研究者詳細 - 根岸　一乃

論文 - 根岸　一乃

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Color of Intra-Ocular Lens and Cataract Type Are Prognostic Determinants of Health Indices After Visual and Photoreceptive Restoration by Surgery

Ayaki M., Negishi K., Suzukamo Y., Tsubota K.

Rejuvenation Research （Rejuvenation Research） 18 （ 2 ） 145 - 152 2015年04月

ISSN 1549-1684

© Copyright 2015, Mary Ann Liebert, Inc. Background: This study compared post-operative quality of life and sleep according to the type of cataract opacity and color of the implanted intra-ocular lens (IOL). Methods: This is a cohort study and participants were 206 patients (average age 74.1 years) undergoing cataract surgery with the implantation of a clear ultra-violet (UV)-blocking IOL (C) or a yellow blue-light-blocking IOL (Y). Participants were evaluated using the National Eye Institute Visual Function Questionnaire (VFQ-25) and Pittsburgh Sleep Quality Index (PSQI) before surgery and 2 and 7 months after surgery. Changes in sub-scale scores of VFQ-25 and PSQI were compared. Results: Sub-scale analyses for improvement after surgery revealed significant differences in ocular pain scores on the VFQ-25 (Y>C; the higher the score, the better the outcome). Furthermore, there were significant differences between the two IOLs in terms of the sleep latency score (C>Y) and sleep disturbances score (C>Y). A posterior sub-capsular cataract was significantly correlated with improvements in ocular pain and sleep latency scores. These effects were successfully represented by the change in scores rather than absolute post-operative scores because individual standard of response may often change after intervention, recognized as a response shift phenomenon in patient-reported outcome study. Regarding seasonal differences, patients who had surgery in summer exhibited relatively better sleep quality than those who had surgery in winter. Conclusions: Analysis of sub-scales of health indices demonstrated characteristic prognoses for each IOL and cataract type. Cataract surgery may potentially contribute to systemic health in older adults.

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Blue light-induced inflammatory marker expression in the retinal pigment epithelium-choroid of mice and the protective effect of a yellow intraocular lens material in vivo

Narimatsu T., Negishi K., Miyake S., Hirasawa M., Osada H., Kurihara T., Tsubota K., Ozawa Y.

Experimental Eye Research （Experimental Eye Research） 132 48 - 51 2015年03月

ISSN 0014-4835

© 2015 The Authors. Oxidative stress in the retinal pigment epithelium (RPE) is a well-accepted pathogenic change in vision-threatening diseases such as age-related macular degeneration. One source of oxidative stress is excessive light exposure, which causes excessive activation of the visual cycle. Because short wavelength light (blue light) has more energy, it is reported to be more harmful to photoreceptor cells than the other wavelengths of light. However, the biological effect of blue light in the RPE of living animals and the protective effect of a yellow intraocular lens (IOL) material that blocks blue light is still obscure. Therefore, we compared the pathogenic effect in the RPE-choroid complexes of mice exposed to light in a box made of a clear or a yellow IOL material. We measured the level of reactive oxygen species (ROS) using 2', 7'-dichlorodihydrofluorescein diacetate, the mRNA levels of inflammatory cytokines and a macrophage marker by real-time polymerase chain reaction, and the protein level of monocyte chemotactic protein-1 (MCP-1) by ELISA. The ROS level after light exposure was suppressed in the RPE-choroids of light-exposed mice in the yellow IOL material box. In parallel, all the inflammatory cytokines that we measured and a macrophage marker were also suppressed in the RPE-choroids of light-exposed mice in the yellow IOL material box. Therefore, a yellow IOL material suppressed, and thus blue light exacerbated, the increase in the ROS level and inflammatory cytokine expression as well as macrophage recruitment in the RPE-choroid invivo after light exposure.

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Reply: To PMID 24792105.

Kamiya K, Shimizu K, Hayashi K, Negishi K, Bissen-Miyajima H, Sato M

American journal of ophthalmology 159 （ 1 ） 202 - 203 2015年01月

ISSN 0002-9394

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Accuracy of statistical analysis of posterior corneal stability after LASIK

Negishi Kazuno, Nishimura Ryo, Tsubota Kazuo

Journal of cataract and refractive surgery 40 （ 11 ） 1941 - 1942 2014年11月

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Increased Gait Speed After Cataract Surgery Confers Longer Predicted Survival.

Ayaki M, Negishi K, Tsubota K

Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) 3 （ 5 ） 267 - 270 2014年09月

ISSN 2162-0989

PURPOSE: Cataract surgery has potential systemic health effects. Gait speed is a potential health index of predicted life expectancy and incidence of severe illness. We thus measured quality of vision and gait speed before and after cataract surgery. DESIGN: A prospective clinical study. METHODS: We followed up 30 patients for 6 months following cataract surgery by implantation of a yellow soft acrylic lens. A 4-m gait speed was determined, and patients were evaluated before and after surgery using the National Eye Institute Visual Function Questionnaire (vision-related quality of life) as well as ophthalmological and systemic examinations. Life span was estimated on the basis of standard curves derived from a literature. RESULTS: Mean preoperative gait speed was 0.81 +/- 0.23 m/s, with significant increases recorded at 2 and 6 months after surgery to 0.85 +/- 0.20 and 0.91 +/- 0.22 m/s, respectively (P < 0.01, paired t test). According to patient survival determined by gait speed, life expectancy (years) before and 6 months after surgery was approximately 83.4 and 84.9, respectively, for men (1.5-year increase) and 88.8 and 89.8, respectively, for women (1.0-year increase). The mean preoperative 25-item Visual Function Questionnaire score was 59.2 +/- 16.3, and significant improvements were observed 2 months (76.2 +/- 13.9) and 6 months (78.6 +/- 14.4) after surgery (P < 0.001, vs preoperative score). CONCLUSION: In conclusion, cataract surgery improved quality of vision and gait speed for 6 months.

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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年09月

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)

Rejuvenation effects of cataract surgery with ultraviolet blocking intra-ocular lens on circadian Rhythm and gait speed

Ayaki M., Negishi K., Tsubota K.

Rejuvenation Research （Rejuvenation Research） 17 （ 4 ） 359 - 365 2014年08月

ISSN 1549-1684

Background: Previously, we reported improvements in sleep quality and gait speed after implantation of a yellow-colored, blue light-blocking intra-ocular lens (IOL). This study evaluated systemic health parameters for 7 months after cataract surgery with implantation of a clear, ultraviolet (UV)-blocking IOL. Methods: A total of consecutive 71 patients (average age 74.1 years) underwent cataract surgery with the implantation of a clear, UV-blocking IOL. Participants were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the National Eye Institute Visual Function Questionnaire (VFQ-25) before and at 2 and 7 months after surgery. Four-meter gait speed was also determined. The metabolic parameters of serum glycated hemoglobin (HbA1c), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were tested. Results: The pre-operative and post-operative (2 and 7 months after surgery) results were 66.4±16.5, 79.5±12.6, and 81.0±13.0 for VFQ-25 score, 5.7±3.5, 5.1±3.1, and 4.8±2.9 for PSQI, and 0.90±0.22, 0.91±0.22, and 0.92±0.22 meters/sec for gait speed. Significant improvements following surgery were noted in the VFQ-25 score for all cases and in the PSQI for poor sleepers (preoperative PSQI >5.5) (P<0.05, paired t-test). The gait speed and metabolic parameters showed no significant changes. Conclusions: Cataract surgery with implantation of an UV-blocking clear IOL has the potential for improving circadian rhythm and systemic health parameters. © 2014 Mary Ann Liebert, Inc.

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Apparent progression of presbyopia after laser in situ keratomileusis in patients with early presbyopia

Tsuneyoshi Y., Negishi K., Saiki M., Toda I., Tsubota K.

American Journal of Ophthalmology （American Journal of Ophthalmology） 158 （ 2 ） 286 - 292 2014年08月

ISSN 0002-9394

Purpose To assess the effect of laser in situ keratomileusis (LASIK) on near visual function in presbyopic patients. Design Retrospective cohort study. Methods Fifty-three eyes of 40 patients 45 years of age and older who had undergone LASIK for high myopia (-6 diopters [D] and over) were included. The minimal add powers for obtaining the best-corrected near visual acuity (add powers) were measured preoperatively and 3 months postoperatively, and the correlations with the powers corrected by LASIK, corneal higher-order aberrations (HOAs), ocular HOAs, and patient ages were evaluated using univariate analysis. Factors correlated with the changes in add powers were evaluated further by multivariate analysis. Results The mean ± standard deviation patient age was 50.0 ± 4.1 years; the power corrected by LASIK was -7.56 ± 1.06 D. The mean add power was 1.80 ± 0.60 D preoperatively, which increased significantly (P <.001) to 2.18 ± 0.69 D postoperatively. Significant correlations with the increased add powers were detected with age (P =.01) and the power corrected by LASIK (P =.04) but not with corneal and ocular HOAs (P >.05). Multivariate analysis showed that only age was correlated significantly (P =.01). The percentage of eyes with increased add powers of 0.5 D or more was 60.4%, which was significantly (P =.02) higher in younger patients. Conclusions This study verified the apparent progression of presbyopia after LASIK and the importance of obtaining informed consent from patients, especially those with early presbyopia. © 2014 by Elsevier Inc. All rights reserved.

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Multifocal intraocular lens explantation: A case series of 50 eyes

Kamiya K., Hayashi K., Shimizu K., Negishi K., Sato M., Bissen-Miyajima H.

American Journal of Ophthalmology （American Journal of Ophthalmology） 158 （ 2 ） 215 - 220 2014年08月

ISSN 0002-9394

Objective To assess the visual complaints, reasons, and patient satisfaction for multifocal intraocular lens (IOL) explantation. Design Retrospective observational case series. Methods This study evaluated 50 eyes of 37 patients who underwent multifocal IOL explantation followed by IOL implantation. Before and 3 months after IOL exchange surgery, we investigated the symptoms, reasons, patient demographics, clinical results, and patient satisfaction in eyes undergoing multifocal IOL explantation. Data collected included preoperative subjective and objective findings, reasons, IOL type, postoperative course, and patient satisfaction. Results The most common complaints for IOL explantation were waxy vision, followed by glare and halos, blurred vision at far, dysphotopsia, blurred vision at near, and blurred vision at intermediate. The most common reasons for IOL explantation were decreased contrast sensitivity, followed by photic phenomenon, unknown origin including neuroadaptation failure, incorrect IOL power, preoperative excessive expectation, IOL dislocation/decentration, and anisometropia. The axial length was 25.13 ± 1.83 mm. Of the explanted multifocal IOLs, 84% were diffractive and 16% were refractive. Monofocal IOLs accounted for 90% of the exchanged IOLs. Patient satisfaction was significantly improved from 1.22 ± 0.55 preoperatively to 3.78 ± 0.97 postoperatively, which was graded on a scale of 1 (very dissatisfied) to 5 (very satisfied) (Wilcoxon signed-rank test, P <.001). Conclusions Multifocal IOL explantation was required in some patients undergoing multifocal IOL implantation. IOL exchange surgery appears to be a feasible surgical option for dissatisfied patients with persistent visual symptoms after multifocal IOL implantation. © 2014 by Elsevier Inc. All rights reserved.

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The effect of tinted soft contact lens wear on functional visual acuity and higher-order aberrations

Watanabe K., Kaido M., Ishida R., Dogru M., Negishi K., Tsubota K.

Contact Lens and Anterior Eye （Contact Lens and Anterior Eye） 37 （ 3 ） 203 - 208 2014年06月

ISSN 1367-0484

Purpose: To investigate the differences of functional visual acuity (FVA) and high order aberrations (HOAs) in relation to tinted and clear hydrogel soft contact lens (SCL) wear. Methods: A prospective comparative study was performed in 16 eyes of 16 healthy volunteers. Dynamic visual acuity (using a FVA measurement system) and higher-order aberrations (using a wavefront sensor) were compared in subjects wearing two types of soft contact lenses: 1-day Acuvue® (Vistakon, Jacksonville, FL) clear and the 1-day Acuvue® DefineTM (Vistakon, Jacksonville, FL) tinted lens. The blink rates were recorded during FVA testing. The correlation between the difference of HOAs and differences in FVA values was analyzed. Results: The mean LogMAR FVA scores with clear and tinted SCLs were 0.07 ± 0.13 and 0.14 ± 0.17 (P< 0.05). The mean blink frequencies with clear and tinted SCL wear were 18.4 ± 8.3 and 25.3 ± 4.7. blinks/min (P< 0.05). Both 3rd-order aberrations and total HOAs showed statistically significant differences between the two types of soft contact lenses for 6. mm pupil measurements (P< 0.05). A significant positive linear correlation was observed between δHOAs and δLogMAR FVA for 6. mm pupil measurements (R= 0.53, P= 0.04). Conclusions: Tinted contact lens wear appears to induce a reduction in optical quality. Functional visual acuity measurement is a useful procedure to study the changes of visual performance and quality in tinted contact lens wear. © 2013 British Contact Lens Association.

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

Saiki M., Negishi K., Kato N., Torii H., Dogru M., Tsubota K.

Japanese Journal of Ophthalmology （Japanese Journal of Ophthalmology） 58 （ 3 ） 276 - 281 2014年05月

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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Image quality in eyes with premium multifocal intraocular lens simulation of the patients' view

Negishi K., Ohnuma K., Hidaka Y., Noda T.

Cataract Surgery: Maximizing Outcomes Through Research （Cataract Surgery: Maximizing Outcomes Through Research） 169 - 177 2014年04月

ISSN 9784431545378

© 2014 Springer Japan. All rights reserved. The results of visual simulation of the retinal images in eyes with three different multifocal intraocular lenses (IOLs) (apodized diffractive-refractive, full diffractive, and refractive) to evaluate optical performance and characteristics of the IOLs using an optical bench are described in this chapter. Because the optical characteristics of the tested multifocal IOLs differed markedly, careful consideration should be given to implantation of these multifocal IOLs based on the patients' lifestyles.

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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年04月

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)

Myopic regression after phakic intraocular lens implantation and LASIK

Torii H., Negishi K., Watanabe K., Arai H., Kato N., Tsubota K.

Optometry and Vision Science （Optometry and Vision Science） 91 （ 2 ） 231 - 239 2014年02月

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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Peripheral optical quality and myopia progression in children

Yamaguchi Takefumi, Ohnuma Kazuhiko, Konomi Kenji, Satake Yoshiyuki, Shimazaki Jun, Negishi Kazuno

Graefe's Archive for Clinical and Experimental Ophthalmology 252 （ 1 ） 175 2014年01月

ISSN 0721-832X

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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（㈱医学書院） 68 （ 9 ） 1279 - 1283 2014年

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.

Peripheral optical quality and myopia progression in children

Yamaguchi Takefumi, Ohnuma Kazuhiko, Konomi Kenji, Satake Yoshiyuki, Shimazaki Jun, Negishi Kazuno

Graefe's Archive for Clinical and Experimental Ophthalmology 251 （ 10 ） 2451 - 2461 2013年10月

ISSN 0721-832X

<p>Background: To investigate the peripheral optical quality and its relationship with axial elongation, myopic progression in Japanese children. Methods: Twenty-nine Japanese children, ages 10 to 12 years old, with baseline refraction from +0.75D to -5.5 D, were included and followed for 9 months. The central and peripheral point spread functions (PSFs; 0, 10, 20, 30 nasally) were obtained at 0.25 D steps around ±2.5 D of best-focus PSF (BF-PSF) using double-pass PSF system. Modulation transfer function (MTF) area of the BF-PSF was calculated from BF-PSF to represent the peripheral optical quality. Relative peripheral defocus (RPD), the refraction of anterior/posterior focal lines, MTF area, and their correlations with myopia progression were analyzed. Results: The average refractive change in 9 months was -0.5 ± 0.8 D. The change in axial length was significantly positively correlated with the amount of myopic progression (P = 0.0058) and RPD (P = 0.0007, 0.0036 and 0.0040, at 10, 20, 30 respectively) at the initial visit, but did not correlate with the peripheral MTF area. Myopic progression of more than 0.5 D with axial elongation was observed in seven children (MP group). The RPDs at 20 and 30 in the MP group were significantly more hyperopic than in the non-MP group (P = 0.002 and 0.007), whereas there was no significant difference in axial length, and central and peripheral MTF area between the MP and non-MP groups. MP group had more hyperopic focal lines compared with non-MP group at 20 and 30. Conclusion: These results suggest that the progression of axial myopia in children is associated with hyperopic RPD and refraction of focal lines, not with peripheral optical quality. © 2013 Springer-Verlag Berlin Heidelberg.</p>

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

Torii H., Negishi K., Watanabe K., Saiki M., Kato N., Tsubota K.

Journal of Refractive Surgery （Journal of Refractive Surgery） 29 （ 10 ） 693 - 700 2013年10月

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

Kobayashi F., Torii H., Negishi K., Watanabe K., Saiki M., Tsubota K.

Japanese Journal of Clinical Ophthalmology （Japanese Journal of Clinical Ophthalmology） 67 （ 10 ） 1679 - 1684 2013年10月

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.

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年10月

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)

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