研究者詳細 - 根岸　一乃

論文 - 根岸　一乃

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Ocular complications in mulvihill-smith syndrome

Ibrahim O. M A, Takefumi Y., Dogru M., Negishi K., Kosaki K., Tsubota K.

Eye 24 （ 6 ） 1123 - 1124 2010年06月

ISSN 0950-222X

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Efficacy of small-incision intraocular lens exchange of opacified Hydroview implants

Yamaguchi Takefumi, Shimizu Tsutomu, Yamaguchi Kazuko, Dogru Murat, Negishi Kazuno, Tsubota Kazuo

British Journal of Ophthalmology 94 （ 6 ） 808 - 809 2010年06月

ISSN 0007-1161

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Implantation of multifocal intraocular lens in two cases after LASIK

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

Japanese Journal of Clinical Ophthalmology （Japanese Journal of Clinical Ophthalmology） 64 （ 6 ） 881 - 884 2010年06月

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.

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年06月

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)

Reply:Decreased anterior chamber depth after myopic LASIK.

Nishimura Ryo, Negishi Kazuno

Journal of Cataract and Refractive Surgery 36 （ 5 ） 873 - 874 2010年05月

ISSN 0886-3350

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Passive cigarette smoke exposure and soft contact lens wear

Ward S., Dogru M., Wakamatsu T., Ibrahim O., Matsumoto Y., Kojima T., Sato E., Ogawa J., Schnider C., Negishi K., Tsubota K.

Optometry and Vision Science （Optometry and Vision Science） 87 （ 5 ） 367 - 372 2010年05月

ISSN 1040-5488

PURPOSE.: To prospectively investigate the effects of passive cigarette smoke exposure on the ocular surface and tear film in soft contact lens (SCL) wearers. METHODS.: Twelve right eyes of 12 SCL wearers without any ocular or systemic diseases and 10 right eyes of 10 subjects who never wore CLs were examined before and 2 h after 5 min of passive cigarette smoke exposure in a controlled smoke chamber. Tear evaporation rate measurement, tear film break-up time (TBUT) examination, ocular surface fluorescein, rose bengal stainings, and Schirmer I test were performed at each visit. RESULTS.: The mean tear evaporation rates, TBUTs, and vital staining scores were significantly worse in CL wearers compared with healthy control subjects. TBUTs showed significant worsening after passive smoke exposure in both groups. The mean tear evaporation rate and vital staining scores showed a significant increase with brief passive smoke exposure in subjects not wearing CLs but not in CL wearers. CONCLUSION.: Even brief passive exposure to cigarette smoke is associated with adverse effects on the ocular surface as evidenced by an increase in tear instability and damage to the ocular surface epithelia in SCL wearers and non-CL wearers. Copyright © 2010 American Academy of Optometry.

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

Negishi K., Kodama C., Yamaguchi T., Torii H., Saiki M., Dogru M., Ohnuma K., Tsubota K.

Journal of Cataract and Refractive Surgery （Journal of Cataract and Refractive Surgery） 36 （ 5 ） 756 - 761 2010年05月

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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慶應義塾大学病院眼科におけるlaser in situ keratomileusis術後の裂孔原性網膜剥離の検討

谷口紗織, 内田敦郎, 川村亮介, 鈴木浩太郎, 篠田肇, 野田航介, 今村裕, 小沢洋子, 根岸一乃, 石田晋

眼科臨床紀要（眼科臨床紀要会） 3 （ 5 ） 472 - 476 2010年05月

ISSN 1882-5176

目的:Laser in situ keratomileusis(LASIK)術後に生じた裂孔原性網膜剥離の特徴と治療成績についての報告。対象および方法:1999年12月〜2008年7月までに慶應義塾大学病院眼科を受診したLASIK術後の裂孔原性網膜剥離症例8例8眼の治療経過を検討した。結果:全例が男性であった。LASIK術前後の等価球面度数は、術前平均-7.91D、術後平均-0.34Dであった。網膜剥離に対して部分強膜バックリング術3例、硝子体手術3例、強膜バックリング術と硝子体手術の併施2例を行い、全例で水晶体を温存した。術後最終(平均7.1ヵ月)での等価球面度数は、部分強膜バックリング術施行例では平均-0.17D、硝子体手術施行例では平均-1.63D、強膜バックリング術と硝子体手術の併施例では平均-5.94Dの近視化を認めた。結論:強膜バックリング術よりも硝子体手術に近視化が多く認められる傾向があった。LASIK後の網膜剥離に対して水晶体温存硝子体手術を施行する場合には、術後近視化についての十分な説明を術前に行うことが重要である。(著者抄録)

The role of oxidative stress and inflammation in conjunctivochalasis

Ward S., Wakamatsu T., Dogru M., Ibrahim O., Kaido M., Ogawa Y., Matsumoto Y., Igarashi A., Ishida R., Shimazaki J., Schnider C., Negishi K., Katakami C., Tsubota K.

Investigative Ophthalmology and Visual Science （Investigative Ophthalmology and Visual Science） 51 （ 4 ） 1994 - 2002 2010年04月

ISSN 0146-0404

PURPOSE. To investigate the status of oxidative stress and histopathologic alterations in patients with conjunctivochalasis and compare the findings with those in healthy control subjects. METHODS. Eleven patients (n = 20 eyes) with Yokoi grade 3 conjunctivochalasis and 11 health control subjects (n = 22 eyes) were prospectively recruited. ELISA for tear hexanoyllysine (HEL) and inflammatory cytokines, tear film break-up time tests, Schirmer test measurements, and fluorescein and rose bengal vital staining were performed. Conjunctival specimens obtained during surgery for conjunctivochalasis and cataract underwent immunohistochemical staining for HEL+8- OHdG, MMP-3, and MMP-9, and positively stained cells were counted. Transmission electron microscopy was also performed, with staining for elastic fibers in the conjunctival stroma. RESULTS. The mean tear stability and vital staining scores were significantly worse in the conjunctivochalasis patients than in the control subjects. The tear HEL and tear cytokine levels showed significantly higher values in eyes with conjunctivochalasis. IL-1β and IL-6 levels showed a significant correlation with corneal epithelial damage. IL-1β and TNFα showed a significant correlation with 8-OHdG-stained cell counts. Specimens from patients with conjunctivochalasis revealed a significantly higher number of cells positively stained for HEL, 8-OHdG, MMP-3, and MMP-9 than did specimens from age- and sex-matched control subjects. Transmission electron microscopy showed decreased intercellular cohesiveness, with the conjunctival stroma showing an accumulation of elastic fibers. CONCLUSIONS. Lipid and DNA oxidative stress were present in the conjunctiva. Increased tear inflammation seemed to coexist with loss of conjunctival epithelial cohesiveness and increased collagenolytic activity, which may explain the conjunctival laxity observed in patients with conjunctivochalasis. © Association for Research in Vision and Ophthalmology.

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Biconvex posterior chamber accommodating intraocular lens implantation after cataract surgery: Long-term outcomes

Saiki M., Negishi K., Dogru M., Yamaguchi T., Tsubota K.

Journal of Cataract and Refractive Surgery （Journal of Cataract and Refractive Surgery） 36 （ 4 ） 603 - 608 2010年04月

ISSN 0886-3350

Purpose: To evaluate the long-term efficacy of a biconvex accommodating intraocular lens (IOL) to restore near visual performance. Setting: Department of Ophthalmology, Keio University Hospital, Tokyo, Japan. Methods: This 4-year study comprised eyes that had cataract surgery with implantation of a 1CU accommodating IOL. At all postoperative visits, the following were assessed: subjective spherical equivalent (SE) refraction; uncorrected (UDVA) and corrected (CDVA) distance visual acuities; uncorrected (UNVA), distance-corrected (DCNVA), and corrected (CNVA) near visual acuities; change in minimum additional (add) power (diopters) to attain CNVA; and accommodation amplitude. A questionnaire was administered at the last visit. Results: Twelve eyes of 8 cataract patients (mean age 59.0 years ± 18.4 [SD]) were evaluated. Postoperatively, the mean SE at 1 year and 4 years was significantly more hyperopic than at 1 month (P<.05). The mean UDVA increased significantly at 4 years compared with 1 month (P<.05). There were no significant changes in CDVA, UNVA, CNVA, and DCNVA throughout the follow-up period. The change in the minimum add power to attain CNVA and in the subjective and objective accommodation amplitudes also did not change significantly over time. Eighty-three percent of patients reported being satisfied with the results. Conclusion: Four years after implantation of an accommodating IOL, most patients had good vision and were satisfied, although the accommodation amplitude for near vision was not sufficient throughout the follow-up. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2010 ASCRS and ESCRS.

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The Efficacy, Sensitivity, and Specificity of In Vivo Laser Confocal Microscopy in the Diagnosis of Meibomian Gland Dysfunction

Ibrahim O., Matsumoto Y., Dogru M., Adan E., Wakamatsu T., Goto T., Negishi K., Tsubota K.

Ophthalmology （Ophthalmology） 117 （ 4 ） 665 - 672 2010年04月

ISSN 0161-6420

Purpose: To evaluate the efficacy, sensitivity and specificity of confocal microscopy (CM) parameters: meibomian gland (MG) acinar longest diameter (MGALD), MG acinar shortest diameter (MGASD), inflammatory cell density (ICD), and MG acinar unit density (MGAUD) in the diagnosis of MG dysfunction (MGD). Design: Prospective, controlled, single-center study. Participants: Twenty MGD patients (9 males, 11 females; mean age, 63.5±16.5 years) and 26 age- and gender-matched control subjects (13 males, 13 females; mean age, 53.2±15.7 years) were recruited. Methods: All subjects underwent slit-lamp examinations, tear film break-up time (BUT) measurements, assessment of tear evaporation rate from the ocular surface (TEROS), vital stainings, Schirmer test, meibography, MG expressibility, and CM of the MG. Data were compared between the 2 groups using the Mann-Whitney and chi-square tests. Main Outcome Measures: The correlation between the clinical findings of tear functions, vital staining scores, and the 4 CM parameters were tested by Spearman's correlation coefficient by rank test. Receiver operating characteristic curve technique was used to evaluate the sensitivity, specificity, and cutoff values of CM parameters. Results: The mean tear film BUT, vital staining scores, TEROS values, MG expressibility, and MG dropout grades by meibography were significantly worse in MGD patients compared with controls (P<0.001). The mean values of the MGALD, MGASD, ICD, and MGAUD in MGD patients were significantly worse than those observed in the controls with CM. All CM parameters showed a strong, significant correlation with tear functions, ocular surface vital stainings, MG expressibility, and MG dropout grades. The cutoff values for MGALD, MGASD, ICD, and MGAUD in the diagnosis of MGD were 65 μm, 25 μm, 300 cells/mm2, and 70 glands/mm2, respectively. The sensitivity and specificity values of these parameters under these cutoff values were 90% and 81% for MGALD, 86% and 96% for MGASD, 100% and 100% for ICD, 81% and 81% for MGAUD. Conclusions: Confocal microscopy has the potential to diagnose the simple MGD with high sensitivity and specificity. The CM-based diagnostic parameters correlated significantly and strongly with the status of the ocular surface disease. Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article. © 2010 American Academy of Ophthalmology.

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

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

Japanese Journal of Clinical Ophthalmology （Japanese Journal of Clinical Ophthalmology） 64 （ 4 ） 459 - 463 2010年04月

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.

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年04月

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)

Pupillary Block Glaucoma After Implantation of Iris-Fixated Phakic Intraocular Lens.

Okumura Y, Yamaguchi T, Shiba D, Murat D, Kawamura R, Toda I, Tsubota K, Negishi K

Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye 1 - 3 2010年03月

ISSN 1542-8877

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虹彩支持型有水晶体眼内レンズの術後早期成績

渡辺一弘, 山口剛史, 根岸一乃, 鳥居秀成, 小玉千代, 佐伯めぐみ, 河口奈々恵, 坪田一男

IOL & RS （(株)杏林舎内「IOL&RS」編集事務局） 24 （ 1 ） 84 - 89 2010年03月

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)

Rhegmatogenous retinal detachment in eyes undergoing laser in situ keratomileusis at Keio University Hospital

Yaguchi S., Uchida A., Kawamura R., Suzuki K., Shinoda H., Noda K., Imamura Y., Ozawa Y., Negishi K., Ishida S.

Folia Japonica de Ophthalmologica Clinica （Folia Japonica de Ophthalmologica Clinica） 3 （ 5 ） 472 - 476 2010年

ISSN 1882-5176

Purpose : To report the characteristics and surgical outcomes of rhegmatogenous retinal detachment (RRD) in myopic patients who underwent laser in situ keratomileusis (LASIK). Methods : We retrospectively reviewed the medical records of 8 patients with RRD developed after LASIK, who visited the clinics of the Department of Ophthalmology, Keio University Hospital, between December 1999 and July 2008. Results : AU 8 patients were male. The mean values of pre-LASIK and post-LASIK spherical equivalent were -7.91D and -0.34D, respectively. The patients underwent local scleral buckling(3 cases), pars plana vitrectomy(3 cases) and scleral buckling combined with vitrectomy(2 cases). The lenses were spared in all cases. At the final follow-up (mean 7.1 months), the changes in the mean values of spherical equivalent were -0.17D in cases treated with local scleral buckling, -1.63D in cases treated with pars plana vitrectomy and -5.94D in cases treated with combined surgery, respectively. Conclusions : In our patients, myopic change was highly increased in the patients who underwent vitrectomy, compared with patients treated with buckling surgery. This suggests the importance of preoperative explanation on the myopic progression after lens-sparing vitrectomy for RRD after LASIK.

Foldable acrylic intraocular lens with distended haptics for transscleral fixation

Yaguchi Saori, Yaguchi Shigeo, Noda Yoshiko, Taguchi Yoko, Negishi Kazuno, Tsubota Kazuo

Journal of Cataract and Refractive Surgery 35 （ 12 ） 2047 - 2050 2009年12月

ISSN 0886-3350

We describe a foldable acrylic intraocular lens (IOL) with distended haptics suitable for transscleral fixation and the insertion procedure. The IOL has an acrylic optic and poly(methyl methacrylate) haptics with a microscopic indentation 1.3 mm from the tip. Transscleral fixation of the IOL was performed through corneal incisions in 22 eyes, and surgical results were retrospectively assessed. The IOL was sutured firmly in position using the cow-hitch procedure, and there was no suture loosening to the distended haptic. The IOL design provided suitable fixation and may be indicated for bag fixation as well as transscleral fixation. © 2009 ASCRS and ESCRS.

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Effect of age on changes in anterior chamber depth and volume after laser in situ keratomileusis

Nishimura Ryo, Negishi Kazuno, Dogru Murat, Saiki Megumi, Arai Hiroyuki, Toda Ikuko, Yamaguchi Takefumi, Tsubota Kazuo

Journal of Cataract and Refractive Surgery 35 （ 11 ） 1868 - 1872 2009年11月

ISSN 0886-3350

Purpose: To evaluate the effect of age on anterior chamber depth (ACD) and anterior chamber volume (ACV) after laser in situ keratomileusis (LASIK) for myopia. Setting: Department of Ophthalmology, Keio University School of Medicine, and a private clinic, Tokyo, Japan. Methods: In this retrospective study, patients who had uneventful LASIK for myopia or myopic astigmatism were divided into 2 groups: younger (younger than 40 years) and older (40 years and older). Central corneal thickness, central corneal true net power, ACV, and central ACD were measured using a rotating Scheimpflug camera preoperatively and 1 month postoperatively. These parameters were compared between the 2 groups. Results: The study evaluated 161 eyes of 83 patients (mean age 34.5 years ± 8.3 [SD]). The decreases in central ACD and ACV after LASIK were statistically significant in the younger group (P<.0001 and P = .0050, respectively) but not in the older group. Conclusion: Central ACD and the ACV decreased significantly after LASIK in younger patients (<40 years) but not in older patients, indicating that age influences changes in ACD and ACV after LASIK. © 2009 ASCRS and ESCRS.

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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 35 （ 10 ） 1725 - 1733 2009年10月

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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The evaluation of the treatment response in obstructive meibomian gland disease by in vivo laser confocal microscopy

Matsumoto Yukihiro, Shigeno Yuta, Sato Enrique Adan, Ibrahim Osama M A, Saiki Megumi, Negishi Kazuno, Ogawa Yoko, Dogru Murat, Tsubota Kazuo

Graefe's Archive for Clinical and Experimental Ophthalmology 247 （ 6 ） 821 - 829 2009年06月

ISSN 0721-832X

Purpose: To evaluate the status of periglandular inflammation, ocular surface and tear function alterations in patients with obstructive meibomian gland disease (OMGD) by in vivo confocal microscopy before and after anti-inflammatory treatment, and to compare the results with patients receiving only topical non-preserved artificial tears and sodium hyaluronate eye drops without anti-inflammatory agents. Methods: Thirty-two eyes of 16 OMGD patients receiving anti-inflammatory treatment (treatment group) and 22 eyes of 11 OMGD patients receiving only topical non-preserved artificial tears and sodium hyaluronate eye drops (control group) were recruited in this prospective study. All subjects underwent slit-lamp examinations, tear film break-up time (BUT) measurements, fluorescein and Rose-Bengal stainings, Schirmer test I without anesthesia, transillumination of the lids (meibography), and in vivo laser confocal microscopy of the lids (HRTII-RCM). Results: The mean BUT, fluorescein staining scores, and inflammatory cell densities observed by in vivo confocal microscopy improved significantly in the group receiving anti-inflammatory treatment (p<0.05), whereas no significant alterations of these parameters were observed in the group not receiving anti-inflammatory agents (p>0.05). Conclusions: In vivo confocal microscopy was able to effectively demonstrate the treatment responses in patients with OMGD. Inflammatory cell density calculation seems to be a promising new parameter of in vivo confocal microscopy in the evaluation of treatment responses. © Springer-Verlag 2008.

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