ASCRS and ESCRS.

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Bilateral endophthalmitis in a patient with bacterial meningitis caused by Streptococcus pneumoniae

Torii Hidemasa, Miyata Hiroshi, Sugisaka Eiko, Ichikawa Yuho, Shinoda Kei, Inoue Makoto

Ophthalmologica (Ophthalmologica) 222 ( 5 ) 357 - 359 2008.09

ISSN 0030-3755

Aim: To present a patient who developed bilateral endogenous endophthalmitis secondary to Streptococcus pneumoniae meningitis. Methods: A 44-year-old man who was unconscious because of bacterial meningitis was referred to us for conjunctival hyperemia and decreased pupillary light reflexes. Ophthalmoscopy revealed inflammation in the anterior chamber and vitreous opacities in both eyes. He was diagnosed as having endogenous endophthalmitis associated with the meningitis. Ceftazidime and vancomycin hydrochloride were injected intravitreally and subconjunctivally repeatedly in both eyes. Results: Vision improved to 20/200 in the left eye 1 month later, but the right eye became hypotonic and blind. Vision deteriorated to light perception in the left eye due to a retinal detachment with proliferative vitreoretinopathy, and vitreous surgery successfully reattached the retina. Vision recovered to 20/80, and the retina has remained attached for 1 year. Conclusions: We recommend that endogenous endophthalmitis be suspected in cases of meningitis, and if present, intravitreal and subconjunctival antibiotics should be promptly given to preserve vision. Copyright © 2008 S. Karger AG.

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Short-term outcome of epipolis LASIK for refractive anomaly

Torii Hidemasa, Negishi Kazuno, Saiki Megumi, Yamaguchi Tsuyoshi, Kawaguchi Nanae, Tsubota Kazuo

Japanese Journal of Clinical Ophthalmology (Japanese Journal of Clinical Ophthalmology) 61 ( 9 ) 1635 - 1639 2007

ISSN 0370-5579

Purpose: To report short-term outcome of epipolis LASIK for refractive anomaly. Cases: This retrospective study was made on 28 eyes of 14 cases who received epipolis LASIK for myopia with or without astigmatism. The series comprised 6 males and 8 females. The age averaged 32.6 ± 7.2 years. All had myopia ranging from - 2.25D to -9.63 diopters. Astigmatism ranged from 0 to 2.5 diopters. Uncorrected visual acuity ranged from 0.032 to 0.2. All the eyes had corrected visual acuity of 1.0 or over. Results: Three months after treatment, the refraction was within 0.5 diopter from the target value in 20 eyes (71%) and within 1.0 diopter in 27 eyes (96%). Safety index was 1.07 and efficacy index was 0.85. As intraoperative complication, free flap and incomplete flap developed in one eye each. Two eyes had temporary haze after surgery. There was no serious postoperative complication. Conclusion: Judging from 3-month results, epipolis LASIK appears to be safe and effective. Improvement of nomogram may contribute to better outcome.

多焦点眼内レンズ入れ替え症例の検討

鳥居秀成、根岸一乃

IOL＆RS (日本白内障屈折矯正手術学会雑誌編集部) 25 ( 1 ) 13-16 - 16 2011

Research paper (scientific journal), Joint Work, ISSN 13413678

Axial Length Stabilization or Reduction in over 40% of Patients Wearing Extended Depth-of-Focus Contact Lenses

D Hazra, E Yotsukura, S Oyama, Y Shigeno, K Mori, R Takeuchi, ...

Journal of Clinical Medicine 14 (5), 1750 14 ( 5 ) 2025.03

Lead author, Last author, Corresponding author, ISSN 2077-0383

Background/Objectives: Preceding studies have reported the efficacy of multifocal contact lenses (MFCLs) in slowing myopia progression. Recently, a novel type of MFCL, i.e., extended depth-of-focus (EDOF) contact lens (CL), was designed. Here, we retrospectively investigated myopia progression associated with EDOF CL wear. Methods: Twenty-four consecutive myopic children (24 eyes; mean age, 13.9 years) received EDOF CLs to control myopia progression and participated in the study. We measured the axial length (AL), spherical equivalent (SE), and choroidal thickness (CT) at baseline and after 1 year of lens wear and compared the changes. Results: The mean baseline AL, SE, and CT were, respectively, 26.31 mm, −6.38 diopter (D), and 235 μm, and at 1 year 26.40 mm (p = 0.03), −6.61 D (p = 0.05), and 244 μm (p = 0.18). The AL decreased in 20.8% of cases (≧−0.05 mm/year), whereas 20.8% and 58.4% of cases had stabilization of the AL or an increased AL (≧+0.05 mm/year), respectively. The patients with a decreased AL engaged in a mean outdoor activity time of 200.6 min/day, the patients with an increased AL (≧+0.05 mm/year) engaged in a mean outdoor activity time of 126.7 min/day. The change in the AL was correlated significantly with the change in the CT (β = −0.46, p < 0.05), and 80% of patients with a shortened AL had increased CT (≧+20 μm/year). Conclusions: Our data showed that the AL stabilized or decreased in over 40% of myopic patients wearing EDOF CLs.

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特集眼科外来診療 -クリニックでの対応と紹介のタイミング- Ⅱ 白内障・屈折矯正　９　先天無虹彩症患者の白内障への対処法

西恭代, 鳥居秀成

眼科 (金原出版) 66 ( 11 ) 1178 - 1183 2024.11

Lead author, Last author, Corresponding author, ISSN 00164488

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

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

Scientific reports 14 (1), 26560 14 ( 1 ) 26560 2024.11

Lead author, Last author, Corresponding author, ISSN 2045-2322

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 2024.09

Lead author, Last author, Corresponding author, ISSN 0021-5155

Slowing of greater axial length elongation stemming from the Coronavirus disease 2019 pandemic with increasing time outdoors: the Tokyo myopia study

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

Ophthalmology Science 4 (5), 100491 4 ( 5 ) 100491 2024.09

Lead author, Last author, Corresponding author, ISSN 2666-9145

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

M Sato, K Kamiya, K Hayashi, H Tabuchi, T Kojima, N Goto, N Hatsusaka, ...

Japanese Journal of Ophthalmology 68 (5), 443-462 68 ( 5 ) 443 - 462 2024.09

Lead author, Last author, Corresponding author, ISSN 0021-5155

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

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

Scientific reports 14 (1), 17600 14 ( 1 ) 17600 2024.07

Lead author, Last author, Corresponding author, ISSN 2045-2322

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

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

Investigative Ophthalmology & Visual Science 65 (7), 6629-6629 65 ( 7 ) 2024.06

Lead author, Last author, Corresponding author, ISSN 0146-0404

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

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

Graefe's Archive for Clinical and Experimental Ophthalmology 262 (6), 1839-1845 262 ( 6 ) 1839 - 1845 2024.06

Lead author, Last author, Corresponding author, ISSN 0721-832X

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

J Baksh, D Lee, K Mori, Y Zhang, H Torii, H Jeong, J Hou, K Negishi, ...

Journal of Clinical Medicine 13 (10), 2777 13 ( 10 ) 2024.05

Lead author, Last author, Corresponding author, ISSN 2077-0383

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 2024.03

Lead author, Last author, Corresponding author, ISSN 00164488

A possible reciprocal relationship between myopia and dry eye disease in Japanese teenagers

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

Clinical Ophthalmology, 1991-1998 18 1991 - 1998 2024

Lead author, Last author, Corresponding author, ISSN 1177-5467

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

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

Clinical Ophthalmology, 1207-1216 18 1207 - 1216 2024

Lead author, Last author, Corresponding author, ISSN 1177-5467

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

Lead author, Last author, Corresponding author

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 2023.12

Lead author, Last author, Corresponding author, ISSN 03705579

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

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

Heliyon 9 (12) 9 ( 12 ) e22500 2023.12

Lead author, Last author, Corresponding author, ISSN 2405-8440

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 2023.09

Lead author, Last author, Corresponding author, ISSN 0021-5155

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

O Hieda, T Hiraoka, T Fujikado, S Ishiko, S Hasebe, H Torii, H Takahashi, ...

Japanese Journal of Ophthalmology, 1-10 2023.08

Lead author, Last author, Corresponding author, 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 2023.07

Lead author, Last author, Corresponding author, ISSN 0029-0203

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

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

Scientific reports 13 (1), 3772 13 ( 1 ) 3772 2023.03

Lead author, Last author, Corresponding author, ISSN 2045-2322

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

H Jeong, T Kurihara, X Jiang, S Kondo, Y Ueno, Y Hayashi, D Lee, ...

Experimental Eye Research 228, 109414 228 109414 2023.03

Lead author, Last author, Corresponding author, ISSN 0014-4835

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Myopia Epidemiological Research and Research Beyond

Torii Hidemasa

The Journal of The Japanese Society for Cataract Research (The Japanese Society for Cataract Research) 35 ( 1 ) 67 - 69 2023

Lead author, Last author, Corresponding author, ISSN 09154302

Choroidal Resident Macrophage Depletion can Induce Myopia in Mice

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

Investigative Ophthalmology & Visual Science 64 (8), 851-851 2023

Lead author, Last author, Corresponding author

臨床：白内障手術関連3編

Kizawa Junya, Torii Hidemasa, Nagata Mayumi

The Journal of The Japanese Society for Cataract Research (The Japanese Society for Cataract Research) 35 ( 1 ) 94 - 95 2023

Lead author, Last author, Corresponding author, ISSN 09154302

Motor

N Kato, T Inagaki, H Torii, K Nakaya, T Fujiwara

US Patent 11,699,935 2023

Lead author, Last author, Corresponding author

Violet light is abundant outdoors but deficient indoors in modern lifestyle in Tokyo

K Tsubota, S Kondo, X Jiang, H Torii, K Mori, T Kurihara

Investigative Ophthalmology & Visual Science 64 (8), 4178-4178 2023

Lead author, Last author, Corresponding author

The orientation of choroidal macrophage polarization significantly influences the development of myopia in murine models

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

bioRxiv, 2023.06. 12.544445 2023

Lead author, Last author, Corresponding author

Sex differences in the relationship between axial length and dry eye in elderly patients

M Ayaki, H Torii, E Yotsukura, K Negishi

Frontiers in Medicine 10, 1170696 10 1170696 2023

Lead author, Last author, Corresponding author, ISSN 2296-858X

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Pump device

N Kato, T Inagaki, K Nakaya, H Torii

US Patent 11,655,827 2023

Lead author, Last author, Corresponding author

Clinical results and factors affecting visual function in eyes implanted with an enhanced monofocal intraocular lens

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

Clinical Ophthalmology, 3965-3973 17 3965 - 3973 2023

Lead author, Last author, Corresponding author, ISSN 1177-5467

Purpose: To compare the clinical results achieved with the enhanced monofocal intraocular lenses (IOLs) with those of the monofocal IOL and investigate factors affecting the distance, intermediate, and near vision. Patients and Methods: Patients were included who underwent bilateral consecutive cataract surgeries using the same IOLs with follow-up to 1 month postoperatively. Refractions, monocular UDVA and CDVA, and binocular distance-corrected functional visual acuity at 5 meters (BDCFVA), at 66 centimeters (BDCIFVA) and at 40 centimeters (DCNVA) were assessed. Multiple regression analysis was used to assess the factors affecting binocular BDCFVA, BDCIFVA, and BDCNFVA. Subjective symptoms were assessed using the Near Activity Visual Questionnaire (NAVQ) and visual analogue scale (VAS). Results: Sixty patients (120 eyes) implanted with the Tecnis Eyhance IOL (30 patients, 60 eyes) or the Tecnis monofocal IOL (30 patients, 60 eyes) were included. The Tecnis Eyhance IOL provided significantly better binocular BDCIFVA than the Tecnis monofocal IOL in patients under 70 years of age. Multiple regression analysis showed that age was the only factor affecting distance and intermediate visual function in eyes with the Tecnis Eyhance IOL; gender, pupillary diameter, axial length, and average keratometry were not significant. There were no significant differences in subjective symptoms. Conclusion: The comprehensive cohort analysis did not confirm the advantage on the intermediate vision of the Tecnis Eyhance IOL. Younger age may be an important factor to benefit from the unique optical characteristics of this IOL.

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増刊号最新臨床研究から探る眼科臨床のギモンQ＆A 2　白内障・視覚矯正小児の近視進行予防は,どれくらいの効果があるのでしょうか?

小川護, 四倉絵里沙, 鳥居秀成

臨床眼科 (株式会社医学書院) 76 ( 11 ) 76 - 82 2022.10

Lead author, Last author, Corresponding author, ISSN 03705579

Short-term exposure to violet light emitted from eyeglass frames in myopic children: a randomized pilot clinical trial

H Torii, K Mori, T Okano, S Kondo, HY Yang, E Yotsukura, A Hanyuda, ...

Journal of clinical medicine 11 (20), 6000 (Journal of Clinical Medicine) 11 ( 20 ) 2022.10

Lead author, Last author, Corresponding author, ISSN 2077-0383

Violet light (VL), 360–400 nm wavelength, is contained in the sunlight and is an effective element for myopia suppression. This study is to investigate the safety and efficacy of novel eyeglasses that emit VL from the frames. This is a double-masked, randomized, pilot clinical trial conducted in a clinic in Japan. Forty-three children with myopia were enrolled. Participants were randomly assigned to two groups, wearing VL-emitting eyeglass frames (VLf) that emitted VL of 310 μW/cm2 (VLf group, n = 22) or pseudo-placebo eyeglass frames with a minimal emission of VL (<10 μW/cm2) (control group, n = 21). The exposure time was 3 h per day. The primary outcomes were visual acuity, tear film break-up time, corneal endothelial cell density, and the slit-lamp/fundus examinations. The secondary outcome was the 6-month changes in the axial lengths and cycloplegic refractions. Forty-one (95%) participants were included; twenty-one in the VLf group and twenty in the control group. No significant differences were seen in any safety evaluation. Significant changes were seen in axial elongation, choroidal thickness, and cycloplegic refractions in the subgroup analysis of 8- to 10-year-old children (p < 0.05), but otherwise no significant differences were seen. The VLf showed short-term safety and effectiveness against myopia progression.

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Scleral PERK and ATF6 as targets of myopic axial elongation of mouse eyes

S Ikeda, T Kurihara, X Jiang, Y Miwa, D Lee, N Serizawa, H Jeong, K Mori, ...

Nature communications 13 (1), 5859 (Nature Communications) 13 ( 1 ) 5859 2022.10

Lead author, Last author, Corresponding author

Axial length is the primary determinant of eye size, and it is elongated in myopia. However, the underlying mechanism of the onset and progression of axial elongation remain unclear. Here, we show that endoplasmic reticulum (ER) stress in sclera is an essential regulator of axial elongation in myopia development through activation of both PERK and ATF6 axis followed by scleral collagen remodeling. Mice with lens-induced myopia (LIM) showed ER stress in sclera. Pharmacological interventions for ER stress could induce or inhibit myopia progression. LIM activated all IRE1, PERK and ATF6 axis, and pharmacological inhibition of both PERK and ATF6 suppressed myopia progression, which was confirmed by knocking down above two genes via CRISPR/Cas9 system. LIM dramatically changed the expression of scleral collagen genes responsible for ER stress. Furthermore, collagen fiber thinning and expression of dysregulated collagens in LIM were ameliorated by 4-PBA administration. We demonstrate that scleral ER stress and PERK/ATF6 pathway controls axial elongation during the myopia development in vivo model and 4-PBA eye drop is promising drug for myopia suppression/treatment.

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

Y Zhang, H Jeong, K Mori, SI Ikeda, C Shoda, Y Miwa, A Nakai, J Chen, ...

PNAS nexus 1 (4), pgac166 1 ( 4 ) pgac166 2022.09

Lead author, Last author, Corresponding author

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Investigating the prediction accuracy of recently updated intraocular lens power formulas with artificial intelligence for high myopia

M Omoto, K Sugawara, H Torii, E Yotsukura, S Masui, Y Shigeno, Y Nishi, ...

Journal of Clinical Medicine 11 (16), 4848 (Journal of Clinical Medicine) 11 ( 16 ) 2022.08

Lead author, Last author, Corresponding author, ISSN 2077-0383

The aim of this study was to investigate the prediction accuracy of intraocular lens (IOL) power formulas with artificial intelligence (AI) for high myopia. Cases of highly myopic patients (axial length [AL], >26.0 mm) undergoing uncomplicated cataract surgery with at least 1-month follow-up were included. Prediction errors, absolute errors, and percentages of eyes with prediction errors within ±0.25, ±0.50, and ±1.00 diopters (D) were compared using five formulas: Hill-RBF3.0, Kane, Barrett Universal II (BUII), Haigis, and SRK/T. Seventy eyes (mean patient age at surgery, 64.0 ± 9.0 years; mean AL, 27.8 ± 1.3 mm) were included. The prediction errors with the Hill-RBF3.0 and Kane formulas were statistically different from the BUII, Haigis, and SRK/T formulas, whereas there was not a statistically significant difference between those with the Hill-RBF3.0 and Kane. The absolute errors with the Hill-RBF3.0 and Kane formulas were smaller than that with the BUII formula, whereas there was not a statistically significant difference between the other formulas. The percentage within ±0.25 D with the Hill-RBF3.0 formula was larger than that with the BUII formula. The prediction accuracy using AI (Hill-RBF3.0 and Kane) showed excellent prediction accuracy. No significant difference was observed in the prediction accuracy between the Hill-RBF3.0 and Kane formulas.

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Children in Tokyo Have a Long Sustained Axial Length from Age 3 Years: The Tokyo Myopia Study

T Maruyama, E Yotsukura, H Torii, K Mori, M Inokuchi, M Tokumura, ...

Journal of Clinical Medicine 11 (15), 4413 (Journal of Clinical Medicine) 11 ( 15 ) 2022.07

Lead author, Last author, Corresponding author, ISSN 2077-0383

Background: myopia prevalence is high among Japanese schoolchildren, but the underlying causes are unclear. Objective: To examine the distributions of ocular biometry and refraction and their associations with lifestyle variables among Japanese schoolchildren. Methods: This cross-sectional school-based study included 2140 children aged 3–14 years in Tokyo, Japan, and evaluated the distributions under non-cycloplegic conditions and the associated environmental factors. Results: The prevalence of spherical equivalent (SE) ≤−0.75 diopter among preschoolers (aged 3–6 years), elementary school students (aged 6–11 years), and junior high school students (aged 12–14 years) was 49.7%, 72.4%, and 87.7%, respectively. Multiple linear regression analyses showed that the time spent using digital devices was associated positively with lens thickness (β = 0.010; p < 0.050) but not SE, axial length, or vitreous chamber depth. The time spent reading was associated negatively with lens thickness (β = −0.012; p < 0.050), SE (β = −0.152; p < 0.010), axial length (β = 0.110; p < 0.001), and vitreous chamber depth (β = 0.110; p < 0.001). Conclusions: The data indicated that almost half of preschoolers may be myopic. The association with the lens thickness differed depending on the type of near work performed.

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Relation between dry eye and myopia based on tear film breakup time, higher order aberration, choroidal thickness, and axial length

D Hazra, E Yotsukura, H Torii, K Mori, T Maruyama, M Ogawa, A Hanyuda, ...

Scientific reports 12 (1), 10891 (Scientific Reports) 12 ( 1 ) 10891 2022.06

Lead author, Last author, Corresponding author, ISSN 2045-2322

The purpose of this study was to investigate the association between dry eye disease (DED) and myopia by evaluating higher order aberrations (HOAs) and choroidal thickness (CT). We recruited 72 myopic children with DED symptoms (mean age 12.8 years), measured the tear film breakup time (TBUT), corneal/intraocular/total ocular HOAs, CT, and axial length (AL), administered lifestyle questionnaires, and evaluated the relationships among TBUT, HOAs, CT, and AL. The TBUT was correlated significantly with the corneal HOAs and intraocular HOAs but not with the total ocular HOAs. Multiple regression analyses showed that the AL was associated significantly with the TBUT (β = − 0.067, P = 0.004), the intraocular HOAs, and total ocular HOAs but not with the corneal HOAs. The CT was associated significantly with the TBUT and AL (β = 9.15 and − 7.85, respectively; P < 0.001 and = 0.01, respectively). Our data suggested the association between DED and myopia might be independent of the HOAs. We showed that the TBUT was associated with the CT, which is related to the AL. Because the parasympathetic nervous system affects the lacrimal glands and CT, the parasympathetic nervous system might be a common upstream factor in the association between DED and myopia.

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Dry eye disease and high myopia in teenagers; a reciprocal relationship

OI Hirayama, M Ayaki, E Yotsukura, H Torii, K Negishi

Investigative Ophthalmology & Visual Science 63 (7), 1442–F0400-1442–F0400 63 ( 7 ) 2022.06

Lead author, Last author, Corresponding author, ISSN 0146-0404

Lipidomic analysis revealed n-3 polyunsaturated fatty acids suppressed choroidal thinning and myopia progression in mice.

Mori K, Kuroha S, Hou J, Jeong H, Ogawa M, Ikeda SI, Kang JX, Negishi K, Torii H, Arita M, Kurihara T, Tsubota K

FASEB journal : official publication of the Federation of American Societies for Experimental Biology (FASEB Journal) 36 ( 6 ) e22312 2022.06

Lead author, Last author, Corresponding author, ISSN 0892-6638

Myopia is increasing worldwide and its preventable measure should urgently be pursued. N-3 polyunsaturated fatty acids (PUFAs) have been reported to have various effects such as vasodilative and anti-inflammatory, which myopia may be involved in. This study is to investigate the inhibitory effect of PUFAs on myopia progression. A lens-induced myopia (LIM) model was prepared using C57B L6/J 3-week-old mice, which were equipped with a −30 diopter lens to the right eye. Chows containing two different ratios of n-3/n-6 PUFA were administered to the mice, and myopic shifts were confirmed in choroidal thickness, refraction, and axial length in the n-3 PUFA-enriched chow group after 5 weeks. To exclude the possibility that the other ingredients in the chow may have taken the suppressive effect, fat-1 transgenic mice, which can produce n-3 PUFAs endogenously, demonstrated significant suppression of myopia. To identify what elements in n-3 PUFAs took effects on myopia suppression, enucleated eyes were used for targeted lipidomic analysis, and eicosapentaenoic acid (EPA) were characteristically distributed. Administration of EPA to the LIM model confirmed the inhibitory effect on choroidal thinning and myopia progression. Subsequently, to identify the elements and the metabolites of fatty acids effective on myopia suppression, targeted lipidomic analysis was performed and it demonstrated that metabolites of EPA were involved in myopia suppression, whereas prostaglandin E2 and 14,15-dihydrotestosterone were associated with progression of myopia. In conclusion, EPA and its metabolites are related to myopia suppression and inhibition of choroidal thinning.

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Relationship between Dry Eye and Myopia in Children

K Tsubota, D Hazra, E Yotsukura, K Mori, T Maruyama, M Ogawa, ...

Investigative Ophthalmology & Visual Science 63 (7), 249–A0103-249–A0103 63 ( 7 ) 2022.06

Lead author, Last author, Corresponding author, ISSN 0146-0404

Relationship of choroidal thickness and axial length with posterior vitreous detachment in patients with high myopia

A Hanyuda, H Torii, K Hayashi, A Uchida, K Mori, E Yotsukura, M Ogawa, ...

Scientific reports 12 (1), 4093 (Scientific Reports) 12 ( 1 ) 4093 2022.03

Lead author, Last author, Corresponding author, ISSN 2045-2322

Although accumulating evidence suggests a higher prevalence of posterior vitreous detachment (PVD) in highly myopic eyes, the relation between ocular biometric features and PVD stages in such eyes remains unclear. Therefore, we enrolled 170 patients with high myopia (axial length ≥ 26.0 mm) to investigate the status of PVD regarding subfoveal choroidal thickness and axial length. Utilising swept-source optical coherence tomography, we classified the PVD status into five stages. The distribution of PVD grades increased as the choroidal thickness decreased and axial length increased (P < 0.01). On adjusting for age and sex, decreased choroidal thickness and increased axial length were associated with more advanced PVD stages: odds ratios with the highest vs. lowest groups were 0.31 (95% confidence interval [CI] 0.09–1.01; Ptrend = 0.009) for choroidal thickness and 5.16 (95% CI 1.34–19.80; Ptrend = 0.002) for axial length. The inverse association between choroidal thickness and PVD status seemed stronger in women than in men (Pinteraction = 0.05). In conclusion, we firstly observed a significant trend of decreased choroidal thickness, along with increased axial length, with increased grade of PVD, particularly among women with highly myopic eyes, suggesting that advanced morphological myopic changes contribute to PVD in middle-aged adults.

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綜説多焦点眼内レンズ

四倉絵里沙, 鳥居秀成

眼科 (金原出版) 64 ( 2 ) 147 - 155 2022.02

Lead author, Last author, Corresponding author, ISSN 00164488

臨床: 多焦点眼内レンズ関連3編

Kizawa Junya, Torii Hidemasa, Nagata Mayumi

The Journal of The Japanese Society for Cataract Research (The Japanese Society for Cataract Research) 34 ( 1 ) 85 - 86 2022

Lead author, Last author, Corresponding author, ISSN 09154302

Ginkgo biloba Extracts Showed Myopia Suppressive Effects in a Lens-Induced Myopia Model in Mice

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

Investigative Ophthalmology & Visual Science 63 (7), 1452–F0410-1452–F0410 2022

Lead author, Last author, Corresponding author

Lipidomic analysis revealed n‐3 polyunsaturated fatty acids suppressed choroidal thinning and myopia progression in mice

K Mori, S Kuroha, J Hou, H Jeong, M Ogawa, S Ikeda, JX Kang, K Negishi, ...

The FASEB Journal 36 (6), e22312 2022

Lead author, Last author, Corresponding author

Intensive outdoor activity for 1 week increased choroidal thickness

M Ogawa, H Torii, E Yotsukura, K Mori, A Hanyuda, J Matsumura, ...

Investigative Ophthalmology & Visual Science 63 (7), 246–A0100-246–A0100 2022

Lead author, Last author, Corresponding author

有水晶体眼内レンズ挿入後眼の白内障手術における眼内レンズ度数計算精度

菅原薫子, 鳥居秀成, 増井佐千子, 重野雄太, 西恭代, 四倉絵里沙, 根岸一乃

IOL & RS ((株)杏林舎内「IOL&RS」編集事務局) 35 ( 4 ) 632 - 638 2021.12

Lead author, Last author, Corresponding author, ISSN 1341-3678

目的:有水晶体眼内レンズ挿入後眼の白内障手術における眼内レンズ(IOL)度数計算精度を検討する。対象と方法:対象は慶應義塾大学病院にて、有水晶体IOL挿入後眼の白内障手術を行い、術後1ヵ月以上経過観察できた9例12眼(平均年齢52.3歳)で、Hill-RBF 2.0(Hi)、Barrett-Universal II(Ba式)、Haigis(Ha式)、SRK/T(S式)による術後屈折誤差(術後予測屈折値と術後1ヵ月の自覚等価球面値の差)を後方視的に比較した。結果:挿入されたIOLはDCB00/DCB00V(Johnson & Johnson、D群)が6例8眼(平均眼軸長27.62mm)、MA60MA(Alcon、M群)が3例4眼(平均眼軸長31.25mm)であった。術後屈折誤差は算術値、絶対値ともに両群とも各計算法間で有意差を認めなかった。術後屈折誤差が±0.5D以内の割合(%)は、D群ではHi、Ba式、Ha式、S式の順に85.7、50.0、37.5、50.0、M群では75.0、75.0、50.0、50.0であり、±1.0D以内の割合(%)は、D群ではいずれの計算法でも100.0、M群では100.0、100.0、75.0、75.0であった。結論:Hiは、有水晶体IOL挿入後眼の白内障手術におけるIOL度数計算法として4つの中で最も有用である可能性が示唆された。(著者抄録)

Effect of violet light-transmitting eyeglasses on axial elongation in myopic children: a randomized controlled trial

K Mori, H Torii, Y Hara, M Hara, E Yotsukura, A Hanyuda, K Negishi, ...

Journal of clinical medicine 10 (22), 5462 (Journal of Clinical Medicine) 10 ( 22 ) 2021.11

Lead author, Last author, Corresponding author, ISSN 2077-0383

The fact that outdoor light environment is an important suppressive factor against myopia led us to invent violet light-transmitting eyeglasses (VL glasses) which can transmit violet light (VL), 360–400 nm in wavelength, for the suppression of myopia, and can meanwhile block harmful ultra-violet waves from sunlight. The current study is a double-blinded randomized clinical trial to investigate the myopia-suppressive effect of VL glasses compared to conventional eyeglasses (placebo glasses) that do not transmit VL. The subjects were children aged from 6 to 12 years old, the population in which myopia progression is generally accelerated, and the myopia suppressive effect was followed up for two years in a city in Japan. Periodical ophthalmic examinations, interviews, and measurements of reflection and axial length under mydriasis were performed at the initial visit (the baseline) and at 1, 6, 12, 18, and 24 months. The mean change in axial length in the VL glasses group was significantly smaller than in the placebo glasses group when time for near-work was less than 180 min and when the subjects were limited to those who had never used eyeglasses before this trial (p < 0.01); however, this change was not significant without subgrouping. The suppressive rate for axial elongation in the VL glasses group was 21.4% for two years.

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Corrigendum to Ratio of Axial Length to Corneal Radius in Japanese Patients and Accuracy of Intraocular Lens Power Calculation Based on Biometric Data. Am J Ophthalmol 2020;218:320-329.

Omoto MK, Torii H, Hayashi K, Ayaki M, Tsubota K, Negishi K

American journal of ophthalmology (American Journal of Ophthalmology) 231 210 2021.11

Lead author, Last author, Corresponding author, ISSN 0002-9394

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増刊号この症例このまま診ていて大丈夫?　病診連携にもとづく疾患別眼科診療ガイド 4　白内障眼内レンズ交換

鳥居秀成

臨床眼科 (株式会社医学書院) 75 ( 11 ) 159 - 166 2021.10

Lead author, Last author, Corresponding author, ISSN 03705579

Clinical outcomes of KeraVio using violet light: emitting glasses and riboflavin drops for corneal ectasia: a pilot study

H Kobashi, H Torii, I Toda, S Kondo, M Itoi, K Tsubota

British Journal of Ophthalmology 105 (10), 1376-1382 (British Journal of Ophthalmology) 105 ( 10 ) 1376 - 1382 2021.10

Lead author, Last author, Corresponding author, ISSN 0007-1161

Background/aims We developed a novel technology consisting of violet light (VL)-emitting glasses and defined the combination of VL irradiation and riboflavin treatment as KeraVio. Our goal was to evaluate the clinical results of KeraVio in patients with progressive corneal ectasia. Methods Eyes were exposed to VL (375 nm, irradiance 310 μW/cm 2)-emitting glasses for 3 hours daily for 6 months, and a riboflavin solution was administered onto the corneal epithelium six times during each 3-hour VL irradiation. The primary end point was a change in the maximum keratometry (Kmax) value over 6 months compared with that over the 1 year before baseline. Results The efficacy of KeraVio was evaluated in 20 eyes with severe progression, and its safety was evaluated in all 40 eyes. The mean changes in Kmax over the 1 year before baseline and during the 6-month observation period were 6.03±3.41 dioptres (D) and -0.81±3.34 D, respectively (p=0.002). At 6 months, the Kmax value decreased by more than 2 D in 4 eyes (20%), remained within 2 D in 13 eyes (65%), and increased by 2 D or more in 3 eyes (15%). The corneal stromal demarcation line was identified in 16 eyes (80%), and its depth was 206.3±54.9 μm at 1 month. No significant decrease in endothelial cell density, lenticular opacity or transient corneal haze was noted. Conclusion Based on our 6-month results, daily treatment of progressive corneal ectasia with KeraVio can halt disease progression without any safety concerns. Clinical trial registration number jRCTs032180217.

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Association between ocular axial length and anthropometrics of Asian adults

A Shinojima, T Kurihara, K Mori, Y Iwai, A Hanyuda, K Negishi, H Torii, ...

BMC Research Notes 14, 1-5 (BMC Research Notes) 14 ( 1 ) 328 2021.08

Lead author, Last author, Corresponding author

Objective: The purpose of this study is to analyze axial length, body height, hand length, and foot length to find new factors that predict myopia and to identify gender differences as one of the factors of high myopia. A cross-sectional study was conducted as a single observation. Body height, hand length, and foot length were measured according to standard anthropometric methods. Axial length, retinal thickness, and choroidal thickness were measured using the IOL Master 700 and the Heidelberg Spectralis-OCT. To account for body height differences among participants, foot length/body height and hand length/body height were analyzed using a mixed-effects model. Results: A total of 80 eyes (men, n = 20, 40 eyes; women, n = 20, 40 eyes) were analyzed. The mean age was 33.5 years (range 21–59 years, SD: 9.6). For choroidal thickness, there was a significant association with axial length in men (p < 0.001) and a trend toward an association in women (p = 0.072). There was also a significant association between foot length/body height and axial length in men (p = 0.015), but not in women (p = 0.58). These results suggest that factors that determine body height and foot length may be related to axial length, although they vary by gender.

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Short-term efficacy and safety of cataract surgery combined with iris-fixated phakic intraocular lens explantation: A multicentre study

MK Omoto, H Torii, S Masui, M Ayaki, I Toda, H Arai, T Nakamura, ...

Journal of Clinical Medicine 10 (16), 3672 (Journal of Clinical Medicine) 10 ( 16 ) 2021.08

Lead author, Last author, Corresponding author, ISSN 2077-0383

The purpose of this study was to evaluate the short-term efficacy and safety of cataract surgery for patients with iris-fixated phakic intraocular lenses (pIOLs). This study included 96 eyes of 91 patients. The changes in the logMAR uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), subjective spherical equivalent (SE), astigmatism, and endothelial cell density (ECD) were collected retrospectively. The intraoperative and postoperative complications also were investigated to assess the surgical safety. The preoperative UCVA and BCVA improved significantly at month 1 postoperatively, respectively (p <0.001 for both comparisons). The efficacy and safety index at month 1 postoperatively were 1.02 ± 0.56 and 1.31 ± 0.64, respectively. The SE at month 1 postoperatively was significantly (p <0.001) higher compared to preoperatively, whereas the subjective astigmatism did not differ significantly (p = 0.078). The ECD significantly decreased at month 1 (p < 0.001). The most common postoperative complication was intraocular pressure elevation exceeding 25 mmHg in 10.4% of eyes, which was controlled with medications in all cases until month 1 postoperatively. No intraoperative complications developed. Cataract surgeries for patients with iris-fixated pIOLs were performed safely with good visual outcomes.

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Violet light suppresses lens-induced myopia via neuropsin (OPN5) in mice

Jiang Xiaoyan, Pardue Machelle T., Mori Kiwako, Ikeda Shin-ichi, Torii Hidemasa, D'Souza Shane, Lang Richard A., Kurihara Toshihide, Tsubota Kazuo

PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA 118 ( 22 ) 2021.06

Lead author, Last author, Corresponding author, ISSN 0027-8424

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Violet light suppresses lens-induced myopia via neuropsin (OPN5) in mice.

Jiang X, Pardue MT, Mori K, Ikeda SI, Torii H, D'Souza S, Lang RA, Kurihara T, Tsubota K

Proceedings of the National Academy of Sciences of the United States of America 118 ( 22 ) 2021.06

Lead author, Last author, Corresponding author, ISSN 0027-8424

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Violet light suppresses lens-induced myopia via neuropsin (OPN5) in mice

Jiang X., Pardue M.T., Mori K., Ikeda S.I., Torii H., D'Souza S., Lang R.A., Kurihara T., Tsubota K.

Proceedings of the National Academy of Sciences of the United States of America (Proceedings of the National Academy of Sciences of the United States of America) 118 ( 22 ) 2021.06

Lead author, Last author, Corresponding author, ISSN 00278424

Myopia has become a major public health concern, particularly across much of Asia. It has been shown in multiple studies that outdoor activity has a protective effect on myopia. Recent reports have shown that short-wavelength visible violet light is the component of sunlight that appears to play an important role in preventing myopia progression in mice, chicks, and humans. The mechanism underlying this effect has not been understood. Here, we show that violet light prevents lens defocus-induced myopia in mice. This violet light effect was dependent on both time of day and retinal expression of the violet light sensitive atypical opsin, neuropsin (OPN5). These findings identify Opn5-expressing retinal ganglion cells as crucial for emmetropization in mice and suggest a strategy for myopia prevention in humans.

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Predicting keratoconus progression using deep learning

N Kato, H Masumoto, M Tanabe, C Sakai, K Negishi, H Torii, H Tabuchi, ...

Investigative Ophthalmology & Visual Science 62 (8), 769-769 62 ( 8 ) 2021.06

Lead author, Last author, Corresponding author, ISSN 0146-0404

Violet light suppresses lens-induced myopia via neuropsin (OPN5) in mice

Xiaoyan Jiang, Machelle T. Pardue, Kiwako Mori, Shin-ichi Ikeda, Hidemasa Torii, Shane D’Souza, Richard A. Lang, Toshihide Kurihara, Kazuo Tsubota

Proceedings of the National Academy of Sciences (Proceedings of the National Academy of Sciences) 118 ( 22 ) 2021.05

Lead author, Last author, Corresponding author, ISSN 00278424

<jats:title>Significance</jats:title>
<jats:p>
The increasing prevalence of myopia is a significant public health concern. Unfortunately, the mechanisms driving myopia remain elusive, limiting effective treatment options. This report identifies a refractive development pathway that requires
<jats:italic>Opn5</jats:italic>
-expressing retinal ganglion cells (RGCs). Stimulation of
<jats:italic>Opn5</jats:italic>
RGCs with short-wavelength violet light prevented experimental myopia in mice. Furthermore, this effect was dependent on the time of day, with evening exposure being sufficient to protect against experimental myopia. Thus, these studies suggest
<jats:italic>Opn5</jats:italic>
RGCs may contribute to the mechanisms of emmetropization and identify the OPN5 pathway as a potential target for the treatment of myopia.
</jats:p>

小児の近視予防に用いられる0.01%アトロピンの有効性と安全性について検討した2年無作為化プラセボ対照試験(Efficacy and safety of 0.01% atropine for prevention of childhood myopia in a 2-year randomized placebo-controlled study)

Hieda Osamu, Hiraoka Takahiro, Fujikado Takashi, Ishiko Satoshi, Hasebe Satoshi, Torii Hidemasa, Takahashi Hiroshi, Nakamura Yo, Sotozono Chie, Oshika Tetsuro, Morimoto Takeshi, Nishida Kohji, Nishikawa Noriko, Song Young-Seok, Tokutake Tomoki, Nishi Yasuyo, Shigeno Yuta, Kurihara Toshihide, Negishi Kazuno, Tsubota Kazuo, Ono Masafumi, Nakai Tomoko, Tan Donald, Tanaka Shiro, Kinoshita Shigeru, the ATOM-J.Study Group

Japanese Journal of Ophthalmology (シュプリンガー・ジャパン(株)) 65 ( 3 ) 315 - 325 2021.05

Lead author, Last author, Corresponding author, ISSN 0021-5155

日本人小児の近視予防に0.01%アトロピン点眼剤が有効かどうか検討した。本研究は多施設共同無作為化二重盲検プラセボ対照試験であり、6～12歳児168名をアトロピン点眼剤投与群84名(男児38名、女児46名、平均8.99±1.44歳)とプラセボ投与群84例(男児36名、女児48名、平均8.98±1.50歳)に割り付け、それぞれ24ヵ月間投与した。評価項目は等価球面度数(SE)と眼軸長(AL)の変化とした。全例におけるベースライン時のSEは平均-2.95D、ALは平均24.5mmであった。2週後、遠視への移行はみられず、これ以降全例で近視の進行がみられた。24ヵ月後におけるSEの平均変化はアトロピン投与群が-1.26D、プラセボ群が-1.48D、ALの平均変化はアトロピン投与群が0.63mm、プラセボ群が0.77mmであり、いずれも有意な群間差が認められた。また、両群とも眼圧に関して24ヵ月後に有意な変化はみられなかったが、アトロピン群において2週後と12週後に明所視虹彩径が有意に増大していた。試験期間中に生じた非重篤な有害事象として、アトロピン群に片麻痺性片頭痛1例、プラセボ群に視神経乳頭出血を認め、副作用としてアトロピン群に羞明1例、プラセボ群に近見障害1例がみられた。小児にみられる近視の進行予防に際して、0.01%アトロピン点眼剤は有効かつ安全であることが示された。

Efficacy and safety of 0.01% atropine for prevention of childhood myopia in a 2-year randomized placebo-controlled study

O Hieda, T Hiraoka, T Fujikado, S Ishiko, S Hasebe, H Torii, H Takahashi, ...

Japanese Journal of Ophthalmology 65, 315-325 (Japanese Journal of Ophthalmology) 65 ( 3 ) 315 - 325 2021.05

Lead author, Last author, Corresponding author, ISSN 0021-5155

Purpose: Atropine eye drops prevent the progression of myopia, but their use has not been tested in the Japanese schoolchildren population. Here, we evaluate the efficacy and safety of 0.01% atropine eye drops for myopia control in Japanese children. Study design: Multicenter (7 university hospitals), randomized, double-masked, placebo-controlled trial. Methods: Participants were 171 Japanese schoolchildren aged 6 to 12 years, with progressive myopia, spherical equivalence (SE) of −1.00 to −6.00 diopters (D), and astigmatism of ≤1.5 D. They were randomized to receive either 0.01% atropine (n=85) or placebo (n=86) eye drops once nightly OU for 24 months. Primary and secondary efficacy endpoints were changes in SE and axial length (AL), respectively, from baseline to month 24. Results: Data from 168 subjects were analyzed. At month 24, compliance was similar in both groups (atropine: 83.3%; placebo: 85.7%). The least squares mean change in SE and AL from baseline were, respectively, −1.26 D (95% confidence interval [CI]: −1.35, −1.17) and 0.63 mm (0.59, 0.67) for atropine and −1.48 D (− 1.57, −1.39) and 0.77 mm (0.73, 0.81) for placebo. Inter-group differences were 0.22 D (95% CI: 0.09, 0.35; P < 0.001) for SE and − 0.14 mm (−0.20, −0.08; P < 0.001) for AL. Three patients experienced mild allergic conjunctivitis side effects, with no inter-group difference in incidence (atropine: 2.4%; 2/84 patients; placebo: 1.4%; 1/84 patients). Conclusion: With good compliance, 0.01% atropine is effective and safe for preventing the progression of childhood myopia.

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Predicting keratoconus progression and need for corneal crosslinking using deep learning

N Kato, H Masumoto, M Tanabe, C Sakai, K Negishi, H Torii, H Tabuchi, ...

Journal of clinical medicine 10 (4), 844 (Journal of Clinical Medicine) 10 ( 4 ) 1 - 9 2021.02

Lead author, Last author, Corresponding author, ISSN 2077-0383

We aimed to predict keratoconus progression and the need for corneal crosslinking (CXL) using deep learning (DL). Two hundred and seventy-four corneal tomography images taken by Pentacam HR® (Oculus, Wetzlar, Germany) of 158 keratoconus patients were examined. All patients were examined two times or more, and divided into two groups; the progression group and the non-progression group. An axial map of the frontal corneal plane, a pachymetry map, and a combination of these two maps at the initial examination were assessed according to the patients’ age. Training with a convolutional neural network on these learning data objects was conducted. Ninety eyes showed progression and 184 eyes showed no progression. The axial map, the pachymetry map, and their combination combined with patients’ age showed mean AUC values of 0.783, 0.784, and 0.814 (95% confidence interval (0.721–0.845) (0.722–0.846), and (0.755–0.872), respectively), with sen-sitivities of 87.8%, 77.8%, and 77.8% ((79.2–93.7), (67.8–85.9), and (67.8–85.9)) and specificities of 59.8%, 65.8%, and 69.6% ((52.3–66.9), (58.4–72.6), and (62.4–76.1)), respectively. Using the proposed DL neural network model, keratoconus progression can be predicted on corneal tomography maps combined with patients’ age.

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特集近視コントロールアップデート１　世界の近視の激増(日本も含む)

羽入田明子, 鳥居秀成

眼科 (金原出版) 63 ( 1 ) 3 - 14 2021.01

Lead author, Last author, Corresponding author, ISSN 00164488

Corrigendum to Ratio of Axial Length to Corneal Radius in Japanese Patients and Accuracy of Intraocular Lens Power Calculation Based on Biometric Data. Am J Ophthalmol 2020 …

MK Omoto, H Torii, K Hayashi, M Ayaki, K Tsubota, K Negishi

American Journal of Ophthalmology 231, 210 2021

Lead author, Last author, Corresponding author

Association between Axial Length of the Eye and Length of Each Part of the Body

A Shinojima, T Kurihara, K Mori, Y Iwai, A Hanyuda, K Negishi, H Torii, ...

2021

Lead author, Last author, Corresponding author

Glucose levels between the anterior chamber of the eye and blood are correlated based on blood glucose dynamics

T Kurihara, D Lee, A Shinojima, T Kinoshita, S Nishizaki, Y Arita, Y Hidaka, ...

PloS one 16 (9), e0256986 (PLoS ONE) 16 ( 9 ) e0256986 2021

Lead author, Last author, Corresponding author, ISSN 1932-6203

Glycemic control is essential to manage metabolic diseases such as diabetes. Frequent measurements of systemic glucose levels with prompt managements can prevent organ damages. The eye is a glucose highly demanding organ in our body, and the anterior chamber (AC) in the eye has been suggested for a noninvasive blood glucose monitoring site. However, calculating blood glucose levels from measuring glucose levels in AC has been difficult and unclear. In this study, we aimed to examine glucose levels from AC and find a correlation with blood glucose levels. A total of 30 patients with cataracts (men and women, study 1; 7 and 3, study 2; 9 and 11) who visited Keio University Hospital from 2015 to 2018 and agreed to participate in this study were recruited. Glucose levels from AC and the blood were examined by a UV-hexokinase or H2O2-electrode method before/during the cataract surgery. These values were analyzed with regression analyses depending on the groups (blood glucose-ascending and descending groups). In the blood glucose-descending group, glucose levels from AC were strongly correlated with blood glucose levels (a high R2 value, 0.8636). However, the relatively moderate correlation was seen in the blood glucose-ascending group (a low R2 value, 0.5228). Taken together, we showed different correlation ratios on glucose levels between AC and the blood, based on blood glucose dynamics. Stacking data regarding this issue would enable establishing noninvasive blood glucose monitoring from measuring glucose levels in AC more correctly, which will be helpful for proper and prompt managements for glucose-mediated complications.

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Violet light suppresses lens-induced myopia via neuropsin (OPN5) in mice

X Jiang, MT Pardue, K Mori, S Ikeda, H Torii, S D’Souza, RA Lang, ...

Proceedings of the National Academy of Sciences 118 (22), e2018840118 2021

Lead author, Last author, Corresponding author

Violet light suppresses lens-induced myopia via neuropsin (OPN5) in mice

T Kurihara, X Jiang, M Pardue, K Mori, S Ikeda, H Torii, S D’Souza, ...

Investigative Ophthalmology & Visual Science 62 (8), 2277-2277 2021

Lead author, Last author, Corresponding author

RATIO OF AXIAL LENGTH TO CORNEAL RADIUS IN JAPANESE PATIENTS AND ACCURACY OF INTRAOCULAR LENS POWER CALCULATION BASED ON BIOMETRIC DATA (vol 218, pg 320, 2020)

MK Omoto, H Torii, K Hayashi, M Ayaki, K Tsubota, K Negishi

AMERICAN JOURNAL OF OPHTHALMOLOGY 231 2021

Lead author, Last author, Corresponding author

Multi-Functionality of Eyes: Visual and Non-Visual Roles

K Tsubota, H Torii, T Kurihara

Brain and Nerve= Shinkei Kenkyu no Shinpo 73 (11), 1185-1191 2021

Lead author, Last author, Corresponding author

Light source for myopia prevention article and method of using light source for myopia prevention article

M Yamakawa, H Torii, T Kurihara, K Tsubota

US Patent App. 17/301,859 2021

Lead author, Last author, Corresponding author

Light source for myopia prevention article and method of using light source for myopia prevention article

M Yamakawa, H Torii, T Kurihara, K Tsubota

US Patent 11,007,375 2021

Lead author, Last author, Corresponding author

Axial length and prevalence of myopia among schoolchildren in the equatorial region of Brazil

E Yotsukura, H Torii, H Ozawa, RY Hida, T Shiraishi, I Corso Teixeira, ...

Journal of Clinical Medicine 10 (1), 115 (Journal of Clinical Medicine) 10 ( 1 ) 1 - 11 2020.12

Lead author, Last author, Corresponding author, ISSN 2077-0383

The prevalence of myopia is increasing globally, and the outdoor light environment is considered as a possible factor that can retard myopia. The aim of this study was to evaluate the prevalence of myopia and the light environment in Aracati, equatorial Brazil. We surveyed 421 children (421 right eyes; mean age, 10.6 years) and performed ocular examinations that in- cluded non-cycloplegic refraction and axial length (AL). Multiple regression analyses were performed to identify factors affecting myopia such as time spent outdoors and in near work. We measured illuminance and violet light irradiance in Aracati. The mean spherical equivalent (SE) and AL were-0.44 ± 1.38 diopters (D) and 22.98 ± 0.87 mm, respectively. The prevalence of myopia (SE≤-0.75 D) and high myopia (SE ≤-6.0 D/AL≥26.0 mm) was 20.4 and 1.4/0.48%, respectively. Multiple regression analyses showed that myopia was not associated with lifestyle factors. The average illuminance in Aracati was about 100,000 lux from morning to evening. The current results reflect the ALs and the prevalence of myopia among Brazilian schoolchildren. There is a possibility that the light environment in addition to other confounding factors including racial differences affects the ALs and refractive errors.

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Oral bovine milk lactoferrin administration suppressed myopia development through matrix metalloproteinase 2 in a mouse model

SI Ikeda, T Kurihara, M Toda, X Jiang, H Torii, K Tsubota

Nutrients 12 (12), 3744 (Nutrients) 12 ( 12 ) 1 - 9 2020.12

Lead author, Last author, Corresponding author

Recent studies have reported an association between myopia development and local ocular inflammation. Lactoferrin (LF) is an iron-binding protein present in saliva, tears, and mother’s milk. Furthermore, sequestering iron by LF can cause its antibacterial property. Moreover, LF has an anti-inflammatory effect. We aimed to determine the suppressive effect of LF against the development and progress of myopia using a murine lens-induced myopia (LIM) model. We divided male C57BL/6J mice (3 weeks old) into two groups. While the experimental group was orally administered LF (1600 mg/kg/day, from 3-weeks-old to 7-weeks-old), a similar volume of Ringer’s solution was administered to the control group. We subjected the 4-week-old mice to −30 diopter lenses and no lenses on the right and left eyes, respectively. We measured the refraction and the axial length at baseline and 3 weeks after using a refractometer and a spectral domain optical coherence tomography (SD-OCT) system in both eyes. Furthermore, we determined the matrix metalloproteinase-2 (MMP-2) activity, and the amount of interleukin-6 (IL-6), MMP-2, and collagen 1A1 in the choroid or sclera. The eyes with a minus lens showed a refractive error shift and an axial length elongation in the control group, thus indicating the successful induction of myopia. However, there were no significant differences in the aforementioned parameters in the LF group. While LIM increased IL-6 expression and MMP-2 activity, it decreased collagen 1A1 content. However, orally administered LF reversed these effects. Thus, oral administration of LF suppressed lens-induced myopia development by modifying the extracellular matrix remodeling through the IL-6–MMP-2 axis in mice.

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Axial length shortening in a myopic child with anisometropic amblyopia after wearing violet light-transmitting eyeglasses for 2 years

Y Ofuji, H Torii, E Yotsukura, K Mori, T Kurihara, K Negishi, K Tsubota

American Journal of Ophthalmology Case Reports 20, 101002 (American Journal of Ophthalmology Case Reports) 20 101002 2020.12

Lead author, Last author, Corresponding author, ISSN 24519936

Purpose: To report a case in which the axial length (AL) shortened and the choroid thickened due to the use of violet light-transmitting eyeglasses. Observations: A 4-year-old boy with high myopia was referred to Keio University Hospital. He was prescribed standard eyeglasses. Six months after the first visit, his best-corrected visual acuities were 1.2 and 0.4 in the right and left eyes, respectively, with the standard eyeglasses, and he was diagnosed with anisometropic amblyopia. The right eye then was patched for 6 hours daily during the daytime. Because of the availability of violet light-transmitting eyeglasses, we changed the eyeglasses and instructed his parents to have him engage in outdoor activities for over 2 hours daily to be exposed to sufficient violet light. As a result, the violet light entered his left eye and minimal violet light entered his right eye. The changes in the ALs, choroidal thicknesses, and cycloplegic objective refractions in the right and left eyes during 2 years of wearing violet light-transmitting eyeglasses were +0.85 and −0.20 mm, +4.9 and + 115.7 μm, and −1.02 and + 1.88 D, respectively. Conclusions and importance: We successfully described a case in which the myopia improved, the AL shortened, and the choroid thickened after using violet light-transmitting eyeglasses.

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Subjective happiness and satisfaction in postoperative anisometropic patients after refractive surgery for myopia

K Negishi, I Toda, M Ayaki, H Torii, K Tsubota

Journal of Clinical Medicine 9 (11), 3473 (Journal of Clinical Medicine) 9 ( 11 ) 1 - 11 2020.10

Lead author, Last author, Corresponding author, ISSN 2077-0383

Laser-assisted in situ keratomileusis (LASIK) contributes to increased patient happiness one month after surgery; however, longer term effects are unknown. We performed a retrospective cross-sectional study on 472 patients who underwent bilateral LASIK surgery to measure happiness and satisfaction with LASIK, and to identify affecting factors. Patients completed questionnaires on satisfaction with the surgery and the subjective happiness scale (SHS) before, and 1, 3, 6, and 12 months after surgery. Multiple regression analyses were performed to determine independent predictors of SHS and satisfaction scores. Mean SHS increased at one month but was similar to baseline levels by six months. The SHS of older patients was greater than younger ones at baseline and at one and three months, while satisfaction among the older group was poorer at one and three months. Multiple regression analyses revealed that the decrease in SHS score from one month to three months correlated with baseline SHS, SHS at one month, uncorrected distance visual acuity (UDVA), and age. Regression analysis revealed SHS at six months correlated with preoperative SHS, SHS at one month, and satisfaction at six months. Satisfaction at final visit correlated with age, UDVA, anisometropia, and with SHS at each visit. We conclude that happiness and satisfaction were age-and UDVA-dependent, and anisometropic patients report poorer satisfaction scores.

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Changes in Patient Subjective Happiness and Satisfaction with Cataract Surgery

Yotsukura Erisa, M Ayaki, N Nezu, H Torii, H Arai, K Sakatani, K Tsubota, K Negishi

The Journal of The Japanese Society for Cataract Research (The Japanese Society for Cataract Research) 10 ( 1 ) 17273 - 83 2020.10

Lead author, Last author, Corresponding author, ISSN 09154302

The purpose of this study was to investigate the changes in patient subjective happiness and satisfaction with cataract surgery and evaluate the association between satisfaction and types of cataract. This study surveyed 247 participants (mean age, 67.9 years) and they completed questionnaires on their satisfaction with the surgery, the subjective happiness scale (SHS) and the Pittsburgh Sleep Quality Index (PSQI) before and after surgery. The SHS increased postoperatively from 4.6 ± 0.7 to 4.8 ± 0.7 (P = 0.007) and 83.4% of patients were satisfied with the surgical results and the average satisfaction score was 4.2 out of a possible 5.0. Multiple regression analysis showed that patient satisfaction was significantly associated with the postoperative SHS (β = 0.380; P < 0.001), the postoperative PSQI (β = −0.041; P = 0.035) and the presence of a posterior subcapsular cataract (PSC) (β = 0.277; P = 0.026). This study clarified that cataract surgery may improve both visual function and patient happiness and that patient satisfaction was affected by postoperative sleep quality and the disappearance of a PSC.

Author Correction: Ocular biometry and refractive outcomes using two swept-source optical coherence tomography-based biometers with segmental or equivalent refractive indices.

Omoto MK, Torii H, Masui S, Ayaki M, Tsubota K, Negishi K

Scientific reports (Scientific Reports) 10 ( 1 ) 13181 2020.07

Lead author, Last author, Corresponding author

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Five-year outcomes of corneal cross-linking for Keratoconus: comparison between conventional and accelerated procedures

N Kato, K Negishi, C Sakai, I Toda, T Ide, H Torii, K Tsubota

Cornea 39 (1), e1 (Cornea) 39 ( 1 ) e1 - e2 2020.01

Lead author, Last author, Corresponding author, ISSN 0277-3740

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Ratio of axial length to corneal radius in Japanese patients and accuracy of intraocular lens power calculation based on biometric data

MK Omoto, H Torii, K Hayashi, M Ayaki, K Tsubota, K Negishi

American Journal of Ophthalmology 218, 320-329 (American Journal of Ophthalmology) 218 320 - 329 2020

ISSN 00029394

© 2020 The Authors Purpose: To evaluate the features of the axial length-to-corneal radius (AL/CR) ratio in Japanese patients with cataracts and to determine the accuracy of intraocular lens (IOL) power calculation formulas according to the AL/CR features and the axial length (AL). Design: Retrospective observational case series. Methods: Setting was a clinical practice. Patient population was a total of 1,135 eyes (1,135 patients) with cataracts. Observation procedures included measurement of the AL and corenal radius (CR) by optical biometry and evaluation of the refractive outcomes by using the SRK/T, Holladay 1, Hoffer Q, Haigis, and Barrett Universal II formulas. Main outcome measurements were the features of the AL/CR ratio and the accuracy of IOL power calculations based on the AL/CR ratio and the AL. Results: The mean AL/CR ratio was 3.15 ± 0.19. Significant weak negative correlations were observed between the spherical equivalent (SE) and AL (r = −0.7489; P < .001) and between the SE and AL/CR ratio (r = −0.8069; P < .001); no correlation was found between the SE and CR (r = 0.0208, P = .483). For medium ALs and high AL/CR ratios, the SRK/T formula performed less accurately. For long ALs and high AL/CR ratios, the Holladay 1 and Hoffer Q formulas performed less accurately. The Barrett Universal II formula performed well across a range of ALs and AL/CR ratios. Conclusions: The AL/CR ratio explained the total variation in the SE better than the AL alone. Surgeons should pay attention to the selection of IOL power calculation formulas in eyes with high AL/CR ratios.

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Estimation of the minimum eﬀective dose of dietary supplement crocetin for prevention of myopia progression in mice

Mori K., Kurihara T., Jiang X., Ikeda S.I., Yotsukura E., Torii H., Tsubota K.

Nutrients (Nutrients) 12 ( 1 ) 2020

© 2020, MDPI AG. All rights reserved. The natural carotenoid crocetin has been reported to suppress phenotypes of an experimental myopia model in mice. We investigated the minimum effective dose to prevent myopia progression in a murine model. Three-week-old male mice (C57B6/J) were equipped with a −30 diopter (D) lens to induce myopia, and fed with normal chow, 0.0003%, or 0.001% of crocetin-containing chow. Changes in refractive errors and axial lengths (AL) were evaluated after three weeks. Pharmacokinetics of crocetin in the plasma and the eyeballs of mice was evaluated with specific high sensitivity quantitative analysis using liquid chromatography tandem mass spectrometry (LC-MS/MS) to determine the minimum effective dosage. A concentration of 0.001% of crocetin-containing chow showed a significant (p < 0.001) suppressive effect against both refractive and AL changes in the murine model. Meanwhile, there was no significant difference of AL change between the 0.0003% and the normal chow groups. The concentration of crocetin in the plasma and the eyeballs from mice fed with 0.001% crocetin-containing chow was significantly higher than control and 0.0003% crocetin-containing chow. In conclusion, we suggest 0.001% of crocetin-containing extract is the minimum effective dose showing a significant suppressive effect against both refractive and AL changes in the murine model.

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Accuracy of Intraocular Lens Power Calculation Formulas in Eyes after Laser in Situ Keratomileusis

T Suzuki, H Torii, Y Nishi, K Tsubota, K Negishi

2020 ASCRS Annual Meeting 2020

Lead author, Last author, Corresponding author

Centrifugal Pump

H Torii, K Nakaya

US Patent App. 16/763,241 2020

Lead author, Last author, Corresponding author

Author Correction: Ocular biometry and refractive outcomes using two swept-source optical coherence tomography-based biometers with segmental or equivalent refractive indices

MK Omoto, H Torii, S Masui, M Ayaki, K Tsubota, K Negishi

Scientific reports 10 (1), 13181 2020

Lead author, Last author, Corresponding author

Estimation of the minimum effective dose of dietary supplement crocetin for prevention of myopia progression in mice

K Mori, T Kurihara, X Jiang, S Ikeda, E Yotsukura, H Torii, K Tsubota

Nutrients 12 (1), 180 2020

Lead author, Last author, Corresponding author

Subjective Happiness and Sleep in University Students with High Myopia

I Iehisa, K Negishi, R Sakamoto, H Torii, M Ayaki, K Tsubota

Psych 2 (4), 279-286 2020

Lead author, Last author, Corresponding author

Refractive stability of a new single-piece hydrophobic acrylic intraocular lens and corneal wound repair after implantation using a new automated intraocular lens delivery system

K Negishi, S Masui, H Torii, Y Nishi, K Tsubota

PLoS one 15 (9), e0238366 (PLoS ONE) 15 ( 9 ) e0238366 2020

Lead author, Last author, Corresponding author, ISSN 1932-6203

Purpose To investigate refractive stability and characterize corneal incision repair up to 3 months after implantation of a new hydrophobic acrylic intraocular lens (IOL) with hydroxyethyl-methacrylate using a new automated IOL delivery system. Methods This prospective case series included 50 eyes of 50 patients undergoing phacoemulsification and implantation of the Clareon® CNA0T0 IOL using the AutonoMe® automated delivery system in the Department of Ophthalmology, Keio University School of Medicine. The clinical data were collected from 46 eyes of 46 patients preoperatively and 1 day, 1 week, and 1 and 3 months postoperatively. Endothelial-side incision gaping, posterior incision retraction, and Descemet’s membrane detachment were recorded as present or absent using anterior-segment optical coherence tomography postoperatively. Results The uncorrected distance and corrected distance visual acuities improved and stabilized 1 week postoperatively. The anterior chamber depth was stable from 1 week postoperatively. The subjective refraction was stable from 1 day postoperatively. Descemet’s membrane detachments and endothelial-side wound gaping were seen in 19 (41.3%) eyes and 34 (73.9%) eyes 1 day postoperatively and decreased gradually. Posterior incision retraction was seen in eight eyes (17.4%) on day 1 and increased to 19 eyes (41.3%) 3 months postoperatively. Conclusions The Clareon IOL had excellent refractive stability from day 1 postoperatively. The AutonoMe automated delivery system enables safe IOL implantation through a 2.4-mm corneal incision, although the wound required longer than 1 month to heal postoperatively.

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Optical element

S Shioya, K Tsubota, T Kurihara, H Torii

US Patent 10,866,433 2020

Lead author, Last author, Corresponding author

Ocular biometry and refractive outcomes using two swept-source optical coherence tomography-based biometers with segmental or equivalent refractive indices (vol 63, 251, 2020)

MK Omoto, H Torii, S Masui, M Ayaki, K Tsubota, K Negishi

SCIENTIFIC REPORTS 10 (1) 2020

Lead author, Last author, Corresponding author

Myopia treatment device

K Tsubota, K Negishi, H Torii, T Kurihara

US Patent 10,823,982 2020

Lead author, Last author, Corresponding author

Implantation of a Toric Intraocular Lens after Several Radial Keratotomy Procedures: A Case Report

SS Chen, H Torii, E Yotsukura, Y Nishi, K Tsubota, K Negishi

2020 ASCRS Annual Meeting 2020

Lead author, Last author, Corresponding author

Glass

K Nagai, T Nakashima, Y Kuroiwa, H Hijiya, M Tanida, A Koike, ...

US Patent 10,865,134 2020

Lead author, Last author, Corresponding author

Oral crocetin administration suppressed refractive shift and axial elongation in a murine model of lens-induced myopia

K Mori, T Kurihara, M Miyauchi, A Ishida, X Jiang, S Ikeda, H Torii, ...

Scientific reports 9 (1), 295 (Scientific Reports) 9 ( 1 ) 295 2019.12

ISSN 2045-2322

© 2019, The Author(s). Increased global incidence of myopia necessitates establishment of therapeutic approaches against its progression. To explore agents which may control myopia, we screened 207 types of natural compounds and chemical reagents based on an activity of a myopia suppressive factor, early growth response protein 1 (Egr-1) in vitro. Among the candidates, crocetin showed the highest and dose-dependent activation of Egr-1. For in vivo analysis, experimental myopia was induced in 3-week-old C57BL/6 J mice with −30 diopter (D) lenses for 3 weeks. Animals were fed with normal or mixed chow containing 0.003% (n = 19) and 0.03% (n = 7) of crocetin during myopia induction. Refraction and axial length were measured at 3-week-old and the 6-week-old with an infrared photorefractor and a SD-OCT system. Compared to controls (n = 14), crocetin administration showed a significant smaller change of refractive errors (−13.62 ± 8.14 vs +0.82 ± 5.81 D for 0.003%, p < 0.01, −2.00 ± 4.52 D for 0.03%, p < 0.01) and axial elongation (0.27 ± 0.03 vs 0.22 ± 0.04 mm for 0.003%, p < 0.01, 0.23 ± 0.05 mm for 0.03%, p < 0.05). These results suggest that a dietary factor crocetin may have a preventive effect against myopia progression.

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Effects of hyperoxia on the refraction in murine neonatal and adult models

K Mori, T Kurihara, X Jiang, S Ikeda, A Ishida, H Torii, K Tsubota

International journal of molecular sciences 20 (23), 6014 (International Journal of Molecular Sciences) 20 ( 23 ) 2019.12

ISSN 16616596

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Whether hyperoxia affects the refraction in neonatal and adult mice is unknown. The mice exposed to 85% oxygen at postnatal 8 days (P8d) for 3 days and the mice exposed to normal air were assigned to the neonatal hyperoxia and normoxia groups, respectively. The refraction, the corneal curvature radius (CR) and the axial length (AL) were measured at P30d and P47d. Postnatal 6 weeks (P6w) adult mice were divided into the adult hyperoxia and normoxia groups. These parameters were measured before oxygen exposure, after 1 and 6 weeks, and every 7 weeks. The lens elasticity was measured at P7w and P26w by enucleation. The neonatal hyperoxia group showed a significantly larger myopic change than the neonatal normoxia group (P47d −6.56 ± 5.89 D, +4.11 ± 2.02 D, p < 0.001), whereas the changes in AL were not significantly different (P47d, 3.31 ± 0.04 mm, 3.31 ± 0.05 mm, p = 0.852). The adult hyperoxia group also showed a significantly larger myopic change (P12w, −7.20 ± 4.09 D, +7.52 ± 2.54 D, p < 0.001). The AL did not show significant difference (P12w, 3.44 ± 0.03 mm, 3.43 ± 0.01 mm, p = 0.545); however, the CR in the adult hyperoxia group was significantly smaller than the adult normoxia group (P12w, 1.44 ± 0.03 mm, 1.50 ± 0.03 mm, p = 0.003). In conclusion, hyperoxia was demonstrated to induce myopic shift both in neonatal and adult mice, which was attributed to the change in the CR rather than the AL. Elucidation of the mechanisms of hyperoxia and the application of this result to humans should be carried out in future studies.

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Ocular biometry and refractive outcomes using two swept-source optical coherence tomography-based biometers with segmental or equivalent refractive indices

MK Omoto, H Torii, S Masui, M Ayaki, K Tsubota, K Negishi

Scientific reports 9 (1), 6557 (Scientific Reports) 9 ( 1 ) 6557 2019.12

ISSN 2045-2322

© 2019, The Author(s). This study compared the axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), mean anterior corneal radius of curvature (Rm), and postoperative refractive outcomes obtained from two different swept-source optical coherence biometers, the ARGOS (Movu, Nagoya, Japan), which uses the segmental refractive index for each segment, and the IOLMaster 700 (Carl Zeiss Meditec, Jena, Germany), which uses an equivalent refractive index for the entire eye. One hundred and six eyes of 106 patients with cataracts were included. The refractive outcomes using the Barrett Universal II, Haigis, Hoffer Q, and SRK/T formulas were evaluated. The mean AL, CCT, ACD, and Rm differed significantly (P < 0.001) with the IOLMaster 700 (25.22 mm, 559 µm, 3.23 mm, and 7.69 mm) compared with the ARGOS (25.14 mm, 533 µm, 3.33 mm, and 7.66 mm). The mean LTs did not differ significantly. The percentages of eyes within ±0.50 and ±1.00 diopter of the predicted refraction did not differ significantly (P > 0.05). The accuracy of the intraocular lens power calculations was clinically acceptable with both biometers, although the ocular biometry using these two biometers exhibited certain differences.

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Current prevalence of myopia and association of myopia with environmental factors among schoolchildren in Japan

E Yotsukura, H Torii, M Inokuchi, M Tokumura, M Uchino, K Nakamura, ...

JAMA ophthalmology 137 (11), 1233-1239 (JAMA Ophthalmology) 137 ( 11 ) 1233 - 1239 2019.11

ISSN 21686165

© 2019 American Medical Association. All rights reserved. Importance: Given the estimates of increasing prevalence of myopia, especially in Asia, it is important to determine the current prevalence of myopia among populations of schoolchildren in Japan. Objective: To investigate the current prevalence rate of myopia and the association between environmental factors and myopia in Japanese schoolchildren. Design, Setting, and Participants: This cross-sectional study assessed 1478 participants, including 726 elementary school students and 752 junior high school students, at 2 schools in Tokyo, Japan, who underwent eye examinations from April 1 to May 31, 2017, that included measurement of the refractive errors by autorefractometry with noncycloplegic refraction and ocular biometric factors. After excluding those who had been treated with atropine or orthokeratology (n = 11), had a history of eye disease (n = 2), had no parental consent (n = 41), and were absent (n = 8), 1416 schoolchildren were analyzed. Main Outcomes and Measures: The primary outcome was the prevalence of myopia and high myopia. Secondary outcomes were environmental factors that were associated with myopia. Results: A total of 1416 schoolchildren (mean [SD] age, 10.8 [2.7] years; 792 [55.9%] male) were studied. The prevalence rates of myopia (spherical equivalent ≤-0.5 diopters [D]) were 76.5% (95% CI, 73.4%-79.7%) among the elementary school students and 94.9% (95% CI, 93.3%-96.5%) among the junior high school students. The prevalence rates of high myopia (spherical equivalent ≤-6.0 D) were 4.0% (95% CI, 2.5%-5.4%) among the elementary school students and 11.3% (95% CI, 8.8%-13.7%) among the junior high school students. The prevalence rates of high myopia classified based on axial length of 26.0 mm or longer were 1.2% (95% CI, 0.4%-2.0%) among elementary school students and 15.2% (95% CI, 12.5%-17.8%) among junior high school students. Multiple regression analysis showed that higher-order aberrations and dry eye disease were associated with refractive error in elementary school students (spherical aberration: β = 6.152; 95% CI, 3.161-9.143; P <.001; dry eye disease: β = -0.626; 95% CI, -1.189 to -0.063; P =.03) and with axial length in junior high school students (spherical-like aberration: β = 26.546; 95% CI, 18.708-34.385; P <.001; dry eye disease: β = 0.354; 95% CI, 0.131-0.578; P <.002). Conclusions and Relevance: Although the use of noncycloplegic autorefraction with a cutoff of -0.50 D could lead to overestimation of results, these findings suggest that the current prevalence rates of myopia among elementary and junior high school students in Asia are high, especially if the results from these 2 schools are generalizable to all schoolchildren in Japan and Asia..

High myopia and its associated factors in JPHC-NEXT eye study: a cross-sectional observational study

K Mori, T Kurihara, M Uchino, H Torii, M Kawashima, M Sasaki, Y Ozawa, ...

Journal of Clinical Medicine 8 (11), 1788 (Journal of Clinical Medicine) 8 ( 11 ) 2019.10

Lead author, Last author, Corresponding author, ISSN 2077-0383

The increasing prevalence of high myopia has been noted. We investigated the epidemiological characteristics and the related factors of high myopia in a Japanese adult population. Japan Public Health Center-Based Prospective Study for the Next Generation (JPHC-NEXT) Eye Study was performed in Chikusei-city, a rural area in mid-east Japan, between 2013 and 2015. A cross-sectional observational analysis was conducted to investigate prevalence and related factors of high myopia. A total of 6101 participants aged ≥40 years without a history of ocular surgeries was included. High myopia was defined as a spherical equivalent refraction of ≤−6.00 diopters according to the American Academy of Ophthalmology. Potential high myopia-related factors included intraocular pressure (IOP), corneal structure, corneal endothelial cell density, age, height, body mass index, heart rate, blood pressure, biochemical profile, and current history of systemic and ocular disorders. The odds ratios of high myopia were estimated using the logistic regression models adjusted for the associated factors. The prevalence of high myopia was 3.8% in males and 5.9% in females with a significant difference. Age was inversely associated, IOP was positively associated, and none of other factors were associated with high myopia in both sexes. In conclusion, only age and IOP were associated with high myopia in this community-based sample.

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Ultra-widefield retinal imaging for analyzing the association between types of pathological myopia and posterior staphyloma

R Mimura, K Mori, H Torii, N Nagai, M Suzuki, S Minami, Y Ozawa, ...

Journal of clinical medicine 8 (10), 1505 (Journal of Clinical Medicine) 8 ( 10 ) 2019.09

Lead author, Last author, Corresponding author, ISSN 2077-0383

High myopia may develop to pathologic myopia, which brings severe visual impairment; however, the etiology is not fully understood. We, therefore, investigated the relationship between the presence of posterior staphyloma and posterior ocular disorders by assessing the patients with high myopia. A retrospective study was performed for the patients, who have more than 26 mm of the axial length and of whom fundus photography was taken with an ultra-widefield retinal imaging system. The objectives were 138 cases encompassing 229 eyes. In 138 cases, 91 were bilateral and 47 were unilateral. The averages ± SD of axial length of bilateral and unilateral were 28.8 ± 2.2 mm, 27.3 ± 1.2 mm, respectively, showing statistically significant difference. The number of eyes with and without posterior staphyloma were 107 (46.7%) and 122 (53.3%), respectively. Retinal detachment and retinal breaks are more observed in cases without posterior staphyloma (p = 0.017). Myopic choroidal neovascularization (mCNV) (p = 0.002), chorioretinal atrophy (p < 0.001), retinoschisis (p < 0.001), and optic neuropathy (p = 0.038) are more often seen in cases with posterior staphyloma. In conclusion, the prevalence rates of myopic choroidal neovascularization, retinal choroidal atrophy, and optic neuropathy were significantly higher with posterior staphyloma. The rate of periocular disorders such as retinal detachment was significantly higher without posterior staphyloma. These results indicate associations between types of pathological myopia and presence or absence of posterior staphyloma analyzed by ultra-widefield retinal imaging.

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連載症例から学ぶ　白内障手術の実践レクチャー・術後編20 グレア・ハロー・dysphotopsia

鳥居秀成

臨床眼科 (株式会社医学書院) 73 ( 9 ) 1122 - 1127 2019.09

Lead author, Last author, Corresponding author, ISSN 03705579

The effect of dietary supplementation of crocetin for myopia control in children: a randomized clinical trial

K Mori, H Torii, S Fujimoto, X Jiang, S Ikeda, E Yotsukura, S Koh, ...

Journal of clinical medicine 8 (8), 1179 (Journal of Clinical Medicine) 8 ( 8 ) 2019.08

Lead author, Last author, Corresponding author, ISSN 2077-0383

The prevalence of myopia has been increasing in recent years. The natural carotenoid crocetin has been reported to suppress experimental myopia in mice. We evaluated the effects of crocetin on myopia suppression in children. A multicenter randomized double-blind placebo-controlled clinical trial was performed with 69 participants aged 6 to 12 years, whose cycloplegic spherical equivalent refractions (SER) were between −1.5 and −4.5 diopter (D). The participants were randomized to receive either a placebo or crocetin and followed up for 24 weeks. Axial length (AL) elongation and changes in SER were evaluated for 24 weeks. Both written informed assent from the participants and written informed consent from legal guardians were obtained in this study because the selection criteria of this trial included children aged between 6 and 12 years old. This trial was approved by the institutional review boards. A mixed-effects model was used for analysis, using both eyes. Two participants dropped out and 67 children completed this trial. The change in SER in the placebo group, −0.41 ± 0.05 D (mean ± standard deviation), was significantly more myopic compared to that in the crocetin group, −0.33 ± 0.05 D (p = 0.049). The AL elongation in the placebo group, 0.21 ± 0.02 mm, was significantly bigger than that in the crocetin group, 0.18 ± 0.02 mm (p = 0.046). In conclusion, dietary crocetin may have a suppressive effect on myopia progression in children, but large-scale studies are required in order to confirm this effect.

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Ocular-component-specific miRNA expression in a murine model of lens-induced myopia

Y Tanaka, T Kurihara, Y Hagiwara, S Ikeda, K Mori, X Jiang, H Torii, ...

International journal of molecular sciences 20 (15), 3629 (International Journal of Molecular Sciences) 20 ( 15 ) 2019.08

ISSN 16616596

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. To identify tissues and molecules involved in refractive myopic shift and axial length elongation in a murine lens-induced myopia model, we performed a comprehensive analysis of microRNA (miRNA) expression. Three weeks after negative 30 diopter lens fixation on three-week-old C57BL/6J mice, total RNA was extracted from individual ocular components including cornea, iris, lens, retina, retinal pigment epithelium (RPE)/choroid, and sclera tissue. The miRNA expression analysis was pooled from three samples and carried out using Agilent Mouse miRNA Microarray (8 × 60 K) miRBase21.0. The expression ratio was calculated, and differentially expressed miRNAs were extracted, using GeneSpring GX 14.5. Myopic induction showed a significant myopic refractive change, axial elongation, and choroidal thinning. Through the comprehensive miRNA analysis, several upregulated miRNAs (56 in cornea tissue, 13 in iris tissue, 6 in lens tissue, 0 in retina tissue, 29 in RPE/choroid tissue, and 30 in sclera tissue) and downregulated miRNAs (7 in cornea tissue, 28 in iris tissue, 17 in lens tissue, 9 in retina tissue, 7 in RPE/choroid tissue, and 40 in sclera tissue) were observed. Overlapping expression changes in miRNAs were also found in different ocular components. Some of this miRNA dysregulation may be functionally involved in refractive myopia shift and axial length elongation.

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Clinical Outcomes of KeraVio using Violet Light Emitting Glasses and Riboflavin for Corneal Ectasia: A Pilot Study

H Kobashi, H Torii, I Toda, K Tsubota

Investigative Ophthalmology & Visual Science 60 (9), 318-318 60 ( 9 ) 2019.07

Lead author, Last author, Corresponding author, ISSN 0146-0404

Omega-3 polyunsaturated fatty acids suppressed experimental myopia progression in mice

K Mori, T Kurihara, X Jiang, S Ikeda, M Arita, H Torii, K Tsubota

Investigative Ophthalmology & Visual Science 60 (9), 5892-5892 60 ( 9 ) 2019.07

Lead author, Last author, Corresponding author, ISSN 0146-0404

Wavelength Specificity of Violet Light on Suppressing Refractive Change and Axial Elongation in A Murine Model of Lens-induced Myopia

X Jiang, T Kurihara, K Mori, S Ikeda, H Torii, K Tsubota

Investigative Ophthalmology & Visual Science 60 (9), 3153-3153 60 ( 9 ) 2019.07

Lead author, Last author, Corresponding author, ISSN 0146-0404

Comparison of the accuracy of newer intraocular lens power calculation methods in eyes that underwent previous phototherapeutic keratectomy

Y Yagi-Yaguchi, K Negishi, M Saiki, H Torii, K Tsubota

Journal of Refractive Surgery 35 (5), 310-316 (Journal of Refractive Surgery) 35 ( 5 ) 310 - 316 2019.05

ISSN 1081597X

Copyright © SLACK Incorporated. PURPOSE: To evaluate the accuracy of intraocular lens (IOL) power calculations using ray tracing software in patients who had undergone phototherapeutic keratectomy (PTK). METHODS: In this retrospective case series, 37 eyes of 22 patients (mean age: 69.4 years; range: 56 to 85 years) who underwent cataract surgery after PTK were reviewed. The prediction error, defined as the difference between the estimated postoperative spherical equivalent and the postoperative manifest refraction at the spectacle plane, was calculated using the following formulas: OKULIX (Tedics, Dortmund, Germany), PhacoOptics (IOL Innovations ApS, Aarhus, Denmark), Barrett True K No History (NH), and Camellin-Calossi. The PhacoOptics formula was used in three different ways: historical method (H), no history method (NH), and C-constant method (C). The median values of the arithmetic and absolute prediction errors among these six IOL calculation methods were compared. RESULTS: The median arithmetic errors (in diopters [D]) and percentages of eyes within ±0.50 D of the absolute errors were as follows: OKULIX (0.33, range: -2.20 to 2.50, 30.6%), PhacoOptics (H) (-0.12, range: -3.28 to 4.85, 22.2%), PhacoOptics (NH) (-0.25, range: -2.08 to 1.70, 48.4%), PhacoOptics (C) (0.04, range: -1.40 to 2.18, 48.5%), Barrett True K (NH) (-0.35, range: -1.90 to 1.89, 48.6%), and Camellin-Calossi (-0.19, range: -1.78 to 1.47, 59.5%). CONCLUSIONS: The PhacoOptics, especially the C-constant method (C), and Camellin-Calossi formulas were good options for calculating IOL powers in eyes that underwent PTK.

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IMI–Clinical myopia control trials and instrumentation report

JS Wolffsohn, PS Kollbaum, DA Berntsen, DA Atchison, A Benavente, ...

Investigative ophthalmology & visual science 60 (3), M132-M160 (Investigative Ophthalmology and Visual Science) 60 ( 3 ) M132 - M160 2019.02

ISSN 01460404

© 2019 The Authors. The evidence-basis based on existing myopia control trials along with the supporting academic literature were reviewed; this informed recommendations on the outcomes suggested from clinical trials aimed at slowing myopia progression to show the effectiveness of treatments and the impact on patients. These outcomes were classified as primary (refractive error and/or axial length), secondary (patient reported outcomes and treatment compliance), and exploratory (peripheral refraction, accommodative changes, ocular alignment, pupil size, outdoor activity/ lighting levels, anterior and posterior segment imaging, and tissue biomechanics). The currently available instrumentation, which the literature has shown to best achieve the primary and secondary outcomes, was reviewed and critiqued. Issues relating to study design and patient selection were also identified. These findings and consensus from the International Myopia Institute members led to final recommendations to inform future instrumentation development and to guide clinical trial protocols.

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Inducement and evaluation of a murine model of experimental myopia

X Jiang, T Kurihara, S Ikeda, H Kunimi, K Mori, H Torii, K Tsubota

JoVE (Journal of Visualized Experiments), e58822 (Journal of Visualized Experiments) 2019 ( 143 ) 2019.01

ISSN 1940087X

© 2019 Journal of Visualized Experiments. Murine model of myopia can be a powerful tool for myopia research because of the comparatively easy genetic manipulation. One way to induce myopia in animals is to put clear minus lenses in front of eyes for weeks (lens-induced myopia, LIM). However, extant protocols for inducement and evaluation vary from laboratory to laboratory. Here, we described a highly practical and reproducible method to induce LIM in mice using newly designed eyeglasses. The method fixes the lens stably in front of the mouse eye while allows the lens to be taken off for cleaning or topical drug administration. The phenotype is robust and efficient, and the variance is small. The method described here can be applied to mice right after weaning which extends the possible duration for experiments. We also gave technical advises for achieving reproducible results in refraction and axial length measurements. We hope the step-by-step protocol described here and the detailed article can help researchers perform myopia experiments with myopia more smoothly and make the data comparable across laboratories.

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Dietary Supplement Crocetin Has a Suppressive Effect Against Myopia Progression: A Randomized Clinical Trial

K Mori, H Torii, S Fujimoto, X Jiang, S Ikeda, E Yotsukura, S Koh, ...

Available at SSRN 3384857 2019

Lead author, Last author, Corresponding author

IMI Clinical Myopia Control Trials and Instrumentation Report

DAA Berntsen, A Benavente, A Bradley, H Buckhurst, M Collins, ...

2019

Lead author, Last author, Corresponding author

Violet Light Can be a Protective Factor Against Myopia Progression?

Torii Hidemasa

The Journal of The Japanese Society for Cataract Research (The Japanese Society for Cataract Research) 31 ( 1 ) 43 - 46 2019

Lead author, Last author, Corresponding author, ISSN 09154302

A highly efficient murine model of experimental myopia

Jiang Xiaoyan, Kurihara Toshihide, Kunimi Hiromitsu, Miyauchi Maki, Ikeda Shin Ichi, Mori Kiwako, Tsubota Kinya, Torii Hidemasa, Tsubota Kazuo

Scientific Reports (Scientific Reports) 8 ( 1 ) 2018.12

ISSN 2045-2322

Despite the global pandemic of myopia, the precise molecular mechanism of the onset of myopia remains largely unknown. This is partially because of the lack of efficient murine myopic models that allow genetic manipulation at low cost. Here we report a highly practical and reproducible lens-induced myopia model by specially designed frames and lenses for mice. A lens power dependent myopic induction in mice was shown until minus 30 diopter lenses. The phenotype was significantly stronger than form-deprivation myopia. We presented the protocol for precise evaluations of the state of myopia, including refraction, corneal curvature and axial length using up-to-date devices. We also found that myopic mouse eyes showed decreased visual acuity on optokinetic response examination. Finally, we confirmed the anti-myopic effect of 1% atropine using this model, which showed its potential in drug screening. The strong phenotype, stable evaluation and the potential for gene manipulation utilizing the presented method in mice will accelerate the translational research of myopia.

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Effect of spectacle lenses designed to reduce relative peripheral hyperopia on myopia progression in Japanese children: a 2-year multicenter randomized controlled trial

H Kanda, T Oshika, T Hiraoka, S Hasebe, K Ohno-Matsui, S Ishiko, ...

Japanese journal of ophthalmology 62, 537-543 (Japanese Journal of Ophthalmology) 62 ( 5 ) 537 - 543 2018.09

ISSN 00215155

© 2018, Japanese Ophthalmological Society. Purpose: Novel spectacle lenses (MyoVision, Carl Zeiss) designed to reduce relative peripheral hyperopia have been developed and reported to be effective for preventing myopia progression in a subgroup of Chinese children. In this study we examined the efficacy of MyoVision lenses in Japanese children. Study design: This was a multicenter prospective randomized double-blind placebo-controlled trial. Method: We enrolled 207 participants (aged 6–12 years) with spherical equivalent refractions (SERs) ranging from −1.5 to −4.5 diopters (D) and with at least 1 myopic parent. The participants were randomized to receive either single vision lenses (SVLs) or MyoVision lenses and were followed up every 6 months for 2 years. The primary outcome was myopia progression evaluated by cycloplegic autorefraction, and the secondary outcome was elongation of axial length. Results: A total of 203 children (98.1%) completed the follow-up. The mean adjusted change in SER was −1.43 ± 0.10 D in the MyoVision group, which was not significantly different from that of the control group wearing SVLs (−1.39 ± 0.07 D) at the 24-month visit (P =.65). The adjusted axial length elongation was 0.73 ± 0.04 mm in the MyoVision group, which was not significantly different from that in the control group wearing SVLs (0.69 ± 0.03 mm) at the 24-month visit (P =.28). Conclusion: The results of this clinical trial could not verify the therapeutic effect of MyoVision for slowing down myopia progression in Japanese children. Additional studies are needed to design lenses that can reduce peripheral hyperopic defocus individually and to examine the effectiveness of these lenses in preventing myopia progression.

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日本人小児の近視進行に対する相対的周辺部遠視(relative peripheral hyperopia)を軽減するために設計された眼鏡用レンズの影響　2年間の多施設共同無作為化比較試験(Effect of spectacle lenses designed to reduce relative peripheral hyperopia on myopia progression in Japanese children: a 2-year multicenter randomized controlled trial)

Kanda Hiroyuki, Oshika Tetsuro, Hiraoka Takahiro, Hasebe Satoshi, Ohno-Matsui Kyoko, Ishiko Satoshi, Hieda Osamu, Torii Hidemasa, Varnas Saulius R., Fujikado Takashi

Japanese Journal of Ophthalmology (シュプリンガー・ジャパン(株)) 62 ( 5 ) 537 - 543 2018.09

Lead author, Last author, Corresponding author, ISSN 0021-5155

小児の近視進行予防における軸外収差抑制レンズであるMyoVisionの有効性を調査した。両側近視で等価球面屈折度数(SER)が-1.50～-4.50Dであり、親が近視である小児207例(女児57%、平均9.67±1.44歳)を対象とした。単焦点レンズ(SVL)群105例とMyoVisionレンズ群102例に無作為に分け、2年の経過観察期間中、6ヵ月毎に調節麻痺下オートリフレクションによって近視進行を評価し、眼軸長を測定した。2年後のSERにおける平均補正変化はMyoVision群が-1.43±0.10Dで、SVL群の-1.39±0.07Dと有意差がなかった。眼軸長の2年後の平均補正伸長はMyoVision群が0.73±0.04mmで、SVL群の0.69±0.03mmと有意差がなかった。SVLの使用と比較して、MyoVisionレンズの使用で近視進行の比率に有意差が観察されなかった。

Correlations between age and ocular aberrations in school children

YVBL Rautha, RY Hida, C Nascimento, L Hida, K Tsubota, H Torii, ...

Investigative Ophthalmology & Visual Science 59 (9), 4769-4769 59 ( 9 ) 2018.07

Lead author, Last author, Corresponding author, ISSN 0146-0404

The relationship between violet light transmittance of contact lenses and axial length elongation

H Torii, T Kurihara, S Kondo, X Jiang, K Mori, S Ikeda, E Yotsukura, ...

Investigative Ophthalmology & Visual Science 59 (9), 2145-2145 59 ( 9 ) 2018.07

Lead author, Last author, Corresponding author, ISSN 0146-0404

Violet light exposure suppresses refractive change and axial elongation in a murine model of lens-induced myopia

T Kurihara, X Jiang, K Mori, S Ikeda, H Torii, K Tsubota

Investigative Ophthalmology & Visual Science 59 (9), 677-677 59 ( 9 ) 2018.07

Lead author, Last author, Corresponding author, ISSN 0146-0404

Progress and control of myopia by light environments

X Jiang, T Kurihara, H Torii, K Tsubota

Eye & contact lens 44 (5), 273-278 (Eye and Contact Lens) 44 ( 5 ) 273 - 278 2018

ISSN 15422321

Copyright © 2018 Contact Lens Association of Ophthalmologists, Inc. Unauthorized reproduction of this article is prohibited. During the past 30 years, the prevalence rate of myopia has been increased dramatically. Myopia has become one of the leading causes of vision loss in some countries, whereas the mechanism of the main pathological change in myopia is still largely unknown. Although several studies showed genetic background influences the phenotype of myopia to some extent, the sudden increase of morbidity cannot be explained by genetics only. The change in lifestyle results in tremendous change in the light environment, which can be considered to play an important role in the onset and progression of myopia. The difference between indoor and outdoor light environments such as intensity and wavelength of modern electronic lighting equipment may be a cue for myopia control as environmental factors. In this review, we discuss the relationship between myopia and light environment focusing on the basic and clinical studies.

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CLINICAL INVESTIGATION: Effect of spectacle lenses designed to reduce relative peripheral hyperopia on myopia progression in Japanese children: a 2-year multicenter randomized …

H Kanda, T Oshika, T Hiraoka, S Hasebe, K Ohno-Matsui, S Ishiko, ...

Japanese journal of ophthalmology: the official international journal of the … 2018

Lead author, Last author, Corresponding author

Electric pump

H Torii

US Patent 10,030,661 2018

Lead author, Last author, Corresponding author

Irradiation device

K Tsubota, K Negishi, H Torii, T Kurihara

US Patent App. 15/996,842 2018

Lead author, Last author, Corresponding author

Wavelength-selective transparent glass product

H Hirakoso, T Mashimo, K Nagai, K Tsubota, T Kurihara, H Torii

US Patent App. 15/992,408 2018

Lead author, Last author, Corresponding author

Vortex pump and fuel vapor treatment device comprising the vortex pump

H Torii, A Sugimoto, S Suzuki

US Patent 10,041,501 2018

Lead author, Last author, Corresponding author

Violet Light as a Superhero Against Myopia Pandemic

H Torii

2018 ASCRS ASOA Annual Meeting 2018

Lead author, Last author, Corresponding author

Myopia prevention device

K Tsubota, K Negishi, H Torii, T Kurihara

US Patent 10,133,092 2018

Lead author, Last author, Corresponding author

Violet Light Transmission is Related to Myopia Progression in Adult High Myopia

Torii Hidemasa, Ohnuma Kazuhiko, Kurihara Toshihide, Tsubota Kazuo, Negishi Kazuno

Scientific Reports (Scientific Reports) 7 ( 1 ) 2017.12

ISSN 2045-2322

Myopia is increasing worldwide. Although the exact etiology of myopia is unknown, outdoor activity is one of the most important environmental factors for myopia control. We previously reported that violet light (VL, 360-400 nm wavelength), which is abundant in the outdoor environment, suppressed myopia progression for individuals under 20 years of age. However, whether VL is also effective for adult high myopia, which can be sight-threatening, has remained unknown. To investigate the influence of VL for adult myopia, we retrospectively compared the myopic progression and the axial length elongation over five years in adult high myopic patients over 25 years of age after two types (non-VL transmitting and VL transmitting) of phakic intraocular lens (pIOL) implantation. We found that high myopic patients with the non-VL transmitting pIOLs implanted are almost two times more myopic in the change of refraction and four times longer in the change of axial length, compared to those implanted with the VL transmitting pIOLs. This result indicated that the VL transmitting pIOL suppressed myopia progression and axial length elongation compared with the non-VL transmitting one. In conclusion, our study showed the VL possibly has an anti-myopia effect for human adults with high myopia.

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特集近視の進行をコントロールする 6.屋外環境とのかかわり

鳥居秀成, 栗原俊英, 坪田一男

眼科 (金原出版) 59 ( 9 ) 897 - 903 2017.09

Lead author, Last author, Corresponding author, ISSN 00164488

A dose dependent myopic shift in refraction and axial length in a murine model of lens-induced myopia

X Jiang, K Mori, Y Tanaka, S Ikeda, M Miyauchi, E Yotsukura, H Torii, ...

Investigative Ophthalmology & Visual Science 58 (8), 4438-4438 58 ( 8 ) 2017.06

Lead author, Last author, Corresponding author, ISSN 0146-0404

Morphological changes of scleral fibroblasts in a murine lens-induced myopia model

S Ikeda, T Kurihara, X Jiang, Y Tanaka, K Mori, M Miyauchi, H Torii, ...

Investigative Ophthalmology & Visual Science 58 (8), 1115-1115 58 ( 8 ) 2017.06

Lead author, Last author, Corresponding author, ISSN 0146-0404

Transient exposure of high concentration oxygen induces sustained myopia in adult mice

K Mori, T Kurihara, X Jiang, E Yotsukura, Y Tanaka, S Ikeda, M Miyauchi, ...

Investigative Ophthalmology & Visual Science 58 (8), 5471-5471 58 ( 8 ) 2017.06

Lead author, Last author, Corresponding author, ISSN 0146-0404

Comparative analysis of the visual and refractive outcomes of a refractive segmented multifocal intraocular lens with and without toricity: 1-year results

R Shodai, K Negishi, H Arai, I Toda, H Torii, K Tsubota

Japanese journal of ophthalmology 61, 142-149 (Japanese Journal of Ophthalmology) 61 ( 2 ) 142 - 149 2017.03

Lead author, Last author, Corresponding author, ISSN 00215155

Purpose: To compare the visual and refractive outcomes up to 1 year postoperatively following implantation of a refractive segmented or a refractive segmented toric multifocal intraocular lens (IOL). Methods: This retrospective study included 108 eyes of 64 patients who underwent cataract surgery with implantation of a refractive segmented multifocal IOL (Lentis Mplus LS-313 MF30 IOL) (LM group) and 81 eyes of 49 patients with implantation of a refractive segmented toric multifocal IOL (Lentis Mplus LU-313 MF30T IOL) (LMT group). The visual and refractive postoperative outcomes and the rate of additional refractive procedures were evaluated up to 1 year postoperatively. Results: The uncorrected distance visual acuity (VA) and uncorrected near VA exceeded 1.0 and 0.60 in decimal VA, respectively, and both were stable postoperative groups. The postoperative subjective refractive astigmatism was also stable and the postoperative refraction was near emmetropia in both groups. No significant differences were found in the need for additional surgical refractive procedures. Conclusion: The outcomes with a refractive segmented toric multifocal IOL were comparable to those with a non-toric model despite higher preoperative corneal astigmatism.

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分節状屈折型多焦点眼内レンズの視力成績と屈折成績のトーリックレンズ使用の有無による比較分析　1年間の成績(Comparative analysis of the visual and refractive outcomes of a refractive segmented multifocal intraocular lens with and without toricity: 1-year results)

Shodai Ryo, Negishi Kazuno, Arai Hiroyuki, Toda Ikuko, Torii Hidemasa, Tsubota Kazuo

Japanese Journal of Ophthalmology (シュプリンガー・ジャパン(株)) 61 ( 2 ) 142 - 149 2017.03

Lead author, Last author, Corresponding author, ISSN 0021-5155

白内障手術を施行された患者のうち、屈折分節型多焦点眼内レンズ(IOL)移植術を受けた64名108眼(LM群)と屈折分節型トーリック多焦点IOL移植術を受けた49名81眼の成績を1年後まで比較した。小数視力(VA)における裸眼遠見VAは1.0、裸眼近見VAは0.6を超えており、両方とも術後安定していた。術後の主観的屈折乱視も安定しており、術後の屈折は両群ともほぼ正常視であった。外科的屈折矯正処置を追加する必要性には有意差は認められなかった。以上より、分節状屈折型トーリック多焦点IOL施行患者は術前の角膜乱視の程度が高かったにもかかわらず、その成績は非トーリックモデルの成績と同等であった。

Violet Light Exposure Can Be a Preventive Strategy Against Myopia Progression

Torii Hidemasa, Kurihara Toshihide, Seko Yuko, Negishi Kazuno, Ohnuma Kazuhiko, Inaba Takaaki, Kawashima Motoko, Jiang Xiaoyan, Kondo Shinichiro, Miyauchi Maki, Miwa Yukihiro, Katada Yusaku, Mori Kiwako, Kato Keiichi, Tsubota Kinya, Goto Hiroshi, Oda Mayumi, Hatori Megumi, Tsubota Kazuo

EBioMedicine (EBioMedicine) 15 210 - 219 2017.02

ISSN 2352-3964

Prevalence of myopia is increasing worldwide. Outdoor activity is one of the most important environmental factors for myopia control. Here we show that violet light (VL, 360–400 nm wavelength) suppresses myopia progression. First, we confirmed that VL suppressed the axial length (AL) elongation in the chick myopia model. Expression microarray analyses revealed that myopia suppressive gene EGR1 was upregulated by VL exposure. VL exposure induced significantly higher upregulation of EGR1 in chick chorioretinal tissues than blue light under the same conditions. Next, we conducted clinical research retrospectively to compare the AL elongation among myopic children who wore eyeglasses (VL blocked) and two types of contact lenses (partially VL blocked and VL transmitting). The data showed the VL transmitting contact lenses suppressed myopia progression most. These results suggest that VL is one of the important outdoor environmental factors for myopia control. Since VL is apt to be excluded from our modern society due to the excessive UV protection, VL exposure can be a preventive strategy against myopia progression.

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Comparative analysis of the visual and refractive outcomes of a refractive segmented multifocal intraocular lens with and without toricity

Shodai Ryo, Negishi Kazuno, Arai Hiroyuki, Toda Ikuko, Torii Hidemasa, Tsubota Kazuo

Japanese Journal of Ophthalmology 1 - 8 2017.01

ISSN 0021-5155

Purpose: To compare the visual and refractive outcomes up to 1 year postoperatively following implantation of a refractive segmented or a refractive segmented toric multifocal intraocular lens (IOL). Methods: This retrospective study included 108 eyes of 64 patients who underwent cataract surgery with implantation of a refractive segmented multifocal IOL (Lentis Mplus LS-313 MF30 IOL) (LM group) and 81 eyes of 49 patients with implantation of a refractive segmented toric multifocal IOL (Lentis Mplus LU-313 MF30T IOL) (LMT group). The visual and refractive postoperative outcomes and the rate of additional refractive procedures were evaluated up to 1 year postoperatively. Results: The uncorrected distance visual acuity (VA) and uncorrected near VA exceeded 1.0 and 0.60 in decimal VA, respectively, and both were stable postoperative groups. The postoperative subjective refractive astigmatism was also stable and the postoperative refraction was near emmetropia in both groups. No significant differences were found in the need for additional surgical refractive procedures. Conclusion: The outcomes with a refractive segmented toric multifocal IOL were comparable to those with a non-toric model despite higher preoperative corneal astigmatism.

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子どもとメディアの問題を考える 5.「子どもとメディア」視機能への影響

H TORII, K TSUBOTA

日本小児科医会会報, 29-33 2017

Lead author, Last author, Corresponding author

CLINICAL INVESTIGATION: Comparative analysis of the visual and refractive outcomes of a refractive segmented multifocal intraocular lens with and without toricity: 1-year results

R Shodai, K Negishi, H Arai, I Toda, H Torii, K Tsubota

Japanese journal of ophthalmology: the official international journal of the … 2017

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Decreased sleep quality in high myopia children

Ayaki Masahiko, Torii Hidemasa, Tsubota Kazuo, Negishi Kazuno

Scientific Reports (Scientific Reports) 6 2016.09

ISSN 2045-2322

The aim of the present study was to evaluate sleep quality in myopic children and adults. This cross sectional study surveyed 486 participants aged from 10 to 59 years with refractive errors using a questionnaire containing the Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS). Children (< 20 years) in the high myopia group exhibited the poorest PSQI scores (P < 0.01), while the adults showed no such correlations. Subscales of PSQI and HADS in children disclosed that the high myopia groups had the shortest sleep duration (P < 0.01), worst subjective sleep scores (P < 0.001), and latest bedtime (P < 0.05). Regression analyses in children significantly correlated myopic errors with PSQI (P < 0.05), sleep duration (P < 0.01), and bedtime (P < 0.01). Sleep efficacy (P < 0.05) and daytime dysfunction (P < 0.05) were significantly better in contact-lens users compared to the respective non-user groups across all participants. In conclusion, sleep quality in children was significantly correlated with myopic error, with the high myopia group worst affected.

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Yotsukura Erisa, Negishi Kazuno, Torii Hidemasa, Saiki Megumi, Tsubota Kazuo

Journal of Cataract and Refractive Surgery 42 ( 9 ) 1392 - 1393 2016.09

ISSN 0886-3350

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治療的表層角膜切除眼の白内障手術に対する眼内レンズ度数計算式の精度の比較(Comparison of the accuracy of intraocular lens power calculations for cataract surgery in eyes after phototherapeutic keratectomy)

Yaguchi Yukari, Negishi Kazuno, Saiki Megumi, Torii Hidemasa, Tsubota Kazuo

Japanese Journal of Ophthalmology (シュプリンガー・ジャパン(株)) 60 ( 5 ) 365 - 372 2016.09

Lead author, Last author, Corresponding author, ISSN 0021-5155

治療的表層角膜切除術(PTK)後に白内障手術を施行した13名(平均年齢68.8歳)23眼を対象として、近視矯正手術後の眼内レンズ(IOL)度数計算に用いられる幾つかの計算式の精度を白内障手術後のIOL度数計算に用い、計算式の精度を後ろ向きに比較した。予測誤差を術後等価球面屈折率推定値と眼鏡平面における術後に示された屈折率との差として定義し、SRK/T、Haigis-L、Shammas-PL、Camellin-Calossi、OKU-LIX ray tracingソフトウェアの5つの式を用いた。5つの式の算術予測誤差と絶対予測誤差の中央値を比較した。白内障手術後の算術誤差中央値はSRK/Tが0.70ジオプター(D)、Haigis-Lが-0.96D、Shammas-PLが-0.81D、Camellin-Calossiが-0.04D、OKU-LIXが0.68Dであった。PTK施行眼におけるIOL度数計算にはCamellin-Calossiが最も有用な選択肢であると考えられた。

Effects of ultra violet radiation on serum vitamin d levels in chick experimental myopia models

K Mori, T Kurihara, X Jiang, M Miyauchi, Y Katada, Y Miwa, Y Seko, ...

Investigative Ophthalmology & Visual Science 57 (12), 5522-5522 57 ( 12 ) 2016.09

Lead author, Last author, Corresponding author, ISSN 0146-0404

An effective and robust murine lens-induced myopia model evaluated with micro-CT imaging

T Kurihara, X Jiang, K Tsubota, K Mori, Y Miwa, Y Katada, M Miyauchi, ...

Investigative Ophthalmology & Visual Science 57 (12), 5746-5746 57 ( 12 ) 2016.09

Lead author, Last author, Corresponding author, ISSN 0146-0404

Age, eye dominance, and phoria cause errors in measurement of objective refractions

Y Tsuneyoshi, H Torii, Y Nishi, Y Hidaka, S Masui, K Tsubota, K Negishi

Investigative Ophthalmology & Visual Science 57 (12), 6238-6238 57 ( 12 ) 2016.09

Lead author, Last author, Corresponding author, ISSN 0146-0404

Establishment of retinal ganglion cell-specific gene recombination murine models using tet system

Y Katada, M Miyauchi, Y Miwa, X Jiang, K Mori, H Torii, KF Tanaka, ...

Investigative Ophthalmology & Visual Science 57 (12), 747-747 57 ( 12 ) 2016.09

Lead author, Last author, Corresponding author, ISSN 0146-0404

Suppressive effect of metformin against experimental myopia in chick

H Torii, T Kurihara, X Jiang, Y Katada, Y Miwa, K Mori, M Miyauchi, ...

Investigative Ophthalmology & Visual Science 57 (12), 5520-5520 57 ( 12 ) 2016.09

Lead author, Last author, Corresponding author, ISSN 0146-0404

HIF inhibitor topotecan suppresses light-induced retinal degeneration in mice

Y Miwa, M Miyauchi, Y Katada, X Jiang, K Mori, H Torii, K Tsubota, ...

Investigative Ophthalmology & Visual Science 57 (12), 2736-2736 57 ( 12 ) 2016.09

Lead author, Last author, Corresponding author, ISSN 0146-0404

Comparison of the accuracy of intraocular lens power calculations for cataract surgery in eyes after phototherapeutic keratectomy

Yaguchi Yukari, Negishi Kazuno, Saiki Megumi, Torii Hidemasa, Tsubota Kazuo

Japanese Journal of Ophthalmology (Japanese Journal of Ophthalmology) 60 ( 5 ) 1 - 8 2016.06

ISSN 0021-5155

Purpose: To compare the accuracy of several methods of intraocular lens (IOL) power calculations used for cataract surgery in eyes treated with phototherapeutic keratectomy (PTK) that results in changes in the anterior corneal surface and axial length; these results make power calculations less predictable. Methods: We evaluated the medical records of 23 eyes of 13 patients (mean age, 68.8 years; range 62–80 years) who underwent cataract surgery after PTK at Keio University Hospital, Tokyo, Japan. The prediction error, defined as the difference between the estimated postoperative spherical equivalent and the postoperative manifest refraction at the spectacle plane, was calculated using five formulas: SRK/T, Haigis-L, Shammas-PL, Camellin–Calossi, and OKULIX ray tracing software. We compared the median values of the arithmetic and absolute prediction errors among the five formulas. Results: The median arithmetic errors after cataract surgery for the five formulas were 0.70 D (diopter) (range −0.41 to 2.78), −0.96 D (range −2.14 to 0.81), −0.81 D (range −1.89 to 1.15), −0.04 D (range −1.35 to 1.47), and 0.68 D (range −0.61 to 2.50), respectively. Conclusion: The Camellin–Calossi formula is a good option for calculating IOL powers in eyes that underwent PTK.

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特集エイジングと加齢眼疾患４.エイジングからみた強度近視

鳥居秀成

眼科 (金原出版) 58 ( 6 ) 635 - 641 2016.06

Lead author, Last author, Corresponding author, ISSN 00164488

Laser in situ keratomileusis(LASIK)後白内障手術の眼内レンズ度数計算式の精度

堀祥子, 根岸一乃, 佐伯めぐみ, 増井佐千子, 鳥居秀成, 西恭代, 常吉由佳里, 坪田一男

IOL & RS ((株)杏林舎内「IOL&RS」編集事務局) 30 ( 2 ) 232 - 237 2016.06

Lead author, Last author, Corresponding author, ISSN 1341-3678

目的:OKULIX(OK)、A-P法(A-P)、Shammas-PL式(S)、Haigis-L式(H-L)、Iida-Shimizu method(I-S)の5式を用いて、laser in situ keratomileusis(LASIK)後の白内障手術における眼内レンズ(IOL)度数計算の精度を比較する。方法:LASIK術後に白内障手術を行い、術後1ヵ月以上経過観察できた28例36眼で、前述のIOL計算式による術後屈折誤差を後方視的に比較した。結果:術後屈折誤差(算術値)の中央値(D)はOK、A-P、S、H-L、I-Sの順に0.00、0.48、-0.69、-0.83、-0.33でSおよびH-Lは他よりも近視寄りだった(P<0.01)。術後屈折誤差が±1.0D以内の割合(%)は、同順に83.3、80.6、76.0、60.0、86.1であり、±1.0D以内の割合はH-LがOK、I-Sよりも低かった(P<0.05)。結論:計算式によって屈折誤差の分布は異なる。LASIK術後のIOL度数決定の際には各計算式による誤差の特徴も考慮すべきである。(著者抄録)

トーリック眼内レンズ移植に対する3つのマーキング法の臨床成績の比較(Comparison of clinical outcomes among 3 marking methods for toric intraocular lens implantation)

Onishi Hideyuki, Torii Hidemasa, Watanabe Kazuhiro, Tsubota Kazuo, Negishi Kazuno

Japanese Journal of Ophthalmology (シュプリンガー・ジャパン(株)) 60 ( 3 ) 142 - 149 2016.05

Lead author, Last author, Corresponding author, ISSN 0021-5155

白内障手術を施行した48名(平均67.5歳)48眼を対象に、トーリック眼内レンズ(IOL)の位置に関する回転誤差と3つのマーキング法での視機能や屈折に関する成績を比較し、トーリックIOL挿入のためのマニュアルでのマーキング法について評価した。マーキング法は虹彩パターンマーキング法(虹彩パターン群)、振り子マーキング法(振り子群)、3点マーキング法(3点群)の3つを用いた。その結果、回転誤差は虹彩パターン群4.0±3.1°、振り子群5.3±4.1°、3点群7.3±6.0°で、虹彩パターン群が3点群に比べて有意に小さかった。虹彩パターン群と振り子群の間には有意差はなかった。術後の未補正距離視力と乱視の差は3群間で有意差はなかった。3点マーキング法を用いるトーリックIOL移植の屈折と視機能の成績は他の2つの方法と同等であったが、軸の位置の精度は虹彩パターン法と比較して有意に低かった。

Comparison of clinical outcomes among 3 marking methods for toric intraocular lens implantation

Onishi Hideyuki, Torii Hidemasa, Watanabe Kazuhiro, Tsubota Kazuo, Negishi Kazuno

Japanese Journal of Ophthalmology (Japanese Journal of Ophthalmology) 60 ( 3 ) 1 - 8 2016.03

ISSN 0021-5155

Purpose: To compare the clinical outcomes of 3 marking methods for toric intraocular lens (IOL) implantation in cataract patients. Methods: This study included 48 eyes of 48 cataract patients who underwent cataract surgery with toric IOL implantation. The rotational errors of 3 marking methods—the iris pattern marking method (iris pattern group), the pendulum marking method (pendulum group), and the 3-point marking method (3-point group)—were assessed. Results: The respective rotational errors were 4.0° ± 3.1° (mean ± SD), 5.3° ± 4.1°, and 7.3° ± 6.0°. The iris pattern group had significantly (P = 0.048) smaller rotational errors than did the 3-point group; no significant difference was found between the iris pattern and pendulum groups. However, the differences in postoperative uncorrected distance visual acuity and astigmatism did not reach significance among the 3 groups. Conclusion: The refractive and visual results of toric IOL implantation using the 3-point marking method were comparable to the other methods evaluated in this study, although the accuracy of the axis alignment of the toric IOLs was significantly lower than that obtained with the iris pattern method.

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Functional visual acuity of early presbyopia

Katada Yusaku, Negishi Kazuno, Watanabe Kazuhiro, Shigeno Yuta, Saiki Megumi, Torii Hidemasa, Kaido Minako, Tsubota Kazuo

PLoS One (PLoS ONE) 11 ( 3 ) 2016.03

ISSN 1932-6203

Purpose: To evaluate visual function in patients with early presbyopia using the functional visual acuity (FVA) test. Methods: This study included 27 eyes of 27 healthy older volunteers (mean age, 44.1 ± 2.6 years) and 14 eyes of 14 healthy young volunteers (mean age, 28.4±4.8 years). The distance-corrected visual acuity (DCVA), distance-corrected near VA (DCNVA), subjective amplitude of accommodation (AA), and distance and near pupillary diameters were measured. The distance FVA and distance-corrected near FVA (DCNFVA) were measured using the FVA Measurement System. The standard Schirmer test and standard tear break-up time measurement also were performed. Results: The logarithm of the minimum angle of resolution (logMAR) DCVA was better than 0 in all subjects. The percentages of subjects with logMAR DCNVA below 0 was significantly lower in the presbyopia group than in the young group. The DCNFVA in the presbyopia group was significantly (P <0.001) poorer than the DCNVA in that group. Significant linear negative correlations were seen between the DCNVA and AA (r = -0.507, P <0.001) and the DCNFVA and AA (r = -0.681, P <0.001) in the older subjects. Stepwise regression analysis showed that only the AA was a significant factor predictive of the DCNFVA in the presbyopia group. Tear function parameters were not adopted in the regression model. Conclusions: Measurement of the DCNFVA can detect decreased AA in early presbyopia better than measurement of the conventional near VA. The DCNFVA is a good index for early presbyopia.

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Effect of neodymium

Yotsukura Erisa, Torii Hidemasa, Saiki Megumi, Negishi Kazuno, Tsubota Kazuo

Journal of Cataract and Refractive Surgery 42 ( 3 ) 399 - 404 2016.03

ISSN 0886-3350

Purpose To evaluate the effect of neodymium:YAG (Nd:YAG) laser capsulotomy on the visual function in patients with posterior capsule opacification (PCO) and good visual acuity. Setting Keio University Hospital, Tokyo, Japan. Design Observational case series. Methods Eyes were evaluated that had previous cataract surgery with a clinical diagnosis of PCO requiring Nd:YAG laser capsulotomy regardless of a good corrected distance visual acuity (CDVA) (at least 20/20). The CDVA, 10% low contrast visual acuity (LCVA), wavefront aberrations from the 3rd to 6th order, and retinal straylight were measured before and after Nd:YAG laser capsulotomy. Results The study included 16 eyes of 16 patients (10 men, 6 women; mean age 69.5 years ± 9.3 [SD]). The mean CDVA, LCVA, and straylight after Nd:YAG laser capsulotomy improved significantly (P <.05). The root mean square (RMS) of the 3rd Zernike coefficients (S3) and the RMS of the total higher-order aberrations (HOAs) from the 3rd to 6th order decreased significantly after capsulotomy (P <.05). The straylight correlated significantly with the total HOAs (r = 0.727, P = .002) and S3 (r = 0.748, P = .001) before capsulotomy. Subjective symptoms resolved after capsulotomy in all cases. Conclusions Neodymium:YAG laser capsulotomy enabled a significant improvement in visual function even in patients with PCO with good visual acuity. Straylight measurements might be useful to determine the indications for Nd:YAG laser capsulotomy when patients report visual disturbances without decreased visual acuity.

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Effect of neodymium: YAG laser capsulotomy on visual function in patients with posterior capsule opacification and good visual acuity

E Yotsukura, H Torii, M Saiki, K Negishi, K Tsubota

Journal of Cataract & Refractive Surgery 42 (3), 399-404 (Journal of Cataract and Refractive Surgery) 42 ( 3 ) 399 - 404 2016.03

Lead author, Last author, Corresponding author, ISSN 08863350

Purpose To evaluate the effect of neodymium:YAG (Nd:YAG) laser capsulotomy on the visual function in patients with posterior capsule opacification (PCO) and good visual acuity. Setting Keio University Hospital, Tokyo, Japan. Design Observational case series. Methods Eyes were evaluated that had previous cataract surgery with a clinical diagnosis of PCO requiring Nd:YAG laser capsulotomy regardless of a good corrected distance visual acuity (CDVA) (at least 20/20). The CDVA, 10% low contrast visual acuity (LCVA), wavefront aberrations from the 3rd to 6th order, and retinal straylight were measured before and after Nd:YAG laser capsulotomy. Results The study included 16 eyes of 16 patients (10 men, 6 women; mean age 69.5 years ± 9.3 [SD]). The mean CDVA, LCVA, and straylight after Nd:YAG laser capsulotomy improved significantly (P < .05). The root mean square (RMS) of the 3rd Zernike coefficients (S3) and the RMS of the total higher-order aberrations (HOAs) from the 3rd to 6th order decreased significantly after capsulotomy (P < .05). The straylight correlated significantly with the total HOAs (r = 0.727, P = .002) and S3 (r = 0.748, P = .001) before capsulotomy. Subjective symptoms resolved after capsulotomy in all cases. Conclusions Neodymium:YAG laser capsulotomy enabled a significant improvement in visual function even in patients with PCO with good visual acuity. Straylight measurements might be useful to determine the indications for Nd:YAG laser capsulotomy when patients report visual disturbances without decreased visual acuity.

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Abstracts from the 15th International Myopia Conference

A Benavente-Perez, A Nour, T Ansel, K Abarr, L Yan, K Roden, D Troilo, ...

Eye and Vision 3 (1), 1-11 2016

Lead author, Last author, Corresponding author

Effect of an intact posterior capsule on visual function after cataract surgery Reply

E Yotsukura, K Negishi, H Torii, M Saiki, K Tsubota

JOURNAL OF CATARACT AND REFRACTIVE SURGERY 42 (9), 1392-1393 2016

Lead author, Last author, Corresponding author

CLINICAL INVESTIGATION: Comparison of the accuracy of intraocular lens power calculations for cataract surgery in eyes after phototherapeutic keratectomy

Y Yaguchi, K Negishi, M Saiki, H Torii, K Tsubota

Japanese journal of ophthalmology: the official international journal of the … 2016

Lead author, Last author, Corresponding author

Abstracts from the 15th International Myopia Conference: Wenzhou, PR China. 23-27 September 2015

A Benavente-Perez, A Nour, T Ansel, K Abarr, L Yan, K Roden, D Troilo, ...

Eye and Vision 3, 1-11 2016

Lead author, Last author, Corresponding author

Optical reduction of peripheral hyperopic defocus

H Torii, K Negishi, K Tsubota

Acta Ophthalmologica 93 2015

Lead author, Last author, Corresponding author

強度角膜乱視白内障眼に対する乱視矯正眼内レンズの術後成績

冨永隆志, 鳥居秀成, 渡邊一弘, 清水努, 佐伯めぐみ, 根岸一乃, 坪田一男

臨床眼科 ((株)医学書院) 68 ( 9 ) 1279 - 1283 2014.09

Lead author, Last author, Corresponding author, ISSN 0370-5579

目的:強度角膜乱視白内障眼に対する乱視矯正眼内レンズ(TIOL,Alcon社製)の術後成績の報告。対象と方法:強度角膜乱視白内障眼にTIOL(SN6AT6:12眼,SN6AT7:8眼,SN6AT8:3眼,SN6AT9:1眼)を挿入し,術後1ヵ月以上経過観察できた22例24眼(平均年齢68.1歳)である。術前と術後1ヵ月の視力(裸眼・矯正),角膜乱視,自覚屈折,軸回旋誤差を後方視的に検討した。結果:視力(矯正・裸眼)と自覚乱視は術後1ヵ月で有意(p<0.001)に改善した。角膜乱視に有意差はなかった。TIOLの軸回旋誤差は2.8°であった。結論:TIOLは強度乱視白内障眼の乱視矯正に有効である。(著者抄録)

角膜エキシマレーザー手術後の眼内レンズパワー計算のためのレイトレーシングソフトウェア(Ray tracing software for intraocular lens power calculation after corneal excimer laser surgery)

Saiki Megumi, Negishi Kazuno, Kato Naoko, Torii Hidemasa, Dogru Murat, Tsubota Kazuo

Japanese Journal of Ophthalmology (シュプリンガー・ジャパン(株)) 58 ( 3 ) 276 - 281 2014.05

Lead author, Last author, Corresponding author, ISSN 0021-5155

近視レーザー角膜切削形成術(LASIK)後に超音波水晶体乳化吸引術と眼内レンズ(IOL)移植を受けた白内障患者17例24眼(男性11例、年齢30～67歳)を対象に、OKULIXレイトレーシングソフトウェアを使用して、IOLパワー計算の正確度を後方視的に評価した。OKULIXによる算術的予測誤差は0.53D(範囲-0.93～2.59)で、Camellin-Calossi、Shammas-PL、Haigis-L、ダブルK SRK/T[43.5D]式では各-0.37、-0.54、-0.95、0.59Dであった(OKULIXに比べたp値;各0.004、0.004、0.004、1.00)。また、絶対予測誤差はOKULIXから順に0.62、0.62、0.80、1.13、0.74Dで、OKULIXと他の式との間に有意差はなかった。OKULIXによる予測誤差は18眼で±1.0D以内であり、この割合はHaigis-L式よりも有意に高かった(p=0.028)。OKULIXによるIOLパワー計算は、他の式と同等に正確であることが示された。

ICL挿入後のPigment Dispersion Syndromeの1例

堅田侑作, 鳥居秀成, 根岸一乃, 渡邊一弘, 佐伯めぐみ, 加藤直子, 坪田一男

眼科手術 ((公社)日本眼科手術学会) 27 ( 2 ) 269 - 273 2014.04

Lead author, Last author, Corresponding author, ISSN 0914-6806

目的:Implantable collamer lens(ICL:STAAR Surgical Company)挿入術後にpigment dispersion syndrome(PDS)を発症した症例を経験したので報告する。症例:32歳、男性。ICL希望で当科初診。所見:初診時視力は右眼0.04(1.25 -10.75)、左眼0.032(1.25 -8.50 cyl-4.00 Ax180°)。前眼部・眼底所見に特記すべき所見なし。両眼ICL挿入術(右眼:ICM125V4-15.0D、左眼:ICM130V4-17.0D/+5.0D)を施行、周辺虹彩切除を併施した。術1週間後より両眼霧視を自覚、視力は右眼0.8(1.6 -0.50 cyl-1.00 Ax180°)、左眼0.7(1.25 +0.75 cyl-1.75 Ax20°)、前房内フレア値(photons/millisecond)は右眼12.3、左眼14.6と軽度上昇、ICL前面にびまん性に微細な色素沈着を認めた。眼圧は右眼9mmHg、左眼10mmHg。0.1%ベタメタゾン(サンベタゾン)点眼にて、術後1ヵ月の視力は右眼1.25(1.6 -0.25 cyl-1.00 Ax175°)、左眼1.0(1.6 -0.75 cyl-0.75 Ax30°)、自覚症状も改善した。結論:眼圧上昇なく内科的に治療しえたPDS症例を経験した。術中周辺虹彩切除術がPDS発症に寄与した可能性が考えられた。(著者抄録)

The Relation Between Functional Visual Acuity and Functional Visual Field for Elderly Drivers with Normal Cognitive Status.

T Shimizu, S Masui, M Saiki, H Torii, M Dogru, K Tsubota, K Negishi

Investigative Ophthalmology & Visual Science 55 (13), 6116-6116 55 ( 13 ) 2014.04

Lead author, Last author, Corresponding author, ISSN 0146-0404

Modified AP method for intraocular lens power calculation after myopic LASIK

M Saiki, N Kato, H Torii, I Toda, H Arai, M Dogru, K Tsubota, K Negishi

Investigative Ophthalmology & Visual Science 55 (13), 4022-4022 55 ( 13 ) 2014.04

Lead author, Last author, Corresponding author, ISSN 0146-0404

Lack of association between winter coat colour and genetic population structure in the Japanese hare, Lepus brachyurus (Lagomorpha: Leporidae)

Nunome Mitsuo, Kinoshita Gohta, Tomozawa Morihiko, Torii Harumi, Matsuki Rikyu, Yamada Fumio, Matsuda Yoichi, Suzuki Hitoshi

BIOLOGICAL JOURNAL OF THE LINNEAN SOCIETY 111 ( 4 ) 761 - 776 2014.04

Lead author, Last author, Corresponding author, ISSN 0024-4066

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白内障手術後の残余屈折異常に対し追加型眼内レンズを使用した1例

小林文貴, 鳥居秀成, 根岸一乃, 渡辺一弘, 佐伯めぐみ, 坪田一男

臨床眼科 ((株)医学書院) 67 ( 10 ) 1679 - 1684 2013.10

Lead author, Last author, Corresponding author, ISSN 0370-5579

目的:白内障手術後の残余屈折異常に対し,追加型眼内レンズ(IOL)を挿入した1症例の報告。症例:70歳男性が白内障手術を希望して受診した。23年前に両眼に放射状角膜切開術,12年前に両眼にレーザー屈折矯正角膜切除術を受けていた。所見:裸眼視力は右0.5,左0.4で,矯正視力は右0.9,左1.0であった。加齢白内障の診断で,左右眼に超音波乳化吸引術とIOL挿入術を行った。1年後の裸眼視力は右0.5,左0.5で,矯正視力は右1.2,左1.0であった。左眼に+3.0D()cyl-2.0D 65°の屈折異常があった。患者の希望により,左眼に追加型単焦点IOLを挿入した。6ヵ月後の左眼の裸眼視力は0.63,矯正視力は1.0であり,合併症はない。結論:追加型IOLの挿入は,白内障手術後の残余屈折異常に対する治療の,1つの選択肢である。(著者抄録)

学校近視の現況に関する2010年度アンケート調査報告

鳥居秀成, 不二門尚, 宇津見義一

日本の眼科 ((公社)日本眼科医会) 84 ( 6付録 ) 15 - 27 2013.06

Lead author, Last author, Corresponding author, ISSN 0285-1326

目的:学校近視に対する日本の眼科医の先生方の現在の検査、治療法を調査し基礎データを把握、今後の近視研究に対する方向性を検討する。対象および方法:我が国の学校近視に関する眼科医の実態調査を行うため、すべての日本眼科医会会員13719名にアンケート用紙を配布した。結果:回答は幅広い年代層から得られ、合計3165名(23.1%)の先生方から回答を頂いた。また、勤務形態は約70%が医院・診療所の先生方であった。近視の進行予防に関して困った経験をされた先生方は55%であった。コンタクトレンズ(CL)の処方年齢は、中学生からが最も多かったが、小学生高学年から処方されている先生が10%程度であった。近視に対する眼鏡処方は、黒板が見にくいなど日常生活に支障を来す時点で行っている先生が多かった。眼鏡処方の前に行う検査としては、小学生低学年まではシクロペントラート点眼後の屈折検査が多く、高学年になるとトロピカミド点眼が増え、中学生になると調節麻痺点眼を行わない場合が多くなった。眼鏡処方までの治療として、小学生に対してはトロピカミド点眼を1～3ヵ月程度行う先生が多かった。眼鏡処方時の目標矯正視力は1.0とした割合が最も多く、やや低矯正がその次であった。近視進行が抑制できる点眼・眼鏡・CLが市販された場合、導入を考えている先生は76%、同様に近視研究に協力して頂けると返答した先生方は73%であった。最後のコメント・意見の項目では、今後の調査・研究によりevidenceのある学校近視の治療・予防法・ガイドラインの作成を望む声が大半を占めた。結論:各質問に一定の傾向が見られたが回答は様々であり、学校近視の検査・治療に関してevidenceが確立されていない事の表れであると思われた。今後大規模疫学調査による日本人児童生徒等の現状を把握する事が必要であると共に、evidenceのある近視予防・治療法が望まれ、最終的なガイドライン作成や治療・予防方法が求められている。(著者抄録)

Visual Simulation of Retinal Images through a New Asymmetric Refractive Multifocal Intraocular Lens with Two Spherical Surfaces

Y Hidaka, K Negishi, K Ohnuma, K Watanabe, H Torii, M Saiki, K Tsubota

Investigative Ophthalmology & Visual Science 54 (15), 835-835 54 ( 15 ) 2013.06

Lead author, Last author, Corresponding author, ISSN 0146-0404

Visual Simulation of Retinal Images with Various Designs of Pinhole Contact Lenses

Y Nishi, K Negishi, K Watanabe, Y Hidaka, H Torii, M Saiki, K Tsubota

Investigative Ophthalmology & Visual Science 54 (15), 4283-4283 54 ( 15 ) 2013.06

Lead author, Last author, Corresponding author, ISSN 0146-0404

疎水性アクリル眼内レンズのグリスニングとホワイトニングにより視機能低下をきたした1例

日高悠葵, 根岸一乃, 松島博之, 鳥居秀成, 佐伯めぐみ, 渡邊一弘, 稲福沙織, 坪田一男

臨床眼科 ((株)医学書院) 67 ( 2 ) 199 - 202 2013.02

Lead author, Last author, Corresponding author, ISSN 0370-5579

目的:白内障術後,眼内レンズ(IOL)のグリスニングとホワイトニングによると考えられる視機能低下によりIOLを交換した症例を報告する。症例:78歳,女性。右白内障手術6年後の視力低下を主訴に受診した。所見:右矯正視力は白内障手術直後の0.8から0.4に低下しており,IOLのグリスニングおよびホワイトニングを認めた。軽度の網脈絡膜萎縮を認めたが,白内障手術直後から変化はなかった。IOL交換により矯正視力は0.8に回復した。結論:IOLのグリスニングおよびホワイトニングにより視機能低下をきたす可能性があり,その場合には眼内レンズの摘出・交換も考慮すべきである。(著者抄録)

A new central–peripheral corneal curvature method for intraocular lens power calculation after excimer laser refractive surgery

M Saiki, K Negishi, N Kato, H Arai, I Toda, H Torii, M Dogru, K Tsubota

Acta ophthalmologica 91 (2), e133-e139 2013

Lead author, Last author, Corresponding author

Electric pump

H Torii

US Patent App. 13/893,845 2013

Lead author, Last author, Corresponding author

Changes in higher-order aberrations after iris-fixated phakic intraocular lens implantation (要旨); 虹彩支持型有水晶体眼内レンズ挿入術後の高次収差の変化; コウサイシジガタユウスイシ …

H Torii

(No Title) 2013

Lead author, Last author, Corresponding author

A Case of Traumatic Mydriasis with Lens Subluxation Treated by Suturing Iris-Diaphragm Intraocular Lens

YAMASHITA Kazuya, TORII Hidemasa, NEGISHI Kazuno, WATANABE Kazuhiro, SHIGENO Yuta, SAIKI Megumi, TSUBOTA Kazuo

IOL & RS ((株)杏林舎内「IOL&RS」編集事務局) 26 ( 4 ) 448 - 452 2012.12

Lead author, Last author, Corresponding author, ISSN 1341-3678

目的:外傷性散瞳を伴う水晶体亜脱臼に対し虹彩付き眼内レンズ(IOL)を縫着した1例を報告する。症例:50歳、男性。交通事故後、右眼羞明の軽減を希望し、慶應義塾大学病院眼科を紹介され受診した。初診時、右眼の視力は0.4(1.0×C-1.00D Ax130°)で、コントラスト感度検査(Optec 6500 Vision Tester)で右眼のコントラスト感度の低下を認めた。細隙灯顕微鏡検査にて右眼の外傷性散瞳、10時から2時のチン小帯断裂、水晶体亜脱臼と前房への硝子体脱出を認めた。眼底検査では異常はなかった。右眼の水晶体切除術+前部硝子体切除術+虹彩付IOL(MORCHER Type 67F BDI lens)縫着術を施行した。結果:手術1年後の視力は右眼0.15(1.2×S-2.50D C-1.00D Ax160°)で、コントラスト感度は改善し、羞明は軽減した。結論:外傷性散瞳による羞明の軽減に虹彩付きIOL縫着術が有効だった。(著者抄録)

Severe Diffuse Lamellar Keratitis Following Laser in Situ Keratomileusis with an Iatrogenic Double Flap.

Torii H, Negishi K, Dogru M, Tsubota K.

Open Journal of Ophthalmology 2 ( 2 ) 34 - 36 2012.05

Research paper (scientific journal), Joint Work, Accepted

前眼部光干渉断層計を用いたトーリック眼内レンズの簡便で正確な位置調整と回転誤差の評価(Simple and accurate alignment of toric intraocular lenses and evaluation of their rotation errors using anterior segment optical coherence tomography)

Watanabe Kazuhiro, Negishi Kazuno, Torii Hidemasa, Saiki Megumi, Dogru Murat, Tsubota Kazuo

Japanese Journal of Ophthalmology (シュプリンガー・ジャパン(株)) 56 ( 1 ) 31 - 37 2012.01

Lead author, Last author, Corresponding author, ISSN 0021-5155

前眼部光干渉断層計(AS-OCT)を用いて基準点を正確にマークする方法を考案し、トーリック眼内レンズ(IOL)の回転の評価に適用した。AS-OCTによる回転誤差を、波面収差誤差測定器の内部マップを用いて測定した値と比較した。白内障摘出後にアクリル製トーリックIOLを挿入した22名の患者(22眼)を対象とした。AS-OCTで評価したトーリックIOLの回転誤差平均値は、術後1週間では3.2±2.2°、1ヵ月後では3.2±2.4°であった。受診間の基準軸の平均差は1.8±2.1°であった。AS-OCTで測定した位置調整軸の回転誤差と内部マップの差は、2.5±1.9°であった。両法による回転誤差データは、ほぼ完全な直線関係にあった。本法はトーリックIOLの正確な位置調整と回転誤差の評価に有用である。

CLINICAL INVESTIGATION: Simple and accurate alignment of toric intraocular lenses and evaluation of their rotation errors using anterior segment optical coherence tomography

K Watanabe, K Negishi, H Torii

Japanese journal of ophthalmology: the official international journal of the … 2012

Lead author, Last author, Corresponding author

Pre-and Post-operative Corneal, Internal, and Total Higher-order Aberrations in Patients with Iris-fixated Phakic Intraocular Lens Implantation

H Torii, K Negishi, K Watanabe, M Saiki, M Dogru, T Yamaguchi, N Kato, ...

Investigative Ophthalmology & Visual Science 53 (14), 1383-1383 2012

Lead author, Last author, Corresponding author

The Impact Of Changes In Posterior Corneal Aberrations After Cataract Surgery

Y Hidaka, K Negishi, H Torii, K Watanabe, M Saiki, T Yamaguchi, ...

Investigative Ophthalmology & Visual Science 53 (14), 1385-1385 2012

Lead author, Last author, Corresponding author

The Effect Of Intraocular Lens Position On Corrective Error Of Astigmatism After Toric Intraocular Lens Implantation.

K Watanabe, K Negishi, H Torii, M Saiki, D Murat, T Shimizu, N Kato, ...

Investigative Ophthalmology & Visual Science 53 (14), 1376-1376 2012

Lead author, Last author, Corresponding author

Ray Tracing For Intraocular Lens Calculation After Corneal Excimer Laser Surgery

M Saiki, K Negishi, N Kato, H Torii, K Watanabe, M Dogru, R Ogino, ...

Investigative Ophthalmology & Visual Science 53 (14), 1372-1372 2012

Lead author, Last author, Corresponding author

期待のホープ

鳥居秀成

IOL & RS : Japanese journal of cataract and refractive surgery : 日本眼内レンズ屈折手術学会誌 25 ( 4 ) 600 - 604 2011.12

Lead author, Last author, Corresponding author, ISSN 13413678

Near Functional Visual Acuity after Cataract Surgery in Patients with Multifocal Intraocular Lens Implantation

TESHIMA Hitomi, TORII Hidemasa, SAIKI Megumi, OGINO Rika, NEGISHI Kazuno, MURATO Dogru, TSUBOTA Kazuo

IOL & RS ((株)杏林舎内「IOL&RS」編集事務局) 25 ( 4 ) 544 - 549 2011.12

Lead author, Last author, Corresponding author, ISSN 1341-3678

目的:多焦点眼内レンズ(MIOL)挿入眼の近方実用視力を検討する。方法:対象は白内障手術を施行した合併症のない白内障患者16例27眼、平均年齢57.4歳で、使用したMIOLはNXG1(AMO社)、ZM900(AMO社)、SN6AD3(Alcon社)である。術後3ヵ月の自覚屈折、遠方視力、近方視力と近方実用視力(遠方矯正下)を測定した。結果:術後平均屈折は-0.03D、平均遠方視力(logMAR)は裸眼、矯正の順に-0.04、0.13、平均近方視力(logMAR)は裸眼、遠方矯正下、最良矯正の順に0.15、0.08、0.02だった。遠方矯正下において平均近方実用視力は近方視力よりも有意に低かった(p<0.001)。遠方矯正下における近方視力と近方実用視力は3種のIOLの間で有意差はなかった。結論:MIOL挿入眼の遠方矯正下における近方実用視力は、遠方矯正下近方視力より不良であった。(著者抄録)

多焦点眼内レンズの度数ずれ

鳥居秀成, 根岸一乃

あたらしい眼科 = Journal of the eye 28 ( 7 ) 995 - 996 2011.07

Lead author, Last author, Corresponding author, ISSN 09101810

学校近視の現況に関する2010年度アンケート調査報告

鳥居秀成, 不二門尚, 宇津見義一, 日本眼科医会「近視進行防止と屈折矯正」研究班

日本の眼科 ((公社)日本眼科医会) 82 ( 4 ) 531 - 541 2011.04

Lead author, Last author, Corresponding author, ISSN 0285-1326

目的:学校近視に対する日本の眼科医の先生方の現在の検査、治療法を俯瞰し基礎データを把握、今後の近視研究に対する方向性を検討する。対象および方法:我が国の学校近視に関する眼科医の実態調査を行うため、日本眼科医会会員すべて13,719名にアンケート用紙を配布した。結果:回答は幅広い年代層から得られ、合計3,165名(23.1%)の先生方から回答を頂いた。また、勤務形態は約70%が医院・診療所の先生方であった。近視の進行予防に関して困った経験をされた先生方は55%であった。コンタクトレンズ(CL)の処方年齢は、中学生からが最も多かったが、小学生高学年から処方されている先生も10%程度であった。近視に対する眼鏡処方は、黒板が見にくいなど日常生活に支障を来す時点で行っている先生が多かった。眼鏡処方の前に行う検査としては、小学生低学年まではシクロペントラート点眼後の屈折検査が多く、高学年になるとトロピカミド点眼が増え、中学生になると調節麻痺点眼を行わない場合が多くなった。眼鏡処方までの治療として、小学生に対してはトロピカミド点眼を1～3ヵ月程度行う先生が多かった。眼鏡処方時の目標矯正視力は1.0とした割合が最も多く、やや低矯正がその次であった。近視進行が抑制できる点眼・眼鏡・CLが市販された場合、導入を考えておられる先生は76%、同様に近視研究に協力して頂けるとお答え頂いた先生方は73%であった。最後のコメント・意見の項目では、今後の調査・研究によりevidenceのある学校近視の治療・予防法・ガイドラインの作成を望む声が大半を占めた。結論:各質問に一定の傾向が見られたが回答は様々であり、学校近視の検査・治療に関してevidenceが確立されていない事の表れであると思われた。今後大規模疫学調査による日本人児童生徒等の現状を把握する事が必要であると共に、evidenceのある近視予防・治療法が望まれ、最終的なガイドライン作成や治療・予防方法が求められている。(著者抄録)

Report on 2010 Survey regarding current situation of school myopia

H Torii

Journal of Japan Ophthalmologists Association 82, 531-541 2011

Lead author, Last author, Corresponding author

LASIKの周術期管理

鳥居秀成, 根岸一乃

IOL & RS : Japanese journal of cataract and refractive surgery : 日本眼内レンズ屈折手術学会誌 24 ( 4 ) 580 - 584 2010.12

Lead author, Last author, Corresponding author, ISSN 13413678

Outcomes of Distance, Intermediate and Near Binocular Visual Acuities after Bilateral Multifocal Intraocular Lens Implantation

SHIMIZU Tsutomu, NEGISHI Kazuno, TORII Hidemasa, OKUYAMA Hiromi, SAIKI Megumi, YAMAGUCHI Tsuyoshi, MURAT Dogru, TSUBOTA Kazuo

IOL & RS ((株)杏林舎内「IOL&RS」編集事務局) 24 ( 3 ) 437 - 441 2010.09

Lead author, Last author, Corresponding author, ISSN 1341-3678

目的:多焦点眼内レンズ(IOL)両眼挿入例の術後3ヵ月の両眼視力について検討する。方法:両眼多焦点IOL挿入術を受けた18例36眼(21～73歳、平均年齢59.1±12.7歳)を対象とし、両眼屈折型多焦点IOLを使用した群をR群、回折型をD群、優位眼に屈折型、非優位眼に回折型のミックスアンドマッチ症例をM群とし、術後3ヵ月の遠方、中間、近方の裸眼、矯正視力および自覚的屈折力を検討した。結果:術後の自覚的屈折力(D)は各群間に有意差はなかった。両眼裸眼視力はR群とD群の遠方、近方に有意差はなく(R≒D)、中間はR群がD群より有意によかった(R>D)。また全距離ともM群がD群よりよく(M>D)、近方のみM群がR群よりもよかった(M>R)。両眼矯正視力は、R群とD群では遠方、近方とも有意差がなく(R≒D)、遠方、近方ともM群がD群より有意によかったが(M>D)、R群とは有意差はなかった(R≒M、R≒D)。結論:ミックスアンドマッチ症例は両眼屈折型または回折型を挿入した症例よりも全距離で両眼裸眼視力が良好だった。(著者抄録)

Laser in situ keratomileusis後に多焦点眼内レンズを挿入した2例

白畑麗子, 根岸一乃, 鳥居秀成, 村戸ドール, 坪田一男

臨床眼科 ((株)医学書院) 64 ( 6 ) 881 - 884 2010.06

Lead author, Last author, Corresponding author, ISSN 0370-5579

目的:LASIKを受けたのちに生じた白内障に対し,多焦点眼内レンズを挿入した2例の報告。症例:2症例とも男性で,年齢は47歳と55歳である。それぞれ6年前と2年前に近視に対するLASIKを受けた。両症例とも右眼に白内障があり,矯正視力はそれぞれ1.2と0.7であった。白内障手術を行い,回折型多焦点眼内レンズを挿入した。遠見と近見裸眼視力は,1例では1.2と1.0,他の1例ではいずれも1.0で,自覚的には満足が得られた。術後コントラスト感度は2症例とも正常値の下限にあった。結論:LASIKの既往がある眼での白内障手術と多焦点眼内レンズの挿入では,術後の屈折値の誤差と視機能低下の可能性があり,術前のインフォームド・コンセントが必要である。(著者抄録)

羞明感と眼精疲労により多焦点眼内レンズを交換した2例

鳥居秀成, 根岸一乃, 村戸ドール, 坪田一男

臨床眼科 ((株)医学書院) 64 ( 4 ) 459 - 463 2010.04

Lead author, Last author, Corresponding author, ISSN 0370-5579

目的:術後の不満から,多焦点眼内レンズを単焦点眼内レンズに交換した2症例の報告。症例:75歳男性の両眼に白内障手術を行い,回折型多焦点眼内レンズを挿入した。術前からの眼精疲労と羞明感が悪化し,本人の希望で4ヵ月後に単焦点眼内レンズに交換した。症状は持続したが,本態性眼瞼けいれんの治療で症状が改善した。52歳女性の両眼に白内障手術を行い,屈折型多焦点眼内レンズを挿入した。術後に羞明感があり,4ヵ月後に単焦点眼内レンズに交換した。症状は改善しなかった。結論:多焦点眼内レンズを挿入したのち,本人の不満による単焦点眼内レンズへの交換は慎重に判断する必要がある。(著者抄録)

The Effect of Toric Intraocular Lens Correction on Visual Retinal Image Simulations in Pseudophakic Eyes With Astigmatism

K Negishi, K Watanabe, K Ohnuma, M Dogru, H Torii, T Yamaguchi, ...

Investigative Ophthalmology & Visual Science 51 (13), 5732-5732 51 ( 13 ) 2010.04

Lead author, Last author, Corresponding author, ISSN 0146-0404

Early Clinical Results of Iris-Fixated Phakic Intraocular Lens Implantation

WATANABE Kazuhiro, YAMAGUCHI Takefumi, NEGISHI Kazuno, TORII Hidenari, KODAMA Chiyo, SAIKI Megumi, KAWAGUCHI Nanae, TSUBOTA Kazuo

IOL & RS ((株)杏林舎内「IOL&RS」編集事務局) 24 ( 1 ) 84 - 89 2010.03

Lead author, Last author, Corresponding author, ISSN 1341-3678

目的:虹彩支持型有水晶体眼内レンズ(phakic IOL)の術後早期成績を検討する。方法:対象はphakic IOLを挿入した高度近視または近視性乱視9例17眼である。術前・術後の屈折、視機能、角膜内皮細胞密度、高次収差、前房内フレア値を検討した。結果:術後、裸眼視力は有意に改善し、矯正視力に有意差はなかった。術後1年の有効係数は0.89、安全係数は1.15であった。術後1年の屈折は±1.0D以内が89%であった。コントラスト感度、角膜内皮細胞密度、高次収差、前房内フレア値は術前と術後1年で有意差はなかった。結論:Phakic IOLの術後早期成績は良好である。(著者抄録)

Epipolis LASIKの初期手術成績

鳥居秀成, 根岸一乃, 佐伯めぐみ, 山口剛史, 河口奈々恵, 坪田一男

臨床眼科 ((株)医学書院) 61 ( 9 ) 1635 - 1639 2007.09

Lead author, Last author, Corresponding author, ISSN 0370-5579

Epipolis LASIKを施行した近視・近視性乱視14例28眼(男6例・女8例・平均32.6歳)の成績を報告した。術前の平均等価球面度数は-5.53D、乱視度数-0.86D、角膜厚540μm、裸眼視力0.06、矯正視力1.48であった。平均目標矯正量は-5.39Dで、切除深度70.3μm、術後乱視度数-0.30D、術後角膜厚468μmであった。全例のうち目標屈折値の±0.5D以内に71.4%が、±1.0D以内に96.4%が入っていた。術後3ヵ月の裸眼視力は1.0以上が80.8%、0.7以上が88.5%、0.5以上が96.2%で、平均1.19と良好な成績であった。矯正視力は全例1.0以上、平均1.58であった。術後に矯正視力が低下した例はなく、safety indexは1.07、efficacy indexは0.80で、コントラスト感度も有意な変化はなかった。術中合併症はフリーラップ1眼、不完全フラップ1眼で、術後合併症はgrade 0.5のhazeが1眼であった。また、近視の戻りは1例2眼にあり、エキシマレーザー角膜屈折矯正手術を追加した。

Okada purifying therapy improves climacteric symptoms although hormonal imbalance continues

K Suzuki, M Hatayama, A Ishida, H Torii, S Uchida, C Tanaka

JOURNAL OF PSYCHOSOMATIC RESEARCH 58 (6), S65-S65 2005

Lead author, Last author, Corresponding author

Improved visual field following optical canal decompression in a case of optic nerve injury

H Torii

JAPANESE JOURNAL OF CLINICAL OPHTHALMOLOGY 58 (8), 1567-1572 2004

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