研究者詳細 - 根岸　一乃

論文 - 根岸　一乃

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Strip Meniscometry Correlates With Ocular Surface Tests and Symptoms.

Negishi K, Ayaki M, Uchino M, Takei K, Tsubota K.

Transl Vis Sci Technol 9 （ 12 ） 31 2020年11月

研究論文（学術雑誌）

Prospective assessment of plate-haptic rotationally asymmetric multifocal toric intraocular lens with near addition of + 1.5 diopters.

Oshika T, Negishi K, Noda T, Arai H, Inamura M, Inoue Y, Miyoshi T, Fujita Y, Miyata K, Hasegawa Y.

BMC Ophthalmol. （National Library of Medicine） 20 （ 1 ） 454 2020年11月

研究論文（学術雑誌）

Subjective Happiness and Satisfaction in Postoperative Anisometropic Patients after Refractive Surgery for Myopia.

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

J Clin Med （MDPI） 9 （ 11 ） 3473 2020年10月

研究論文（学術雑誌）

Changes in Patient Subjective Happiness and Satisfaction with Cataract Surgery.

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

Sci Rep 10 （ 1 ） 17273 2020年10月

研究論文（学術雑誌）

Ratio of Axial Length to Corneal Radius in Japanese Patients and Accuracy of Intraocular Lens Power Calculation Based on Biometric Data.

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

Am J Ophthalmol. （ELSEVIER） 218 320 - 329 2020年10月

研究論文（学術雑誌）

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シングルピース疎水性アクリル眼内レンズ挿入術後早期の屈折誤差変化に関与する因子

林俊介、吉田起章、林研、根岸一乃、坪田一男

日本眼科学会雑誌 124 （ 10 ） 759 - 764 2020年10月

Factors affecting depth perception and comparison of depth perception measured by the three-rods test in monocular and binocular vision.

Iehisa I, Ayaki M, Tsubota K, Negishi K

Heliyon 6 （ 9 ） e04904 2020年09月

研究論文（学術雑誌）

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.

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

PLos One. 15 （ 9 ） e0238366 2020年09月

研究論文（学術雑誌）

Seasonal variation of intra-ocular pressure in glaucoma with and without dry eye.

Kuze M, Ayaki M, Yuki K, Kawashima M, Uchino M, Tsubota K, Negishi K.

Sci Rep. （Nature Research ） 10 （ 1 ） 13949 2020年08月

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Difference in Pupillary Diameter as an Important Factor for Evaluating Amplitude of Accommodation: A Prospective Observational Study.

Kubota M, Kubota S, Kobashi H, Ayaki M, Negishi K, Tsubota K.

J Clin Med （MDPI） 9 （ 8 ） E2678 2020年08月

研究論文（学術雑誌）

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.

Sci Rep. （Nature Research） 10 （ 1 ） 13181 2020年07月

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The Early Effects of Alcohol Consumption on Functional Visual Acuity, Tear Functions, and the Ocular Surface.

Simsek C, Kojima T, Dogru M, Tanaka M, Takano Y, Wakamatsu T, Ibrahim O, Toda I, Negishi K, Tsubota K.

Eye Contact Lens. （Wolters Kluwer） 2020年07月

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Nocturnal Lagophthalmos and Sleep Quality in Patients with Dry Eye Disease.

Takahashi A, Negishi K, Ayaki M, Uchino M, Tsubota K.

Life(Basel) （MDPI） 10 （ 7 ） E105 2020年07月

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Machine‐learning approach to predict on‐road driving ability in healthy older people.

Yamamoto Y, Hirano J, Yoshitake H, Negishi K, Mimura M, Motoki S, Yamagata B.

PCN 74 488 - 495 2020年06月

研究論文（学術雑誌）

Relationship between Indoor Daytime Light Exposure and Circadian Phase Response under Laboratory Free-Living Conditions.

Yoshimura M, Kitamura S, Eto N, Hida A, Katsunuma R, Ayabe N, Motomura Y, Negishi K, Tsubota K, Mishima K.

Biological Rhythm Research 2020年06月

Relationship Between Visual Function and Cognitive Function in the Elderly: A Cross-Sectional Observational Study.

Kaido M, Fukui M, Kawashima M, Negishi K, Tsubota K.

PLoS One 15 （ 5 ） e0233381 2020年05月

研究論文（学術雑誌）

Loss of Concentration May Occur by Blink Inhibition in DED Simulation Models.

Mitsukura Y, Negishi K, Ayaki M, Santo M, Kawashima M, Tsubota K.

Life(Basel) 10 （ 5 ） 61 2020年05月

研究論文（学術雑誌）

Baseline Factors Predicting the Need for Corneal Crosslinking in Patients With Keratoconus.

Kato N, Negishi K, Sakai C, Tsubota K.

PLoS One 15 （ 4 ） e0231439 2020年04月

研究論文（学術雑誌）

Author Correction: Suppression of Presbyopia Progression With Pirenoxine Eye Drops: Experiments on Rats and Non-Blinded, Randomized Clinical Trial of Efficacy.

Tsuneyoshi Y, Higuchi A, Negishi K(*CO), Tsubota K.

Sci Rep 10 （ 1 ） 6757 2020年04月

研究論文（学術雑誌）

Persistently Worsened Tear Break-up Time and Keratitis in Unilateral Pseudophakic Eyes After a Long Postoperative Period.

Hanyuda A, Negishi K, Tsubota K, Ayaki M.

Biomedicines 8 （ 4 ） 77 2020年04月

研究論文（学術雑誌）

Age Is a Determining Factor of Dry Eye-Related Signs and Symptoms.

Ayaki M, Negishi K, Kawashima M, Uchino M, Kaido M, Tsubota K.

Diagnostics(Basel) （MDPI） 10 （ 4 ） pii:E193 2020年03月

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Tear Break-Up Time and Seasonal Variation in Intraocular Pressure in a Japanese Population.

Ayaki M, Negishi K, Yuki K, Kawashima M, Uchino M, Tsubota K.

Diagnostics(Basel) （MDPI） 10 （ 2 ） 124 2020年02月

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Five-year Outcomes of Corneal Cross-Linking for Keratoconus: Comparison Between Conventional and Accelerated Procedures.

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

Cornea （Wolters Kluwer） 39 （ 1 ） e1 - e2 2020年01月

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Subjective Happiness and Sleep in University Students with High Myopia.

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

Psych （MDPI） 2 （ 4 ） 279 - 286 2020年

研究論文（学術雑誌）

Nationwide Prospective Cohort Study on Cataract Surgery with Multifocal Intraocular Lens Implantation in Japan.

Negishi K, Hayashi K, Kamiya K, Sato M, Bissen-Miyajima H; Survey Working Group Of The Japanese Society Of Cataract And Refractive Surgery.

Am J Ophthalmol. 208 133 - 144 2019年12月

Kinetic visual acuity is correlated with functional visual acuity at higher speeds.

Iehisa I, Negishi K, Ayaki M, Tsubota K.

BMJ Open Ophthalmol. 4 （ 1 ） e000383 2019年11月

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Survey of the effects of internet usage on the happiness of Japanese university students.

Kitazawa M, Yoshimura M, Hitokoto H, Sato-Fujimoto Y, Murata M, Negishi K, Mimura M, Tsubota K, Kishimoto T.

Health Qual Life Outcomes. 17 （ 1 ） 151 2019年10月

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Shortened Measurement Time of Functional Visual Acuity for Screening Visual Function.

Hidaka Y, Masui S, Nishi Y, Ayaki M, Kaido M, Mimura M, Tsubota K, Negishi K.

Journal of Ophthalmology. 8950418 2019年09月

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Suppression of blue light at night ameliorates metabolic abnormalities by controlling circadian rhythms.

Nagai N, Ayaki M, Yanagawa T, Hattori A, Negishi K, Mori T, Nakamura TJ, Tsubota K.

INv Ophth Vis Sci. 60 （ 12 ） 3786 - 3793 2019年09月

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Current Prevalence of Myopia and Association of Myopia With Environmental Factors Among Schoolchildren in Japan.

Yotsukura E, Torii H, Inokuchi M, Tokumura M, Uchino M, Nakamura K, Hyodo M, Mori K, Jiang X, Ikeda SI, Kondo S, Negishi K, Kurihara T, Tsubota K.

JAMA Ophthalmol. 137 （ 11 ） 1233 - 1239 2019年08月

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Survey Working Group Of The Japanese Society Of Cataract And Refractive Surgery. Nationwide Prospective Cohort Study on Cataract Surgery with Multifocal Intraocular Lens Implantation in Japan.

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

Am J Ophthalmol 2019年08月

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Protective effects of blue light-blocking shades on phototoxicity in human ocular surface cells.

Niwano Y, Iwasawa A, Tsubota K, Ayaki M, Negishi K.

BMJ Open Ophthalmol. 4 （ 1 ） e000217 2019年05月

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Comparison of the Accuracy of Newer Intraocular Lens Power Calculation Methods in Eyes That Underwent Previous Phototherapeutic Keratectomy

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

Journal of refractive surgery (Thorofare, N.J. : 1995) （Journal of refractive surgery (Thorofare, N.J. : 1995)） 35 （ 5 ） 310 - 316 2019年05月

ISSN 1081597X

Copyright 2019, 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. [J Refract Surg. 2019;35(5):310-316.].

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

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

Sci Rep. （Scientific Reports） 9 （ 1 ） 6557 2019年04月

© 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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Diurnal variation of human tear meniscus volume measured with tear strip meniscometry self-examination

Ayaki M., Tachi N., Hashimoto Y., Kawashima M., Tsubota K., Negishi K.

PLoS ONE （PLoS ONE） 14 （ 4 ） e0215922 2019年04月

© 2019 Ayaki et al. Purpose Tear secretion is critical for maintenance of healthy ocular surface and vision. Most of normal subjects and dry eye patients feel worsening of ocular dryness in the afternoon, however, diurnal variation of tear meniscus volume has not been directly measured because there was no appropriate method. We used a simple, non-invasive technique, tear strip meniscometry (SM) by self-examination. Previous investigations indicated the values of SM correlated strongly with those of the Schirmer test, tests of tear break up time, and tear meniscus height measurement by anterior optical coherence tomography. The purpose of this study was to capture diurnal variation of aqueous availability at the tear meniscus by measuring wetted length using SM through self-examination. Methods Thirty-six medical personnel (mean age; 35.7 years) participated and SM self-examination was performed using a mirror seven times a day. The strip is applied for 5 seconds to the lateral side of the lower lid tear meniscus without touching the ocular surface. Results The measured SM value was the highest upon awakening (4.44 ± 3.14 mm) and gradually decreased in the evening; 3.81 ± 3.12 at 9:00, 3.31 ± 2.72∗ at 12:00, 2.89 ± 1.88∗ at 15:00, 2.92 ± 1.87∗ at 18:00, 2.78 ± 1.85∗ at 21:00, and 2.89 ± 1.75∗ at bedtime with statistical significance compared to the value upon awakening (∗P < 0.05, Dunnett's multiple comparison test). Proportion of number of subjects with low SM value (< 4 mm) to total number of subjects was 52.8% upon awakening and 83.3% at 21:00, and gradually increased toward evening. Conclusion Our results could identify diurnal variation of tear meniscus volume in the general population.

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Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients.

Hanyuda A, Ayaki M, Tsubota K, Negishi K

Journal of clinical medicine 8 （ 2 ） pii:E211 2019年02月

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Latanoprost could exacerbate the progression of presbyopia

Ayaki M., Tsuneyoshi Y., Yuki K., Tsubota K., Negishi K.

PLoS ONE （PLoS ONE） 14 （ 1 ） e0211631 2019年01月

© 2019 Ayaki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Purpose Prostaglandin analogues (PG) reduce intra-ocular pressure by enhancing uveoscleral flow at the ciliary body, which controls accommodation via the ciliary muscle. We investigated the effect of PG on accommodation and presbyopia progression in glaucoma patients. Methods We conducted a clinic-based, retrospective, cross-sectional study. Inclusion criteria were bilateral phakic patients aged 40–69 years with best corrected visual acuity better than 20/ 30. Exclusion criteria were any disease affecting vision other than glaucoma and history of ocular surgery. Subjects with no prescription or vision-affecting disease served as controls (n = 260). The glaucoma patients were prescribed eye drops containing 0.005% latanoprost for more than six months (n = 23). We measured the binocular near add power at a distance of 30 cm in both groups and compared the results using Kaplan-Meier analysis. Results The mean age (± SD) of the control subjects was 51.5 ± 5.2 years and 39% were male. Similarly, the glaucoma patients had a mean age of 51.0 ± 7.2 years and 39% were male. There were no significant differences in age, gender, intra-ocular pressure, spherical equivalent, astigmatism, or anisometropia between groups. Survival analysis indicated that the glaucoma patients in this study reached the endpoint (near add power of +3.00 D) significantly earlier than control patients (P = 0.0001; generalized Wilcoxon test). Conclusions Exacerbation of presbyopia progression in glaucoma patients is a potential side effect of latanoprost eyedrops.

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Association between retinal nerve fiber layer thickness and eye fatigue

Ayaki M., Kuze M., Kondo M., Tsubota K., Negishi K.

BioMed Research International （BioMed Research International） 2019 3014567 2019年01月

ISSN 23146133

© 2019 Masahiko Ayaki et al. Eye fatigue is a common health problem across all age groups. Herein, we explored the correlation between eye fatigue and thickness of the retinal nerve fiber layer (NFL). Included in the NFL are intrinsically photosensitive retinal ganglion cells (ipRGCs), which are associated with trigeminal pain. This retrospective cross-sectional study included outpatients with best-corrected visual acuity above 20/30 in both eyes and without dry eye, glaucoma, or retinal disease. A total of 1981 patients were initially enrolled and 377 patients were declared as eligible for the study analysis. We tested subjects for the presence of major ocular symptoms and measured thickness of ganglion cell complex (GCC) using optical coherence tomography. A total of 377 outpatients (46.4% men, mean age of 57.1 years) were enrolled for analysis, based on the interview-reported prevalence of six eye symptom, as follows: 31.5% for eye fatigue, 19.2% for blurring, 18.6% for dryness, 15.7% for photophobia, 13.5% for irritation, and 4.6% for pain. The macular GCC was significantly thicker in subjects with eye fatigue compared to the group not reporting eye fatigue (103.8 μm versus 100.3 μm, P = 0.014). Regression analysis identified eye fatigue (P = 0.026, β=0.122, adjusted for age and sex) and dryness (P =0.024, β=0.130) as significantly correlated with the macular GCC thickness, while the full macular thickness showed no significant correlation. In conclusions, eye fatigue and dryness were positively associated with thickness of the macular GCC. Nonvisual symptoms might therefore play a role in the development of eye fatigue.

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The Relationship of Dry Eye Disease with Depression and Anxiety: A Naturalistic Observational Study.

Kitazawa M, Sakamoto C, Yoshimura M, Kawashima M, Inoue S, Mimura M, Tsubota K, Negishi K, Kishimoto T

Translational vision science & technology 7 （ 6 ） 35 2018年12月

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Sleep disorders are a prevalent and serious comorbidity in dry eye

Ayaki M., Tsubota K., Kawashima M., Kishimoto T., Mimura M., Negishi K.

Investigative Ophthalmology and Visual Science （Investigative Ophthalmology and Visual Science） 59 （ 14 Special Issue ） DES143 - DES150 2018年11月

ISSN 01460404

© 2018 The Authors. PURPOSE. Sleep is an essential life habit and closely associated with lifespan, diabetes, hypertension, and mental health. Sleep disorders are a prominent, but overlooked problem in patients with dry eye disease (DED), characterized by a poor sleep index, short sleep duration, long sleep latency, and poor subjective sleep. DED and sleep disorders are more prevalent in women than men. Moreover, sleep quality in DED is worse than in other eye diseases, including glaucoma, retinal diseases, cataract, and allergic and chronic conjunctivitis. METHODS. We reviewed the literature for studies investigating sleep and health, eyes and sleep, and DED and sleep, in terms of systemic and eye health, especially in women. RESULTS. Two studies reported that approximately half of patients with DED suffer from poor sleep. The severity of mood disorders, including anxiety and depression, is correlated strongly with sleep disorders in DED, and the symptoms and signs of DED, especially pain, also are correlated with sleep quality. Sleep disorders are documented in primary Sjögren’s syndrome and an association with sleep apnea and depression is suggested. Primary Sjögren’s syndrome includes arthritis and other rheumatic disease causing pain and fatigue; however, how sicca contributes to sleep disorders is not known. CONCLUSIONS. Possible explanations for sleep disorders in DED may be depression, pain, and eye exposure at night. Reciprocal effects may be expected and consultation-liaison psychiatry is recommended for the management of sleep disorders in DED. Topical medication and lid heating also may be advantageous for sleep quality in DED.

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Corneal crosslinking for keratoconus in Japanese populations: one year outcomes and a comparison between conventional and accelerated procedures

Kato N., Konomi K., Shinzawa M., Kasai K., Ide T., Toda I., Sakai C., Negishi K., Tsubota K., Shimazaki J.

Japanese Journal of Ophthalmology （Japanese Journal of Ophthalmology） 62 （ 5 ） 560 - 567 2018年07月

ISSN 1613-2246

© 2018, Japanese Ophthalmological Society. Purpose: We retrospectively investigated the efficacy of corneal crosslinking (CXL) on progressive keratoconus in a Japanese population and compared the outcomes of conventional and accelerated CXL. Study design: A retrospective cohort study Methods: A total of 108 consecutive eyes in 95 patients (75 men; 21.9 ± 6.2 years) with progressive keratoconus were enrolled. The epithelium was ablated in all eyes. After presoaking the corneal stroma in riboflavin, UV-A was irradiated at 3.0 mW/cm 2 (conventional CXL) for 30 min on 23 eyes and 18.0 mW/cm 2 for 5 min (accelerated CXL) on 85 eyes. Best spectacle-corrected visual acuity (BSCVA), manifest refraction, keratometric value, corneal thickness, corneal endothelial cell density (ECD), intraocular pressure, and complications were evaluated at 1, 3, 6, and 12 months after the procedure. Results: BSCVA, manifest refraction, ECD, and corneal thickness did not change significantly after both procedures. The keratometric value was significantly decreased from the preoperative value at 12 months (p < 0.001). Progression to more than 1.0 D after CXL was observed in 10 eyes (9.3%). The ΔKmax was negatively associated with preoperative Kmax (p < 0.001) and positively associated with preoperative thinnest corneal thickness (p < 0.001). Both treatment modules showed no significant difference in all parameters. Conclusion: CXL was as effective in treating keratoconus in Japanese patients as in individuals of other ethnicities. Overall, CXL could be performed using either the conventional or accelerated approach to halt the progression of keratoconus in Japanese populations.

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Refractive outcomes of intraocular lens power calculation using different corneal power measurements with a new optical biometer

Savini G., Negishi K., Hoffer K., Lomoriello D.

Journal of Cataract and Refractive Surgery （Journal of Cataract and Refractive Surgery） 44 （ 6 ） 701 - 708 2018年06月

ISSN 1873-4502

© 2018 ASCRS and ESCRS Purpose: To evaluate the results of intraocular lens (IOL) power calculation using different corneal power measurements provided by an optical biometer combined with a dual Scheimpflug analyzer and a Placido disk topographer (Galilei G6). Setting: G.B. Bietti Foundation, Rome, Italy, and Keio University Hospital, Tokyo, Japan. Design: Evaluation of diagnostic technology. Methods: Consecutive patients having cataract surgery were enrolled. The IOL power was calculated with the Barrett Universal II, Haigis, Hoffer Q, Holladay 1, and SRK/T formulas. Different options were used to calculate the corneal power: simulated keratometry (K) based on anterior corneal surface measurements only and total corneal power (TCP) based on ray tracing through both corneal surfaces. Three TCP measurements (TCP1, TCP2, and TCP-IOL) were evaluated. Results: The study analyzed 118 eyes. The mean values of simulated K (43.74 diopters [D] ± 1.40 [SD]), TCP1 (43.13 ± 1.35 D), TCP2 (41.87 ± 1.30 D), and TCP-IOL (42.62 ± 1.35 D) were significantly different (P <.0001). The best results were obtained using simulated K: the median absolute error ranged between 0.22 D and 0.29 D and the percentage of eyes with a prediction error of ±0.50 D or less, between 76.2% and 84.7%, depending on the formula. After constant optimization, the results using any TCP value and simulated K were similar with no statistically significant differences. Conclusions: Biometric measurements provided by the Scheimpflug–Placido optical biometer can be used to accurately calculate the IOL power. Simulated K and TCP led to similar outcomes after constant optimization.

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Effects of Cataract Opacity and Surgery on Sleep Quality

Kokune-Takahashi A., Ayaki M., Tsubota K., Negishi K.

Rejuvenation Research （Rejuvenation Research） 21 （ 1 ） 53 - 60 2018年02月

ISSN 1557-8577

© 2018, Mary Ann Liebert, Inc. This study aimed to identify the type of cataract opacity associated with subjective sleep quality for cataract patients. A total of 180 consecutive patients (average age 74.2 years) underwent cataract surgery with implantation of an ultraviolet-blocking or blue light-blocking intraocular lens. The participants' subjective sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI) before and at 2 months after surgery. Patients were divided into two groups for analysis: normal sleepers (preoperative PSQI ≤5) and poor sleepers (preoperative PSQI ≥6). The preoperative and postoperative PSQI scores were 2.8 ± 1.5 and 3.2 ± 2.0, respectively, for normal sleepers (n = 99), and 8.5 ± 2.9 and 7.4 ± 3.3, respectively, for poor sleepers (n = 81). The improvement in PSQI was significant in poor sleepers (p < 0.0001, Wilcoxon's test) with measured values of 0.22 ± 0.96 hours extension in sleep duration and 0.16 ± 0.62 hours shortening in sleep latency. Patients with posterior subcapsular cataract (PSC) and nuclear opacity showed the greatest improvement in PSQI score, with regression analysis identifying PSC as having a significant effect on improvement in PSQI. Significant correlations were found between the subjective sleep and cataract opacity in cataract patients. Ophthalmic personnel should therefore be aware that cataract patients with PSC have a greater potential for disability and predictable benefits from surgery in vision and subjective sleep.

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Gender differences in adolescent dry eye disease: A health problem in girls

Ayaki M., Kawashima M., Uchino M., Tsubota K., Negishi K.

International Journal of Ophthalmology （International Journal of Ophthalmology） 11 （ 2 ） 301 - 307 2018年

ISSN 2222-3959

© 2018, International Journal of Ophthalmology (c/o Editorial Office). All rights reserved. AIM: To evaluate the signs and symptoms of dry eye disease (DED) in adolescents. METHODS: This was a cross-sectional, case-control study and outpatients aged 10 to 19y were recruited from six eye clinics of various practices and locations in Japan, and 253 non-DED subjects and 70 DED patients were enrolled. Participants were examined for DED-related signs. Patients were also interviewed to ascertain the presence or absence of six common DED-related symptoms: dryness, irritation, pain, eye fatigue, blurring, and photophobia. Main outcome measures were differences in signs and symptoms of dry eye disease between boys and girls. RESULTS: Of the 323 adolescents recruited, 70 (21.7%) were diagnosed with DED. Significant differences between the non-DED and DED groups were found for short tear break-up time (BUT; ≤5s; P=0.000) and superficial punctate keratopathy (SPK; staining score ≥3; P=0.000). Late adolescent girls reported fewer symptoms than late adolescent boys, although their DED-related signs were worse compared to other groups. The prevalence and severity of DED were similar in the Tokyo area compared with suburban and local areas but myopic errors were worse. CONCLUSION: We find that adolescents reported symptoms of DED similar to those found in adults, and the majority have short BUT-type DED. The prevalence and severity of DED in late adolescent girls is comparable with adults. Adolescents with DED are underserved and we believe that DED is a hidden but potentially serious health problem for this age group.

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Strengths use as a secret of happiness: Another dimension of visually impaired individuals’ psychological state

Matsuguma S., Kawashima M., Negishi K., Sano F., Mimura M., Tsubota K.

PLoS ONE （PLoS ONE） 13 （ 2 ） e0192323 2018年

ISSN 1932-6203

© 2018 Matsuguma et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. It is well recognized that visual impairments (VI) worsen individuals’ mental condition. However, little is known about the positive aspects including subjective happiness, positive emotions, and strengths. Therefore, the purpose of this study was to investigate the positive aspects of persons with VI including their subjective happiness, positive emotions, and strengths use. Positive aspects of persons with VI were measured using the Subjective Happiness Scale (SHS), the Scale of Positive and Negative Experience-Balance (SPANE-B), and the Strengths Use Scale (SUS). A cross-sectional analysis was utilized to examine personal information in a Tokyo sample (N = 44). We used a simple regression analysis and found significant relationships between the SHS or SPANE-B and SUS; on the contrary, VI-related variables were not correlated with them. A multiple regression analysis confirmed that SUS was a significant factor associated with both the SHS and SPANE-B. Strengths use might be a possible protective factor from the negative effects of VI.

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Patients’ satisfaction and subjective happiness after refractive surgery for myopia

Matsuguma S., Negishi K., Kawashima M., Toda I., Ayaki M., Tsubota K.

Patient Preference and Adherence （Patient Preference and Adherence） 12 1901 - 1906 2018年

ISSN 1177-889X

© 2018 Matsuguma et al. Purpose: The purpose of this study was to assess patients’ satisfaction and change in subjective happiness after laser-assisted in situ keratomileusis (LASIK). Patients and methods: This was a retrospective cross-sectional study of 307 patients (mean age, 34.3 years; range, 20–63 years) who underwent bilateral LASIK surgery and ocular examinations, including subjective refraction and visual acuity axial length measurements at Minamiaoyama Eye Clinic. Patients also completed questionnaires on their satisfaction with the surgery, and on the subjective happiness scale (SHS) within 1 month before and 1 month after surgery. A multiple regression analysis was performed to determine the independent predictors of the SHS score. Results: In total, 91.2% of the patients were satisfied with surgery (very satisfied: n=155; satisfied: n=125). The SHS score increased postoperatively from 5.2±0.9 to 5.3±0.9 (P<0.001). The multiple regression analysis revealed that the preoperative SHS score (β=0.77; P<0.001) and satisfaction with surgery (β=-0.11; P=0.05) were predictors of postoperative SHS score. Conclusion: LASIK may contribute to increased patient happiness.

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Dry eye, sleep quality, and mood status in glaucoma patients receiving prostaglandin monotherapy were comparable with those in non-glaucoma subjects

Ra S., Ayaki M., Yuki K., Tsubota K., Negishi K.

PLoS ONE （PLoS ONE） 12 （ 11 ） e0188534 2017年11月

ISSN 1932-6203

© 2017 Ra et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Purpose: Prior studies suggested that glaucoma patients suffer worse dry eye and mood and sleep disorders than non-glaucoma subjects. Prostaglandin analogues are first-line therapy for glaucoma, inducing few instillation problems and sufficient pressure-reduction effects. This study compared dry eye, sleep quality, and mood status between glaucoma patients receiving prostaglandin monotherapy and non-glaucoma subjects. Methods: This cross-sectional study evaluated 1520 patients (579 males and 941 females) for glaucoma status and dry eye-related symptoms (dryness, eye fatigue, photophobia, pain, blurring) and signs (Schirmer test, tear break-up time, corneal staining scores). Of the total cohort, 93 patients were also evaluated by Pittsburgh sleep quality index (PSQI) and hospital anxiety and depression score (HADS). Inclusion criteria were consecutive patients ≥ 51 years of age and best-corrected visual acuity ≥ 20/25. Glaucoma patients included those treated with prostaglandin or a fixed combination including prostaglandin. Exclusion criteria were history of ocular surgery within one month. Data were analyzed using the chi-square or Mann-Whitney U tests, at 5% significance. Results: There were no significant differences in dry eye-related signs and symptoms between the control (n = 1431, mean age of 66.9 years) and glaucoma groups (n = 89, 67.9 years). The psychiatric sub-analysis of the control (n = 61, 66.2 years) and glaucoma groups (n = 32, 67.3 years) revealed mean scores of 5.02 ± 3.10 and 5.16 ± 3.46 for PSQI (normal range ≤ 5), 9.47 ± 5.61 and 9.42 ± 7.36 for HADS (normal range ≤ 10), 4.84 ± 3.22 and 4.71 ± 3.45 for anxiety (normal range ≤ 5), and 4.63 ± 3.05 and 4.71 ± 4.40 for depression (normal range ≤ 5), respectively, without statistical significance. Conclusions: Our results were comparable between glaucoma patients on prostaglandin monotherapy and non-glaucoma subjects for dry eye-related clinical manifestations, sleep quality, and mood status.

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

Torii H., Ohnuma K., Kurihara T., Tsubota K., Negishi K.

Scientific Reports （Scientific Reports） 7 （ 1 ） 14523 2017年11月

ISSN 2045-2322

© 2017 The Author(s). 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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Possible association between subtypes of dry eye disease and seasonal variation

Ayaki M., Kawashima M., Uchino M., Tsubota K., Negishi K.

Clinical Ophthalmology （Clinical Ophthalmology） 11 1769 - 1775 2017年09月

ISSN 1177-5467

© 2017 Ayaki et al. Purpose: The purpose of this study was to evaluate the influence of seasons on the signs and symptoms of dry eye disease (DED). Methods: This is a cross-sectional, case-control study, and participants were non-DED subjects (n=1,916, mean age 54.4±14.4 years) and DED patients (n=684, 54.2±12.1 years) visiting six eye clinics at various practices and locations in Japan. We evaluated the signs and symptoms of DED and the seasons with the most severe results were compared to those with the least severe results in both groups. Main outcome measures were differences in the severity of the signs and symptoms of DED between the most and least severe seasons. Results: The majority of DED symptoms were most severe during spring and least severe in summer. Significant differences between these two seasons were found for irritation (P=0.001), pain (P=0.007), blurring (P=0.000), and photophobia (P=0.007) in the DED group. Superficial punctate keratopathy (P=0.001) and tear break-up time (BUT; P=0.000) results also indicated that DED was most severe in spring. In contrast, fewer patients had low Schirmer test results in spring, although this was not statistically significant (P=0.061). Conclusion: Our results demonstrated that the severity of DED is seasonal, which may explain the increase of short BUT-type DED cases observed in spring when air pollen counts are highest.

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A multicenter retrospective survey of refractive surgery in 78,248 eyes

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

Journal of Refractive Surgery （Journal of Refractive Surgery） 33 （ 9 ） 598 - 602 2017年09月

ISSN 1081597X

Copyright © SLACK Incorporated. PURPOSE: To retrospectively evaluate the current practice, trends, and outcomes of refractive surgery in Japan. METHODS: This multicenter survey comprised 78,248 eyes of 39,727 consecutive patients who underwent refractive surgery at 45 major institutions in Japan. The corresponding ophthalmologists responded to a self-administered questionnaire. The authors especially evaluated the safety, efficacy, predictability, stability, and adverse events of LASIK and phakic intraocular lens (IOL) implantation 3 months postoperatively. RESULTS: The most common refractive surgery was LASIK (90.9%), followed by corneal inlay (5.0%), posterior chamber phakic IOL implantation (1.3%), laserassisted subepithelial keratomileusis (1.0%), refractive lens exchange (0.9%), photorefractive keratectomy (0.3%), and refractive lenticule extraction (0.2%). For subgroup analysis, 69,987 eyes (99.5%) and 67,512 eyes (95.9%) achieved corrected and uncorrected distance visual acuity of 20/20 or better, respectively, after LASIK, and 935 eyes (98.8%) and 890 eyes (94.1%), respectively, after phakic IOL implantation. There were 69,176 eyes (98.3%) and 908 eyes (96.0%) within ±1.00 diopter (D) of the attempted correction after LASIK and phakic IOL implantation, respectively. There were 1,926 eyes (2.7%) and 1 eye (0.1%) with changes in refraction of 1.00 D or less from 1 week to 3 months after LASIK and phakic IOL implantation, respectively. No vision-threatening complications occurred in any case. CONCLUSIONS: According to this survey, LASIK remains the most prevalent surgical technique in Japan. Both LASIK and phakic IOL implantation offered good safety and efficacy outcomes, yielding predictable and stable results.

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Suppression of presbyopia progression with pirenoxine eye drops: Experiments on rats and non-blinded, randomized clinical trial of efficacy

Tsuneyoshi Y., Higuchi A., Negishi K., Tsubota K.

Scientific Reports （Scientific Reports） 7 （ 1 ） 6819 2017年07月

ISSN 2045-2322

© 2017 The Author(s). Various methods can correct presbyopia, but all require devices or surgeries. Recently, supplements or warming devices to relieve presbyopic symptoms have been developed, but no eye drops have been developed. We screened certain compounds possibly related to lens degeneration and identified pirenoxine, which has been used for cataracts, as a possible new pharmacologic treatment for presbyopia. We first researched the anti-presbyopic activity of pirenoxine in rats. The lens elasticity significantly (p = 0.028) increased with exposure to tobacco smoke for 12 days, and pirenoxine eye drops significantly (p < 0.001) suppressed lens hardening, which causes presbyopia in humans. In a parallel randomized controlled clinical study of the subjects in their fifth decade of life, the objective accommodative amplitude (AA) decreased significantly (p < 0.01) by 0.16 diopter (D) in the control group, and there was no detectable change in the treatment group after a 6-month treatment period, suggesting that pirenoxine eye drops might prevent progression of presbyopia. Subjects in their sixth decade of life, in whom the AA was already nearly 0 D, did not show similar results. Pirenoxine eye drops might be a new and the first pharmacologic treatment for preventing progression of presbyopia.

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Evaluation of a paper-based visual acuity questionnaire

Uchino M., Kawashima M., Kaido M., Suwaki K., Uchino Y., Kawachi I., Negishi K., Tsubota K.

Clinical Ophthalmology （Clinical Ophthalmology） 11 1213 - 1217 2017年06月

ISSN 1177-5467

© 2017 Uchino et al. Purpose: To validate a paper-based visual acuity (PBVA) questionnaire. Methods: In 2015, a cross-sectional survey was conducted among 301 young and middle-aged, mostly male, Japanese subjects. The participants were asked to self-rate their visual acuity (VA) on a scale from 1 to 5. Self-ratings of VA were categorized into three groups: good (1 and 2), normal (3), and poor (4 and 5). For objective validation, we performed a functional VA (FVA) assessment in the same subjects. Results: A total of 301 subjects answered the PBVA and completed the FVA test including initial VA. We found out that the result of PBVA was significantly correlated with FVA test and initial VA (r=0.33, P<0.0001, r=0.273, P<0.0001). The trend test analysis between PBVA and FVA also showed statistically significant (P<0.0001). Conclusion: There was a significant statistical correlation between the PBVA and the FVA, as well as the initial VA. This short questionnaire on VA might be a sensitive tool that is easy to implement and utilized in large epidemiological and clinical researches.

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Tsuneyoshi Y.,Negishi K.,Tsubota K.

Am J Ophthalmol 178 - 188 2017年06月

Importance of Accommodation and Eye Dominance for Measuring Objective Refractions

Tsuneyoshi Y., Negishi K., Tsubota K.

American Journal of Ophthalmology （American Journal of Ophthalmology） 177 69 - 76 2017年05月

ISSN 1879-1891

© 2017 Elsevier Inc. Purpose To explore factors affecting the difference between objective refractive data measured under monocular closed-field viewing and binocular open-field viewing. Design Prospective observational case series. Methods SETTING: Institutional. STUDY POPULATION: Twenty-nine healthy volunteers (58 eyes; mean age, 38.4 ± 10.0 years; range, 25–60 years). OBSERVATION PROCEDURES: Objective monocular refractions (MR) measured with the Nidek Auto Ref/Keratometer ARK-730A; objective binocular refractions (BR) and objective accommodative amplitude (AA) measured with the Grand Seiko Auto Ref/Keratometer WAM-5500; ocular dominance measured using the hole-in-the-card test; presence and magnitude of far/near (30 cm) phoria evaluated by the cover test and alternating cover test using a prism bar. MAIN OUTCOME MEASURE: The difference between objective refractive data measured under monocular closed-field viewing and binocular open-field viewing. Results The spherical equivalent (SE) of the BR was significantly (P <.001) more hyperopic by 0.51 ± 0.33 diopter (D) than the MR. The difference (BR minus MR) tended to decline with increasing age and decreasing AA (r = −0.231, P =.08; r = 0.223, P =.092, respectively). The correlation between age and difference in SE was significant in dominant eyes (r = −0.372, P =.047) but not in nondominant eyes (r = −0.102, P =.60). In nondominant eyes, the amount of near phoria was correlated significantly (r = 0.403, P =.03) with the difference in SE. The correlation was strong (r = 0.598, P = .01) in 17 subjects with more than 3 D of AA. Conclusions Binocular assessment of refraction is important for precise refractive therapy.

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

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

Japanese Journal of Ophthalmology （Japanese Journal of Ophthalmology） 61 （ 2 ） 142 - 149 2017年03月

ISSN 1613-2246

© 2017, Japanese Ophthalmological Society. 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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A Multicenter Prospective Cohort Study on Refractive Surgery in 15 011 Eyes

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

American Journal of Ophthalmology （American Journal of Ophthalmology） 175 159 - 168 2017年03月

ISSN 1879-1891

© 2016 Elsevier Inc. Purpose To assess the clinical outcomes of currently used refractive surgery procedures performed in 2015. Design Prospective, multicenter cohort study. Methods This prospective study included 15 011 eyes of 7622 consecutive patients who underwent laser in situ keratomileusis (LASIK), surface ablation, refractive lenticule extraction (ReLEx), or phakic intraocular lens (IOL) implantation at 42 major institutions. We determined the safety, efficacy, predictability, stability, and adverse events of these surgeries preoperatively and at 1 week and 1 and 3 months postoperatively. Results Mean logMAR corrected distance visual acuity 3 months after LASIK, surface ablation, ReLEx, posterior chamber phakic IOL, or iris-supported phakic IOL implantation was −0.18 ± 0.07, −0.16 ± 0.08, −0.17 ± 0.09, −0.21 ± 0.08, and −0.10 ± 0.12, respectively; the corresponding values for logMAR uncorrected distance visual acuity were −0.15 ± 0.11, −0.12 ± 0.12, −0.12 ± 0.13, −0.15 ± 0.12, and 0.01 ± 0.21, respectively. The percentages within ±1.0 diopter (D) of the attempted correction were 96%, 93%, 97%, 99%, and 84% after LASIK, surface ablation, ReLEx, posterior chamber phakic IOL, and iris-supported phakic IOL implantation, respectively. Refractive change from 1 week to 3 months was −0.08 ± 0.07, 0.21 ± 0.63, −0.04 ± 0.41, 0.01 ± 0.31, and 0.01 ± 0.46 D, respectively. No vision-threatening complications occurred during the observation period. Conclusions Although more prolonged follow-up is still necessary, currently used refractive surgery procedures have good safety and efficacy outcomes, yielding predictable and stable results. Contemporary LASIK, surface ablation, ReLEx, and phakic IOL implantation appear to be feasible options for the treatment of refractive errors.

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Violet Light Exposure Can Be a Preventive Strategy Against Myopia Progression

Torii H., Kurihara T., Seko Y., Negishi K., Ohnuma K., Inaba T., Kawashima M., Jiang X., Kondo S., Miyauchi M., Miwa Y., Katada Y., Mori K., Kato K., Tsubota K., Goto H., Oda M., Hatori M., Tsubota K.

EBioMedicine （EBioMedicine） 15 210 - 219 2017年02月

ISSN 2352-3964

© 2016 The Authors 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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The large-scale integration built in tablet screen for blue light reduction under optimized color and contrast;the effects on sleep and ocular parameters

Ayaki M.,Hattori A.,Maruyama Y.,Tsubota K.,Negishi K.

Cogent Biol 3 （ 1 ） 1294550 2017年

Sleep and mood disorders in women with dry eye disease

Ayaki M., Kawashima M., Negishi K., Kishimoto T., Mimura M., Tsubota K.

Scientific Reports （Scientific Reports） 6 35276 2016年10月

ISSN 2045-2322

© 2016 The Author(s). The aim of the present study was to evaluate sleep and mood disorders in women aged 30-69 with dry eye disease (DED). All subjects underwent corneal examinations, with 890 completing a questionnaire regarding symptoms of DED and 213 completing both the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale (HADS) questionnaires. Subjects were then divided into three groups based on age (younger [30-45 years], perimenopausal [46-55 years], and older [56-69 years]), and comparisons were made among groups in subjects with and without DED. PSQI scores were significantly worse in subjects with (6.1 ± 2.9) than without (4.9 ± 2.7) DED (P = 0.003) and, in the younger group, HADS scores were worse in those with (13.2 ± 6.0) than without DED (9.7 ± 6.0) (P = 0.020). In contrast, there were no differences in mood indices between those with and without DED in the other groups. PSQI score was significantly correlated with HADS rather than ocular findings. In conclusion, sleep quality had deteriorated in women with DED. However, mood problems contributed more to sleep quality than ocular status, especially in those with DED in the younger group.

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Decreased sleep quality in high myopia children

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

Scientific Reports （Scientific Reports） 6 33902 2016年09月

ISSN 2045-2322

© The Author(s) 2016. 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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Comparison of the accuracy of intraocular lens power calculations for cataract surgery in eyes after phototherapeutic keratectomy

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

Japanese Journal of Ophthalmology 60 （ 5 ） 365 - 372 2016年09月

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

Journal of Cataract and Refractive Surgery 42 （ 9 ） 1392 - 1393 2016年09月

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年06月

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)

Depressed visual field and mood are associated with sleep disorder in glaucoma patients

Ayaki M., Shiba D., Negishi K., Tsubota K.

Scientific Reports （Scientific Reports） 6 25699 2016年05月

The aim of the present study was to evaluate sleep and mood disorders and related ocular parameters in glaucoma patients. We focused on visual fields and the retinal nerve fibre layer, because decreased circadian photoreception by damaged intrinsically photosensitive retinal ganglion cells is suspected in glaucoma. A cross-sectional study was performed on 140 subjects: 69 with glaucoma and 71 normal controls. Individuals with cataract, dry eye, or retinal pathology were excluded from the study. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) and underwent comprehensive ophthalmological examinations for glaucoma. Patients with advanced glaucoma had significantly worse PSQI scores than normal controls (P < 0.05). Stepwise multivariate linear regression analysis revealed PSQI was significantly correlated with the mean deviation in the worse eye, the number and frequency of medications, and anxiety and depression subscores of the HADS after adjustment for age and sex (P < 0.05). We did not find a significant correlation between PSQI scores and the thickness of retinal nerve fibre layer. In conclusion, the subjective sleep quality of glaucoma patients was correlated with visual field loss and mood status.

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

Onishi H., Torii H., Watanabe K., Tsubota K., Negishi K.

Japanese Journal of Ophthalmology （Japanese Journal of Ophthalmology） 60 （ 3 ） 142 - 149 2016年03月

ISSN 0021-5155

© 2016, Japanese Ophthalmological Society. 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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Changes in corneal aberrations after cataract surgery

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

Japanese Journal of Ophthalmology （Japanese Journal of Ophthalmology） 60 （ 3 ） 135 - 141 2016年03月

ISSN 0021-5155

© 2016, Japanese Ophthalmological Society. Purpose: To study the changes in corneal aberrations after cataract surgery. Methods: This study comprised 36 eyes of 36 patients (mean age, 67.3 years) who underwent cataract surgery through a 2.2-mm superior sclerocorneal incision. The anterior, posterior, and total corneal wavefront aberrations for the 6.0-mm pupillary diameter were measured preoperatively and 1 month postoperatively. The postoperative changes in corneal aberrations were evaluated for individual Zernike terms (Z2−2, Z20, Z22, Z3−1, Z31, and Z40) and the root mean squares of the third, fourth, and total higher-order aberrations (S3, S4, and THOA). Results: No significant postoperative changes were observed in S3 and S4 of the total and anterior cornea, although significant changes were observed in S4 and THOA of the posterior cornea. Regarding the preoperative and postoperative Zernike terms of the total cornea, the oblique astigmatism (Z2−2) changed significantly (P = 0.02). Significant positive correlations were observed in the Z2−2, Z20, Z22 Z3−1, Z31 and Z40 between the changes in the total and the anterior cornea (P < 0.001 for all comparisons). However, no correlations were observed in the changes in the Zernike terms between the total and the posterior cornea, except for the Z20. Conclusions: The oblique astigmatism (Z2−2) of the total cornea significantly changed after 2.2-mm-incision cataract surgery. The changes in the lower- and higher-order aberrations of the anterior cornea mainly contributed to the changes in the total cornea.

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

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

Journal of Cataract and Refractive Surgery （Journal of Cataract and Refractive Surgery） 42 （ 3 ） 399 - 404 2016年03月

ISSN 0886-3350

© 2016 ASCRS and ESCRS. 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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Sleep and mood disorders in dry eye disease and allied irritating ocular diseases

Ayaki M., Kawashima M., Negishi K., Kishimoto T., Mimura M., Tsubota K.

Scientific Reports （Scientific Reports） 6 22480 2016年03月

The aim of the present study was to evaluate sleep and mood disorders in patients with irritating ocular diseases. The study design was a cross-sectional/case-control study conducted in six eye clinics. Out of 715 outpatients diagnosed with irritating ocular surface diseases and initially enrolled, 301 patients with dry eye disease (DED) and 202 age-matched control participants with other ocular surface diseases were analyzed. The mean Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) scores were 6.4 ± 3.2 and 11.1 ± 5.7 for severe DED (n = 146), 5.5 ± 3.3 and 9.8 ± 4.0 for mild DED (n = 155), 5.5 ± 3.1 and 9.5 ± 6.6 for chronic conjunctivitis (n = 124), and 5.0 ± 3.3 and 8.9 ± 5.3 for allergic conjunctivitis (n = 78). There were significant differences among these diagnostic groups for PSQI (P < 0.05). Regression analysis of patients with DED revealed the PSQI and HADS scores were significantly correlated with the severity of DED (P < 0.05). Our results demonstrate that sleep quality in patients with DED is significantly worse than in patients with other irritating ocular surface diseases and it is correlated with the severity of DED.

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Functional visual acuity of early presbyopia

Katada Y., Negishi K., Watanabe K., Shigeno Y., Saiki M., Torii H., Kaido M., Tsubota K.

PLoS ONE （PLoS ONE） 11 （ 3 ） e0151094 2016年03月

© 2016 Katada et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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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Preliminary report of improved sleep quality in patients with dry eye disease after initiation of topical therapy

Ayaki M., Toda I., Tachi N., Negishi K., Tsubota K.

Neuropsychiatric Disease and Treatment （Neuropsychiatric Disease and Treatment） 12 329 - 337 2016年02月

ISSN 1176-6328

© 2016 Ayaki et al. Purpose: Dry eye disease (DED) is potentially associated with sleep and mood disorders. This study evaluated sleep quality in patients with DED using a questionnaire-based survey before and after topical eyedrop treatment. The effectiveness of sleep and ophthalmic services in assisting with sleep problems in patients with eye disease was also assessed. Methods: Seventy-one consecutive patients with DED visiting eight general eye clinics in various locations answered a questionnaire containing the Pittsburgh Sleep Quality Index and Hospital Anxiety and Depression Scale. Photophobia and chronotype (morningness/eveningness) were also evaluated with two representative questions from established questionnaires (National Eye Institute Visual Function Questionnaire-25 and Morningness/Eveningness questionnaire). Follow-up evaluation was conducted by interview or mail 3–10 months after the initial evaluation. A sleep service was established in two eye clinics to identify possible ocular diseases related to sleep and mood disorders; it comprised a questionnaire, sleep diary, actigram, medical interviews, visual field testing, retinal ganglion cell layer thickness measurement, and DED examination. Results: Patients with newly diagnosed DED exhibited a greater improvement in sleep after DED treatment compared with patients with established DED. Improvement in Pittsburgh Sleep Quality Index was significant (P<0.05) and strongly correlated with improvement in Hospital Anxiety and Depression Scale (P<0.05) for new patients, but not for patients with established DED. Ten eye clinic patients visited the sleep service and nine of them had DED. They were successfully treated with eyedrops and sleep services, which included blue-light-shield eyewear and wearable blue-light therapy lamps according to their problem. Conclusion: Sleep quality improved in patients with DED after topical treatment with or without the sleep service. Psychiatric treatment focusing on sleep disorders could be beneficial for patients with DED.

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Protective effect of blue-light shield eyewear for adults against light pollution from self-luminous devices used at night

Ayaki M., Hattori A., Maruyama Y., Nakano M., Yoshimura M., Kitazawa M., Negishi K., Tsubota K.

Chronobiology International （Chronobiology International） 33 （ 1 ） 134 - 139 2016年01月

ISSN 0742-0528

© 2016 Taylor & Francis. We investigated sleep quality and melatonin in 12 adults who wore blue-light shield or control eyewear 2 hours before sleep while using a self-luminous portable device, and assessed visual quality for the two eyewear types. Overnight melatonin secretion was significantly higher after using the blue-light shield (P < 0.05) than with the control eyewear. Sleep efficacy and sleep latency were significantly superior for wearers of the blue-light shield (P < 0.05 for both), and this group reported greater sleepiness during portable device use compared to those using the control eyewear. Participants rated the blue-light shield as providing acceptable visual quality.

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Effects of laser in situ keratomileusis on mental health-related quality of life

Tounaka-Fujii K., Yuki K., Negishi K., Toda I., Abe T., Kouyama K., Tsubota K.

Clinical Ophthalmology （Clinical Ophthalmology） 10 1859 - 1864 2016年

ISSN 1177-5467

© 2016 Tounaka-Fujii et al. Purpose: The aims of our study were to investigate whether laser in situ keratomileusis (LASIK) improves health-related quality of life (HRQoL) and to identify factors that affect postoperative HRQoL. Materials and methods: A total of 213 Japanese patients who underwent primary LASIK were analyzed in this study. The average age of patients was 35.0±9.4 years. The subjects were asked to answer questions regarding subjective quality of vision, satisfaction, and quality of life (using the Japanese version of 36-Item Short Form Health Survey Version 2) at three time points: before LASIK, 1 month after LASIK, and 6 months after LASIK. Longitudinal changes over 6 months in the outputs of mental component summary (MCS) score and the physical component summary (PCS) score from the 36-Item Short Form Health Survey Version 2 questionnaire were compared between time points using a linear mixed-effects model. Delta MCS and PCS were calculated by subtracting the postoperative score (1 month after LASIK) from the preoperative score. Preoperative and postoperative factors associated with a change in the MCS score or PCS score were evaluated via a linear regression model. Results: The preoperative MCS score was 51.0±9.4 and increased to 52.0±9.8 and 51.5±9.6 at 1 month and 6 months after LASIK, respectively, and the trend for the change from baseline in MCS through 6 months was significant (P=0.03). PCS score did not change following LASIK. Delta MCS was significantly negatively associated with preoperative spherical equivalent, axial length, and postoperative quality of vision, after adjusting for potential confounding factors. Conclusion: Mental HRQoL is not lost with LASIK, and LASIK may improve mental HRQoL. Preoperative axial length may predict postoperative mental HRQoL.

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Relationship between Functional Visual Acuity and Useful Field of View in Elderly Drivers

Negishi K., Masui S., Mimura M., Fujita Y., Tsubota K.

PloS one （PloS one） 11 （ 1 ） e0147516 2016年

ISSN 1932-6203

PURPOSE: To investigate the relationship between the functional visual acuity (FVA) and useful field of view (UFOV) in elderly drivers and assess the usefulness of the FVA test to screen driving aptitude in elderly drivers.METHODS: This study included 45 elderly drivers (31 men, 14 women; mean age, 68.1 years) and 30 younger drivers (26 men, 4 women; mean age, 34.2 years) who drive regularly. All participants underwent measurement of the binocular corrected distant visual acuity (CDVA), binocular corrected distant FVA (CDFVA), and Visual Field with Inhibitory Tasks Elderly Version (VFIT-EV) to measure UFOV. The tear function and cognitive status also were evaluated.RESULTS: The CDVA, the CDFVA, cognitive status, and the correct response rate (CAR) of the VFIT-EV were significantly worse in the elderly group than in the control group (P = 0.000 for all parameters). The cognitive status was correlated significantly with the CDVA (r = -0.301, P = 0.009), CDFVA (r = -0.402, P = 0.000), and the CAR of the VFIT-EV (r = 0.348, P = 0.002) in all subjects. The results of the tear function tests were not correlated with the CDVA, CDFVA, or VFIT-EV in any subjects. Stepwise regression analysis for all subjects in the elderly and control groups showed that the CDFVA predicted the CAR most significantly among the clinical factors evaluated.CONCLUSION: The FVA test is a promising method to screen the driving aptitude, including both visual and cognitive functions, in a short time.

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Objective Evaluation of Zonular Weakness: Measurement of Lens Movement at the Start of Capsulorhexis Using Extracted Porcine Eyes

Yaguchi Y.,Yaguchi S.,Yaguchi S.,Kozawa T.,Tanaka Y.,Negishi K.,Tsubota K.

J Clin Exp Ophthalmol. 7 541 2016年

Laser in situ後白内障手術(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(1341-3678) 30 （ 2 ） 232 - 237 2016年

Visual function and higher-order aberrations in eyes after corneal transplantation: How to improve postoperative quality of vision

Yamaguchi T., Satake Y., Dogru M., Ohnuma K., Negishi K., Shimazaki J.

Cornea （Cornea） 34 Suppl 11 S128 - S135 2015年11月

ISSN 1536-4798

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. An understanding of corneal optics is important to optimize the visual outcome after eye surgery. Recent advances in the surgical techniques of lamellar keratoplasty have changed the strategies used for corneal transplantation. Lamellar keratoplasty has the advantage of having a lower rate of graft rejection, superior biomechanical properties, and reduced higher-order aberrations (HOAs) compared with penetrating keratoplasty; thus, the use of lamellar keratoplasty has increased over the last 15 years. However, some patients have poor postoperative visual acuity despite a clear cornea, and the reasons for the poor visual outcome are poorly understood. By combining corneal imaging technologies and the latest optical software, we proposed the concept of "parallelism of anterior and posterior surfaces in lamellar keratoplasty." In physiologically normal eyes, in which the anterior and posterior surfaces are parallel to each other, the posterior surface of the cornea compensates the HOAs of the anterior surface, and this is also true in eyes after penetrating keratoplasty. However, after lamellar keratoplasty, in which the anterior and posterior surfaces are independent and not parallel, irregularities in the posterior surface increase the HOAs of the anterior surface. This article introduces this concept to enhance our understanding of visual optics in eyes after penetrating and lamellar keratoplasties and how to apply this concept to surgery to improve and optimize patient visual outcomes.

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Visual function and higher-order aberrations in eyes after corneal transplantation

Yamaguchi Takefumi, Satake Yoshiyuki, Dogru Murat, Ohnuma Kazuhiko, Negishi Kazuno, Shimazaki Jun

Cornea 34 S128 - S135 2015年10月

ISSN 0277-3740

An understanding of corneal optics is important to optimize the visual outcome after eye surgery. Recent advances in the surgical techniques of lamellar keratoplasty have changed the strategies used for corneal transplantation. Lamellar keratoplasty has the advantage of having a lower rate of graft rejection, superior biomechanical properties, and reduced higher-order aberrations (HOAs) compared with penetrating keratoplasty; thus, the use of lamellar keratoplasty has increased over the last 15 years. However, some patients have poor postoperative visual acuity despite a clear cornea, and the reasons for the poor visual outcome are poorly understood. By combining corneal imaging technologies and the latest optical software, we proposed the concept of "parallelism of anterior and posterior surfaces in lamellar keratoplasty." In physiologically normal eyes, in which the anterior and posterior surfaces are parallel to each other, the posterior surface of the cornea compensates the HOAs of the anterior surface, and this is also true in eyes after penetrating keratoplasty. However, after lamellar keratoplasty, in which the anterior and posterior surfaces are independent and not parallel, irregularities in the posterior surface increase the HOAs of the anterior surface. This article introduces this concept to enhance our understanding of visual optics in eyes after penetrating and lamellar keratoplasties and how to apply this concept to surgery to improve and optimize patient visual outcomes.

Motor function benefits of visual restoration measured in age-related cataract and simulated patients: Case-control and clinical experimental studies

Ayaki M., Nagura T., Toyama Y., Negishi K., Tsubota K.

Scientific Reports （Scientific Reports） 5 14595 2015年09月

The aim of the present study was to measure gait velocity in cataract and simulated patients. The study was performed on 239 cataract patients, 115 age-matched subjects, and 11 simulated patients. We measured gait velocity and analyzed gait using a three-dimensional motion analysis system. Mean gait velocity before and 2 and 7 months after cataract surgery was 0.91 ± 0.19, 1.04 ± 0.21, and 1.06 ± 0.21 m/s, respectively, for males and 0.84 ± 0.22, 0.91 ± 0.24, and 0.92 ± 0.25 m/s, respectively, for females. The increase after surgery was significant in both groups at 7 months (P < 0.05). Gait velocity was significantly slower in cataract patients compared with controls before surgery, but no longer different after surgery. In simulated patients, mean velocity was 87.0 ± 11.4% of normal vision with a 3° visual field and 92.4 ± 12.3% of normal when counting fingers. Initial velocity was 89.1 ± 14.6% of normal vision with a 3° visual field and 92.7 ± 11.6% of normal when counting fingers. There was a significant difference between normal and impaired visual function (P < 0.05). The results demonstrate the close relationship between visual function and gait in cataract patients and simulated patients.

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Microincision hydrophobic acrylic aspheric toric intraocular lens for astigmatism and cataract correction

Bissen-Miyajima H., Negishi K., Hieda O., Kinoshita S.

Journal of Refractive Surgery （Journal of Refractive Surgery） 31 （ 6 ） 358 - 364 2015年06月

ISSN 1081-597X

Copyright © SLACK Incorporated. PURPOSE: To evaluate the efficacy and safety of a new acrylic one-piece toric intraocular lens (IOL). METHODS: This prospective multicenter clinical trial included 93 eyes of 61 patients that were implanted with a hydrophobic acrylic toric IOL from 2010 to 2012 and followed for 1 year. This IOL uses the platform of a microincision one-piece aspheric IOL, the NY-60 IOL (HOYA, Tokyo, Japan), with three increments in cylindrical power (NHT15, 1.5 diopters [D]; NHT23, 2.25 D; and NHT30, 3.0 D). The inclusion criterion was preoperative corneal astigmatism from 0.75 to 3.00 D. The primary endpoint was uncorrected distance visual acuity (UDVA) of 0.0 logMAR (20/20 Snellen) or better 6 months postoperatively. In addition to UDVA, corrected distance visual acuity (CDVA), residual astigmatism, stability of the IOL alignment, need of realignment, and the rate of Nd:YAG laser capsulotomy were evaluated up to 1 year postoperatively. Errors in astigmatic correction were assessed using Alpin's vector analysis. RESULTS: The primary endpoint was achieved in 54.8% of eyes. One year postoperatively, the logMAR UDVAs were 0.02 ± 0.13, 0.05 ± 0.17, and 0.09 ± 0.14 with models NHT15, NHT23, and NHT30, which corresponds to 0.96 (19/20 Snellen), 0.89 (18/20 Snellen), and 0.82 (16/20 Snellen), respectively. One year postoperatively, the residual astigmatism was 0.66 ± 0.58 D. In each evaluation, the mean absolute change in the position of the axis mark was between 1.93° and 2.32°. Three eyes required repositioning of the IOL axis and 2 eyes received Nd:YAG laser capsulotomy. The correction error showed an undercorrection with against-the-rule astigmatism and overcorrection with with-the-rule astigmatism. CONCLUSIONS: The new one-piece toric IOL provided desirable clinical outcomes and stability in eyes with corneal astigmatism.

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High prevalence of sleep and mood disorders in dry eye patients: Survey of 1,000 eye clinic visitors

Ayaki M., Kawashima M., Negishi K., Tsubota K.

Neuropsychiatric Disease and Treatment （Neuropsychiatric Disease and Treatment） 11 889 - 894 2015年05月

ISSN 1176-6328

© 2015 Ayaki et al. Purpose: We aimed to explore the prevalence of probable sleep and mood disorders in eye clinic visitors. Methods: This was a cross-sectional study. The participants were outpatients at six eye clinics from January through March, 2014. Outpatients were invited to complete a questionnaire containing the Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS). A final diagnosis was made, and patients were classified into six diagnostic groups. The main outcome measures were the scores of the PSQI and HADS among the diagnostic groups. Results: A total 1,000 outpatients participated, and 730 patients (mean age 59.5±19.0 years; 487 females) were analyzed after exclusion of children and patients diagnosed with healthy eyes, acute injury, or unilateral pseudophakia. The mean PSQI and HADS scores across all patients were 5.3±3.1 and 9.2±6.2, respectively. For the diagnostic groups, the mean PSQI and HADS scores, respectively, were 5.7±3.3 and 10.2±6.0 for dry eye (n=247), 5.4±3.2 and 9.2±5.7 for bilateral cataracts (n=159), 5.3±3.3 and 8.0±5.3 for bilateral pseudophakia (n=99), and, 5.0±3.1 and 9.8±6.6 for glaucoma (n=109). Overall, 37.3% of patients were poor sleepers (PSQI $6), and 45.5% had possible mood disorders (HADS $10). Stepwise regression analysis revealed that the PSQI and HADS scores were significantly correlated with both age (P,0.05) and the presence of dry eye (P,0.05). Conclusion: The prevalence of sleep and mood disorders was significantly higher in patients with dry eye. The present results suggest consultation-liaison psychiatry services may be beneficial among eye disease patients.

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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

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.

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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)

Reply:IOL power calculation after photorefractive surgery:modified Double-K method.

Saiki Megumi, Negishi Kazuno, Kato Naoko, Ogino Rika, Arai Hiroyuki, Toda Ikuko, Dogru Murat, Tsubota Kazuo

Journal of Cataract and Refractive Surgery 39 （ 9 ） 1451 2013年09月

ISSN 0886-3350

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Reply:Intraocular lens power calculation with the Scheimpflug camera after refractive surgery.

Saiki Megumi, Negishi Kazuno, Kato Naoko, Ogino Rika, Arai Hiroyuki, Toda Ikuko, Dogru Murat, Tsubota Kazuo

Journal of Cataract and Refractive Surgery 39 （ 8 ） 1280 - 1281 2013年08月

ISSN 0886-3350

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Deep stromal opacity after corneal cross-linking

Kato N., Konomi K., Saiki M., Negishi K., Takeuchi M., Shimazaki J., Tsubota K.

Cornea （Cornea） 32 （ 7 ） 895 - 898 2013年07月

ISSN 0277-3740

Purpose: To describe 3 cases with deep corneal stromal opacity that occurred several months after corneal cross-linking. Methods: A 36-year-old man, a 19-year-old man, and a 14-yearold girl underwent corneal cross-linking for their progressive keratoconus. Corneal cross-linking was performed according to the Dresden protocol. The corneal epithelium was ablated using an excimer laser in 2 cases and manually in 1 case. After 30 minutes of riboflavin presoaking, hypotonic riboflavin solution was applied until the corneal stroma swelled, after which the eyes were exposed to ultraviolet irradiation. Slit-lamp microscopy findings, uncorrected visual acuity, best-corrected visual acuity, manifest refraction, intraocular pressure, and corneal endothelial cell counts were evaluated, and corneal topography with Scheimpflug imaging was performed. Results: In all cases, the epithelium healed without delay. All eyes showed mild stromal infiltration a few days after the procedure; however, the inflammation was resolved within 1 week. The corneal stroma revealed no opacity up to 1 month after the procedure. A deep stromal opacity that extended to the inferior paracentral area developed after a few months and remained for 6 months to 1 year. Because the opacity was not on the visual axis, the visual acuity was not involved. Conclusions: Deep stromal opacity developed several months after uneventful corneal cross-linking. Postoperative inflammation may play a crucial role in its pathogenesis. © 2013 by Lippincott Williams & Wilkins.

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Aged Drivers May Experience Decreased Visual Function While Driving.

Kaido M, Matsutani T, Negishi K, Dogru M, Tsubota K

Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) 2 （ 3 ） 150 - 8 2013年05月

ISSN 2162-0989

PURPOSE: To investigate conventional visual acuity (VA) and changes therein over time in older drivers. DESIGN: A cross-sectional study. METHODS: One hundred twenty-four drivers (41 younger drivers aged 21-39 years, 40 middle-aged drivers aged 40-59 years, and 43 older drivers aged 60-77 years) who consented to undergo conventional and functional VA testing, perform the Trail Making Test B, and complete a questionnaire on visual performance while driving at an expressway rest stop in Ashigara, Japan, were studied. RESULTS: The overall proportion of the study subjects with a decimal bilateral VA less than 0.7, the Japanese threshold score for obtaining and renewing a driver's license, was 10%. The number of the subjects with decimal functional VA scores and minimum VA scores less than 0.7 was significantly higher in the older group than in the younger group (P < 0.05), although the conventional VA scores did not differ significantly between the older and younger groups (P = 0.621). The Trail Making Test B scores were significantly higher in the older group than in the younger and middle-aged groups (P < 0.05). The total score of the "visual performance during driving at night" category correlated significantly with the logMAR functional VA and logMAR minimum VA (P < 0.05) but not the logMAR VA. CONCLUSIONS: Older drivers might experience decreased functional VA and increased frequency of transient decreases in VA while driving. The functional VA test might capture visual impairment among older drivers that went undetected by the conventional VA test.

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Modified double-K method for intraocular lens power calculation after excimer laser corneal refractive surgery

Saiki M., Negishi K., Kato N., Ogino R., Arai H., Toda I., Dogru M., Tsubota K.

Journal of Cataract and Refractive Surgery （Journal of Cataract and Refractive Surgery） 39 （ 4 ） 556 - 562 2013年04月

ISSN 0886-3350

Purpose: To propose the new anterior-posterior method (A-P method) that does not require historical data to calculate intraocular lens (IOL) power after laser in situ keratomileusis (LASIK) and to compare the accuracy of the method with other IOL formulas after LASIK. Setting: Keio University Hospital, Tokyo, Japan. Design: Case series. Methods: Eyes having phacoemulsification and IOL implantation after myopic LASIK were analyzed retrospectively. The A-P method is a modification of the double-K method using the SRK/T formula in which the estimated pre-LASIK keratometry (K) power calculated from the post-LASIK posterior sagittal power in the 6.0 mm zone is used for the preoperative K value in the double-K method and the post-LASIK anterior sagittal power is used for the postoperative K value. The accuracy of the A-P method was compared with that of other formulas that do not require preoperative data and with formulas that require preoperative data. Results: The median values of the arithmetic and absolute prediction errors using the A-P method were 0.16 diopter (D) and 0.54 D, respectively. The prediction errors using the A-P method were within ±0.50 D in 46.4% of eyes and within ±1.00 D in 75.0%. The percentage of eyes within ±1.00 D of the prediction errors with the A-P method was highest with the no-history methods. Conclusion: The A-P method may be a good option for calculating IOL power in eyes having cataract surgery after LASIK when preoperative LASIK data are unavailable. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2013 ASCRS and ESCRS.

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

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

Acta Ophthalmologica （Acta Ophthalmologica） 91 （ 2 ） 133 - 139 2013年03月

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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Improvements in sleep quality and gait speed after cataract surgery

Ayaki M., Muramatsu M., Negishi K., Tsubota K.

Rejuvenation Research （Rejuvenation Research） 16 （ 1 ） 35 - 42 2013年02月

ISSN 1549-1684

Background: Gait speed and sleep quality are health indices related to longevity and mortality. In the present study, we measured sleep quality, quality of life, gait speed, and visual acuity before and after cataract surgery to evaluate the efficacy of the procedure on systemic health. Methods: The study was conducted on 155 patients (93 women; average age 74.8 years) undergoing cataract surgery with the implantation of a yellow soft acrylic lens. Patients were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the National Eye Institute Visual Function Questionnaire 25 (VFQ-25; vision-related quality of life) before and then 2 and 7 months after surgery. Four-meter gait speed was also determined. Results: Of the 155 patients, 68 (43.9%) were classified as poor sleepers (PSQI>5.5) prior to surgery. Significant improvements were noted in sleep 2 months after surgery (p<0.05, paired t-test), but thereafter the improvements were not significant. Prior to surgery, 117 patients (77.0%) were classified as slow walkers (speed<1.0 meter/s). Gait speed increased significantly in these patients 2 months after surgery (p<0.001, paired t-test). Multiple regression analysis revealed significant correlations between the preoperative VFQ-25 score and both PSQI (p<0.05) and gait speed (p<0.001). Postoperative increases in the VFQ-25 score were positively correlated with decreases in the PSQI (p<0.05). Improvements in visual acuity were correlated with improvements in the VFQ-25 score, but not with either PSQI or gait speed. Conclusion: Cataract surgery effectively improves sleep quality and slow gait speed. © 2013, Mary Ann Liebert, Inc.

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

Hidaka Y., Negishi K., Matsushima H., Torii H., Saiki M., Watanabe K., Inafuku S., Tsubota K.

Japanese Journal of Clinical Ophthalmology （Japanese Journal of Clinical Ophthalmology） 67 （ 2 ） 199 - 202 2013年02月

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.

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年02月

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)

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

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

Journal of Refractive Surgery （Journal of Refractive Surgery） 29 （ 1 ） 25 - 29 2013年01月

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 K., Negishi K., Kawai M., Torii H., Kaido M., Tsubota K.

Journal of Refractive Surgery （Journal of Refractive Surgery） 29 （ 1 ） 19 - 24 2013年01月

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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Parameter comparison of assessing visual fatigue induced by stereoscopic video services

Kawashima K., Okamoto J., Ishikawa K., Negishi K.

Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) （Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)） 8021 LNCS （ PART 1 ） 175 - 183 2013年

ISSN 9783642394041

A number of three-dimensional (3D) video services have already been rolled out over IPTV. In 3D video services, there are concerns that visual fatigue still exists, so evaluation of visual fatigue induced by video compression and delivery factors is necessary to guarantee the safety of 3D video services. To develop an assessment method of visual fatigue, we conducted evaluation experiments designed for 3D videos in which the quality of the left and right frames differ due to encoding. We explain the results from our evaluation experiments of visual fatigue, that is, results of specific parameters of visual fatigue biomedical assessment methods. © 2013 Springer-Verlag Berlin Heidelberg.

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評価者の視機能に基づいた3D映像主観評価結果の分析

川嶋喜美子、岡本淳、石川和夫、根岸一乃

電子情報通信学会ソサイエティ大会講演　論文集（ B-11-19 ） 2013年

他覚的疲労感評価法における実験日影響の除去

川嶋喜美子、岡本淳、石川和夫、根岸一乃

電子情報通信学会総合大会講演論文集（ B-11-16 ） 2013年

評価者の視機能に基づいた疲労感評価実験結果の分析

川嶋喜美子、岡本淳、石川和夫、根岸一乃

日本人間工学会誌（ 49 ） 328 - 339 2013年

瞬目率を用いた3D映像視聴時の疲労感評価検討

川嶋喜美子、岡本淳、石川和夫、根岸一乃

電子情報通信学会技術研究報告 113 （ 123 ） 49 - 54 2013年

他覚的疲労感評価法における実験日影響の除去

川嶋喜美子、岡本淳、石川和夫、根岸一乃

電子情報通信学会総会大会講演論文集 B-11 - 16 2013年

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を縫着した1例

山下和哉, 鳥居秀成, 根岸一乃, 渡辺一弘, 重野雄太, 佐伯めぐみ, 坪田一男

IOL & RS （(株)杏林舎内「IOL&RS」編集事務局） 26 （ 4 ） 448 - 452 2012年12月

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)

Kojima T., Wakamatsu T., Dogru M., Ogawa Y., Igarashi A., Ibrahim O., Inaba T., Shimizu T., Noda S., Obata H., Nakamura S., Wakamatsu A., Shirasawa T., Shimazaki J., Negishi K., Tsubota K.

American Journal of Pathology （American Journal of Pathology） 180 （ 5 ） 1879 - 1896 2012年05月

ISSN 0002-9440

An imbalance between free radical generation and radical scavenging antioxidant systems results in oxidative stress, which has been associated with cell injury observed in many age-related diseases. The superoxide dismutase (SOD) family is a major antioxidant system, and deficiency of Cu,Zn-superoxide dismutase-1 (Sod1) in mice leads to many different phenotypes that resemble accelerated aging. In this study we examined the morphologic features and the secretory functions of the lacrimal glands in Sod1 -/- mice. Lacrimal glands showed atrophy of acinar units; fibrosis; infiltration with CD4 + T cells, monocytes, and neutrophils; increased staining with both 4-hydroxy-2-nonenal and 8-hydroxy-2′-deoxyguanosine; increases in apoptotic cells; and the presence of the epithelial-mesenchymal transition in senescent Sod1 -/- mice. Electron microscopy findings revealed evidence of epithelial-mesenchymal transition, presence of swollen and degenerated mitochondria, and the presence of apoptotic cell death in the lacrimal glands of senescent Sod1 -/- mice. These alterations were also associated with the accumulation of secretory vesicles in acinar epithelial cells, decreased production of both stimulated and nonstimulated tears, and a decline in total protein secretion from the lacrimal glands. Our results suggest that Sod1 -/- mice may be a good model system in which to study the mechanism of reactive oxygen species-mediated lacrimal gland alterations. © 2012 American Society for Investigative Pathology.

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Corneal and retinal effects of ultraviolet-B exposure in a soft contact lens mouse model

Ibrahim O., Kojima T., Wakamatsu T., Dogru M., Matsumoto Y., Ogawa Y., Ogawa J., Negishi K., Shimazaki J., Sakamoto Y., Sasaki H., Tsubota K.

Investigative Ophthalmology and Visual Science （Investigative Ophthalmology and Visual Science） 53 （ 4 ） 2403 - 2413 2012年04月

ISSN 0146-0404

PURPOSE. To investigate the lipid and DNA oxidative stress as well as corneal and retinal effects after ultraviolet B (UV-B) exposure in mice, with or without silicon hydrogel soft contact lenses (SCL). METHODS. Twenty-eight C57BL6-strain male mice were divided into four groups: group I, control group with no SCL (SCL [-]) and no UV-B exposure (UV-B [-]); group II, senofilcon A SCL (senofilcon [+]) with UV-B exposure (UV-B [+]); group III, lotrafilcon A SCL (lotrafilcon [+]) with UV-B exposure (UV-B [+]); and group IV, no SCL (SCL [-]), but with UV-B exposure (UV-B [+]). All mice except group I received UV-B exposure for 5 days for a total dose of 2.73 J/cm 2. All mice underwent tear hexanoyl-lysine (HEL) and tear cytokine ELISA measurements, and fluorescein and rose bengal corneal staining before and after UV-B exposure. Corneal specimens underwent immunohistochemistry staining with CD45, HEL, 4-hydroxynonenal (4-HNE), and 8-hydroxy-20-deoxyguanosine (8-OHdG) antibodies and evaluation with electron microscopy. RESULTS. All mice without SCL but exposed to UV-B developed corneal edema, ulcers, or epithelial damage compared with mice with senofilcon A SCL and exposure to UV-B. Tear HEL and cytokine levels significantly increased in mice without SCL after UV-B exposure. Immunohistochemistry showed a significantly higher number of cells positively stained for CD45, 8-OHdG, HEL, and 4-HNE in the corneas of mice without SCLs compared with those with senofilcon A after UV-B exposure. CONCLUSION. Silicon hydrogel SCL showed corneal and retinal protective effects, owing to UV blocking properties, against oxidative stress-related membrane lipid and cellular DNA damage. © 2012 The Association for Research in Vision and Ophthalmology, Inc.

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Author Reply

Ide, T., Negishi, K., Yamaguchi, T., Hara, S., Toda, I. and Tsubota, K.

Asia Pac J Ophthalmol (Phila) 1 （ 2 ） 68 2012年03月

ISSN 2162-0989

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New Compact Accommodometer to Measure Accommodation Amplitude as a Biomarker.

Ide T, Negishi K, Yamaguchi T, Hara S, Toda I, Tsubota K

Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) 1 （ 1 ） 24 - 7 2012年01月

ISSN 2162-0989

PURPOSE: This study aimed to evaluate a newly designed compact accommodometer (CA) and compare this with a conventional accommodometer for measuring accommodation as a biomarker for aging and lifestyle. DESIGN: This is an observational case series. METHODS: Accommodative amplitude was measured using 2 different accommodometers in 114 patients. We obtained the data of the near-point accommodation amplitude. Subsequently, we used smoking habit as an example of lifestyle-related factor to evaluate its effect on the accommodative power. RESULTS: The first part of the study included 60 eyes of 60 men and 54 eyes of 54 women, with a mean (SD) age of 43.8 (12.9) years (range, 18-58 years). There was a consistency within each measuring method despite a significant difference between the 2 devices (P < 0.01). Measuring accommodation by CA was significantly faster than by conventional modality (190.9 +/- 58.1 seconds for CA and 371.8 +/- 123.6 seconds for D'ACOMO, P < 0.0001, paired t test). In the second part of the study, we found a significant correlation between age and accommodative amplitude both in smokers and in nonsmokers. The accommodative amplitude of the smoker group was significantly lower than that of the nonsmoker group (P < 0.001). CONCLUSIONS: Compact accommodometer may work as an alternative and convenient method in place of the conventional accommodometer for measuring accommodative amplitude as an aging biomarker. Lifestyle factors can affect the magnitude of accommodation, which can be measured by this newly developed CA.

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

Japanese Journal of Ophthalmology （Japanese Journal of Ophthalmology） 56 （ 1 ） 31 - 37 2012年01月

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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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 34 - 36 2012年

3D映像サービスに対する他覚的疲労感評価法の一検討

川嶋喜美子、岡本淳、石川和夫、根岸一乃

電子情報通信学会技術研究報告,112 13 - 18 2012年

3D映像サービスに対する他覚的疲労感評価法の一検討

川嶋喜美子、岡本淳、石川和夫、根岸一乃

電子情報通信学会技術研究報告 112 （ 218 ） 13 - 18 2012年

左右眼映像品質差のある3D映像による疲労感の主観評価検討

川嶋喜美子、岡本淳、石川和夫、根岸一乃

電子情報通信学会ソサイエティ大会講演　論文集 B-11 - 3 2012年

Correlation between contrast sensitivity and higher-order aberration based on pupil diameter after cataract surgery

Yamaguchi T., Negishi K., Ohnuma K., Tsubota K.

Clinical Ophthalmology （Clinical Ophthalmology） 5 （ 1 ） 1701 - 1707 2011年12月

ISSN 1177-5467

Background: The purpose of this study was to evaluate the correlation between contrast sensitivity and calculated higher-order aberrations based on individual natural pupil diameter after cataract surgery. Methods: This prospective study included 120 eyes from 92 patients who were randomized to receive one of four lenses, including three aspheric lenses (Acrysof SN60WF, Tecnis ZA9000, and Hoya Py60AD) and one spherical lens (Acrysof SN60AT). Contrast sensitivity, higher-order aberrations of the whole eye, and pupil diameter under photopic and mesopic conditions were measured 1 month postoperatively. Higher-order aberrations were decomposed into Zernike coefficients, calculated according to individual pupil diameter. The correlation between higher-order aberrations and contrast sensitivity was evaluated. Results: There were no significant differences in contrast sensitivity function between the four types of lenses under photopic conditions. However, the contrast sensitivity function and area under log contrast sensitivity function in the aspheric lenses were significantly better than in the spherical lens under mesopic conditions. Under mesopic conditions, spherical aberration in eyes with aspheric lenses was significantly lower than in eyes with spherical lenses (P,<0.05). Under photopic conditions, coma aberration had a significant negative correlation with contrast sensitivity at 12 cycles/degree. Under mesopic conditions, spherical aberration had a significant negative correlation with contrast sensitivity at 3, 6, and 12 cycles/degree with glare, and with contrast sensitivity at 6 and 18 cycles/degree without glare. Conclusion: In terms of influence on visual function, coma aberration may be more significant under photopic conditions and spherical aberration under mesopic conditions. © 2011 Yamaguchi et al, publisher and licensee Dove Medical Press Ltd.

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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年12月

ISSN 0161-6420

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多焦点眼内レンズ挿入眼の近方実用視力

手島ひとみ, 鳥居秀成, 佐伯めぐみ, 荻野理香, 根岸一乃, 村戸ドール, 坪田一男

IOL & RS （(株)杏林舎内「IOL&RS」編集事務局） 25 （ 4 ） 544 - 549 2011年12月

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)

Effect of controlled adverse chamber environment exposure on tear functions in silicon hydrogel and hydrogel soft contact lens wearers

Kojima T., Matsumoto Y., Ibrahim O., Wakamatsu T., Uchino M., Fukagawa K., Ogawa J., Dogru M., Negishi K., Tsubota K.

Investigative Ophthalmology and Visual Science （Investigative Ophthalmology and Visual Science） 52 （ 12 ） 8811 - 8817 2011年11月

ISSN 0146-0404

Purpose. To prospectively evaluate the effect of controlled adverse chamber environment (CACE) exposure on tear function, including tear osmolarity, in subjects wearing narafilcon A versus those wearing etafilcon A soft contact lens (SCL). Methods. Thirty-one healthy subjects with no history of contact lens wear (13 women, 18 men; average age, 30.5 ± 6.5 years) were randomly divided into age- and sex-matched groups (15 subjects wearing narafilcon A SCL; 16 subjects wearing etafilcon A SCL) and entered a CACE for 20 minutes. All subjects underwent tear osmolarity, tear evaporation rate, strip meniscometry, tear film breakup time, fluorescein vital staining, and functional visual acuity measurement before and after exposure to the controlled adverse chamber. Results. The mean blink rate increased with significant deteriorations in the mean symptom VAS scores, mean tear osmolarity, tear evaporation rate, strip meniscometry score, and tear stability with CACE exposure along with a decrease in visual maintenance ratio in functional visual acuity testing in etafilcon A wearers. The mean symptom VAS scores, mean tear evaporation rate, tear stability, blink rates, and visual maintenance ratios did not change significantly in narafilcon A wearers after CACE exposure. Conclusions. This study suggested marked tear instability, higher tear osmolarity, and increased tear evaporation with marked dry eye and visual symptomatology in nonadapted hydrogel SCL wearers, suggesting that silicone hydrogel SCLs may be suitable for persons who live and work in cool, low-humidity, and windy environments, as tested in this study. © 2011 The Association for Research in Vision and Ophthalmology, Inc.

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The application of in vivo confocal scanning laser microscopy in the diagnosis and evaluation of treatment responses in mooren's ulcer

Hatou S., Dogru M., brahim O., Wakamatsu T., Sato E., Shimmura S., Negishi K., Tsubota K.

Investigative Ophthalmology and Visual Science （Investigative Ophthalmology and Visual Science） 52 （ 9 ） 6680 - 6689 2011年08月

ISSN 0146-0404

Purpose. To evaluate the extent of corneal inflammation and the response to treatment in patients with Mooren's ulcer, by in vivo confocal microscopy (IVCM). Methods. Twenty-two eyes of 15 patients with Mooren's ulcer were enrolled in this prospective study. All subjects underwent routine ophthalmic examinations, IVCM, and conjunctival histopathologic examination of specimens in patients undergoing conjunctival excision. Eyes with active ulcer were treated with topical corticosteroids and additional therapy, depending on the signs and symptoms. Eyes in remission continued to receive the previous treatment protocols. The relation between the severity of ulcer and inflammation status as assessed by IVCM was also studied. The endpoints were inflammatory cell density (ICD), counted by IVCM, and the extent of the limbal arc involved with ulcers. Results. Ten eyes had active corneal ulcers, and 12 eyes had been in remission for the past year. The mean ICD of eyes with active ulcers before treatment was 2092.7 ± 1538.6 cells/mm2 (range, 835.3-7832.7; 95% CI, 3232.5-952.9). Nine of the eyes improved at 8 weeks, with a decrease in ICD to 249.1 ± 109.0 cells/mm2 (range, 100.3-595.3; 95% CI, 329.8-168.3). One eye had corneal perforation, and ICD immediately before perforation was 1677.6 ± 247.6 cells/mm2. The mean ICD of 12 eyes in remission was 357.5 ± 266.8 cells/mm2 (range, 12.7-1127.0; 95% CI, 555.2-159.8). The correlation of the ICD and the extent of limbal involvement with ulcers was strong (R2 = 0.8119). Conclusions. ICD evaluated by IVCM is a useful and promising parameter for evaluation of the degree of inflammation in eyes with Mooren's ulcer and for assessment of response to treatment. © Association for Research in Vision and Ophthalmology.

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The contribution of the posterior surface to the corneal aberrations in eyes after keratoplasty

Yamaguch T., Ohnuma K., Tomida D., Konomi K., Satake Y., Negishi K., Tsubota K., Shimazaki J.

Investigative Ophthalmology and Visual Science （Investigative Ophthalmology and Visual Science） 52 （ 9 ） 6222 - 6229 2011年08月

ISSN 0146-0404

Purpose. To investigate the contribution of posterior corneal surfaces to higher-order aberrations (HOAs) of the cornea, optical quality, and visual acuity after keratoplasty. METHODS. Corneal topography of anterior and posterior surfaces and pachymetry were conducted using anterior segment optical coherence tomography (AS-OCT) in 40 eyes (10 eyes after penetrating keratoplasty [PK], 10 eyes after deep anterior lamellar keratoplasty [DALK], 10 eyes after Descemet's stripping automated endothelial keratoplasty [DSAEK], and 10 normal eyes). Anterior, posterior, and total corneal HOAs were calculated using ray-tracing and decomposition into Zernike polynomials and were evaluated as root mean square values. Modulation transfer functions (MTFs) were also evaluated. RESULTS. Topography maps of the anterior and posterior surfaces showed reverse patterns in the normal, PK, and DALK eyes, but not in DSAEK eyes. In the normal, PK, and DALK eyes, the total corneal HOAs were significantly smaller (~10%) than were the HOAs of the anterior surface (P<0.01), whereas there was no significant difference between total and anterior HOAs in the DSAEK eyes (P=0.483). In the normal, PK, and DALK eyes, the MTFs of the total cornea were slightly better than those of the anterior surface. In the DSAEK eyes, the MTFs of the total cornea were lower than those of the anterior surface. Visual acuity was significantly correlated with total and anterior surface HOAs (P<0.05). CONCLUSIONS. Posterior surfaces compensate for anterior aberrations in normal, PK, and DALK eyes. In DSAEK eyes, the posterior surface increased total corneal HOAs and had a negative influence on MTFs. © 2011 The Association for Research in Vision and Ophthalmology, Inc.

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Repositioning and scleral fixation of subluxated lenses using a T-shaped capsule stabilization hook

Yaguchi S., Yaguchi S., Asano Y., Kozawa T., Miyawaki T., Negishi K., Tsubota K.

Journal of Cataract and Refractive Surgery （Journal of Cataract and Refractive Surgery） 37 （ 8 ） 1386 - 1393 2011年08月

ISSN 0886-3350

We describe a T-shaped capsule stabilization hook (modified capsule expander [M-CE]) used for repositioning and scleral fixation of the lens capsule of subluxated lenses. The 5-0 polypropylene device is flexible and attached to a curved needle. The contact portion is bent at 1.25 mm, and the end bifurcates in a T configuration to form a 3.75 mm footpad from which the capsular bag can be suspended. Modified capsule expanders were implanted in 4 eyes of 4 patients with subluxated cataractous lenses and provided excellent support and centration of the intraocular lens (IOL)-capsular bag complex. The IOLs remained well centered and stable. The corrected distance visual acuity improved to at least 20/20 in all patients after surgery. Thus, M-CEs were effective in fixating the lens capsule to the sclera in patients with significant zonular weakness. Financial Disclosure: Saori Yaguchi, Y. Asano, T. Kozawa, T. Miyawaki, K. Negishi, and K. Tsubota have no financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes. © 2011 ASCRS and ESCRS.

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Retinal image contrast obtained by a model eye with combined correction of chromatic and spherical aberrations

Ohnuma K., Kayanuma H., Lawu T., Negishi K., Yamaguchi T., Noda T.

Biomedical Optics Express （Biomedical Optics Express） 2 （ 6 ） 1443 - 1451 2011年06月

Correcting spherical and chromatic aberrations in vitro in human eyes provides substantial visual acuity and contrast sensitivity improvements. We found the same improvement in the retinal images using a model eye with/without correction of longitudinal chromatic aberrations (LCAs) and spherical aberrations (SAs). The model eye included an intraocular lens (IOL) and artificial cornea with human ocular LCAs and average human SAs. The optotypes were illuminated using a D65 light source, and the images were obtained using two-dimensional luminance colorimeter. The contrast improvement from the SA correction was higher than the LCA correction, indicating the benefit of an aspheric achromatic IOL. © 2011 Optical Society of America.

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Comparison of corneal thickness and haze in DSAEK and penetrating keratoplasty

Uchino Y., Shimmura S., Yamaguchi T., Kawakita T., Matsumoto Y., Negishi K., Tsubota K.

Cornea （Cornea） 30 （ 3 ） 287 - 290 2011年03月

ISSN 0277-3740

Purpose: To compare corneal thickness and haze in Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK). Methods: This study included 30 consecutive patients undergoing DSAEK (18 patients) and PK (12 patients). Central corneal thickness and corneal haze were analyzed longitudinally by Pentacam (Oculus, Wetzlar, Germany) at 2 weeks, 1 month, and 3 months after grafting. Results: The mean age of patients in the DSAEK group was 71.42 ± 9.91 years (range, 55-85 years) and in the PK group was 60.58 ± 16.58 years (range, 31-81 years). Two weeks, 1 month, and 3 months after surgery, the cornea was significantly thicker in the DSAEK group compared with the PK group (P < 0.01). Two weeks, 1 month, and 3 months after the operation, the cornea had significantly more haze in the DSAEK group compared with the PK group (P < 0.05). Haze in the DSAEK group was mainly observed in the subepithelial stroma. Conclusions: DSAEK grafts were significantly thicker with increased haze for up to 3 months after surgery. Scheimpflug system is available for quantifying not only corneal thickness but also corneal haze after various keratoplasty procedures. Copyright © 2011 by Lippincott Williams & Wilkins.

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Functional visual acuity after neodymium:YAG laser capsulotomy in patients with posterior capsule opacification and good visual acuity preoperatively

Wakamatsu T., Yamaguchi T., Negishi K., Kaido M., Matsumoto Y., Ishida R., Kojima T., Ibrahim O., Saiki M., Dogru M., Tsubota K.

Journal of Cataract and Refractive Surgery （Journal of Cataract and Refractive Surgery） 37 （ 2 ） 258 - 264 2011年02月

ISSN 0886-3350

Purpose: To evaluate the changes in functional visual acuity before and after neodymium:YAG (Nd:YAG) laser capsulotomy. Setting: Keio University Hospital, Tokyo, Japan. Design: Case series. Methods: Eyes that had previous cataract surgery with a clinical diagnosis of central posterior capsule opacity requiring Nd:YAG laser capsulotomy were evaluated. All patients had refractive error and corrected distance visual acuity (CDVA) measurements; slitlamp microscopy examinations, including posterior capsule opacification evaluation; high-contrast visual acuity measured at 5 m using a Landolt chart; 10% low-contrast visual acuity (LCVA); functional visual acuity; wavefront examination; and a Schirmer test without anesthesia. Results: The study enrolled 9 patients (4 women, 5 men; 10 eyes) with a mean age of 57.3 years ± 7.0 (SD) (range 47 to 68 years). Although there was no significant difference in CDVA before and after Nd:YAG capsulotomy, there was a significant improvement in the mean functional visual acuity, from 0.18 ± 0.11 logMAR (range -0.03 to 0.31 logMAR) to 0.08 ± 0.07 logMAR (range -0.04 to 0.18 logMAR) (P<.05). The LCVA improved significantly after Nd:YAG laser capsulotomy (P=.003). Higher-order aberrations and the root mean square of the 4th-order coefficients decreased significantly after capsulotomy, and these aberrations were significantly correlated with functional visual acuity and LCVA. Conclusion: Results indicate that measurement of functional visual acuity is useful in assessing the quality of vision in patients who have Nd:YAG laser capsulotomy after cataract surgery. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2011 ASCRS and ESCRS.

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Functional visual acuity measurement in cataract and intraocular lens implantation

Yamaguchi T., Negishi K., Tsubota K.

Current Opinion in Ophthalmology （Current Opinion in Ophthalmology） 22 （ 1 ） 31 - 36 2011年01月

ISSN 1040-8738

Purpose of review: Recently, functional visual acuity (FVA) measurement has been reported to be an important method of determining 'masked impairment of visual function' and assessing visual acuity in detail. This review discusses a new continuous FVA measurement system for the assessment of visual performance and introduces the application of FVA measurement in cataract and intraocular lens implantation. Recent findings: The FVA was first developed to detect impaired visual function for daily activities in dry eye syndrome. The usefulness of this new methodology has been described in patients with tear instability, undergoing laser-assisted in-situ keratomileusis surgery, with Stevens-Johnson syndrome, Sjögren syndrome and mild cataract opacities. The microstructure of the lenticular opacities is highly variable (nucleus sclerosis and/or posterior capsular cataract and/or cortical opacity) causing a combination of different effects on the incident light rays that can be refracted, reflected, absorbed or scattered. In some cases, patients have a good visual acuity but may complain of disturbances in vision quality. We reported the improvement of FVA after cataract surgery in patients with mild cataracts and visual symptomatology despite a good preoperative and postoperative conventional visual acuity. To detect visual impairment due to cataract, measurement of FVA was useful in the evaluation of vision quality and changes in kinetic vision after phacoemulsification surgery. Summary: FVA measurement is an effective and noninvasive test that reflects the complaints of blurring/glare and postoperative satisfaction in patients with mild cataract. © 2010 Wolters Kluwer Health.

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Comparison of anterior and posterior corneal surface irregularity in descemet stripping automated endothelial keratoplasty and penetrating keratoplasty

Yamaguchi T., Negishi K., Yamaguchi K., Dogru M., Uchino Y., Shimmura S., Tsubota K.

Cornea （Cornea） 29 （ 10 ） 1086 - 1090 2010年10月

ISSN 0277-3740

Purpose: To evaluate the irregularity of the anterior and posterior cornea after Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK). Methods: This clinical study comprised 39 eyes: 13 consecutive eyes after DSAEK, 13 consecutive eyes after PK, and 13 age-matched normal eyes. Corneal elevation data were acquired using a rotating Scheimpflug camera 1 and 3 months after DSAEK and PK. Anterior and posterior corneal elevation data were decomposed into a set of Zernike polynomials up to eighth order. Total higher-order root mean square (RMS) and RMS from third to eighth order were calculated. The astigmatism and irregularity of the anterior and posterior surfaces were compared between DSAEK and PK. Results: The regular astigmatism and tilt components of the anterior surface were significantly lower after DSAEK than after PK at 1 and 3 months (P < 0.001), whereas there was no difference in astigmatism of the posterior surface between the groups (P = 0.07, 0.22). The higher-order RMS and RMSs of third- to eighth-order components of the anterior surface were significantly larger after PK than those after DSAEK at 1 and 3 months (P < 0.01), whereas there were no significant differences between DSAEK and PK in higher-order aberration RMS and RMSs of third- to eighth-order components of the posterior surface. Conclusions: Postoperative corneal irregularity of the anterior surface was greater after PK than after DSAEK, whereas there was no significant difference in posterior surface irregularity. DSAEK is superior to PK in terms of the higher-order irregularity of the anterior surface. Copyright © 2010 by Lippincott Williams & Wilkins.

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多焦点眼内レンズ両眼挿入例の遠方・中間・近方両眼視力

清水努, 根岸一乃, 鳥居秀成, 奥山宏美, 佐伯めぐみ, 山口剛史, 村戸ドール, 坪田一男

IOL & RS （(株)杏林舎内「IOL&RS」編集事務局） 24 （ 3 ） 437 - 441 2010年09月

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)

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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Improvement of functional visual acuity after cataract surgery in patients with good pre- and postoperative spectacle-corrected visual acuity

Yamaguchi Takefumi, Negishi Kazuno, Dogru Murat, Saiki Megumi, Tsubota Kazuo

Journal of Refractive Surgery 25 （ 5 ） 410 - 415 2009年05月

ISSN 1081-597X

PURPOSE: To report the changes in functional visual acuity in cataract surgery patients with good pre- and postoperative visual acuity. METHODS: Functional visual acuity was evaluated in 13 eyes of 10 patients before and 1 month after phacoemulsification with implantation of acrylic intraocular lenses. Pre- and postoperative best spectacle-corrected visual acuities (BSCVA) were better than 20/25 in all patients. Low contrast visual acuity and Schirmer tests were also performed before and after surgery. RESULTS: Mean pre- and postoperative logMAR BSCVA were -0.02±0.06 and -0.05±0.04, respectively (P>.05). Mean preoperative logMAR functional visual acuity improved from 0.29±0.17 to 0.092±0.13 post-operatively (P<.05). The visual maintenance ratio in functional visual acuity and low contrast visual acuity also improved significantly after cataract surgery (P<.05). CONCLUSIONS: Measurement of functional visual acuity seems to be useful in the evaluation of timing of surgery, visual quality, and changes in kinetic vision after phacoemulsification surgery.

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Effect of anterior and posterior corneal surface irregularity on vision after Descemet-stripping endothelial keratoplasty

Yamaguchi Takefumi, Negishi Kazuno, Yamaguchi Kazuko, Murat Dogru, Uchino Yuichi, Shimmura Shigeto, Tsubota Kazuo

Journal of Cataract and Refractive Surgery 35 （ 4 ） 688 - 694 2009年04月

ISSN 0886-3350

Purpose: To evaluate irregularity of the anterior and posterior cornea before and after Descemet-stripping endothelial keratoplasty (DSEK) and its effect on visual acuity. Setting: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. Methods: Corneal data were acquired using a rotating Scheimpflug camera before and 1 month and 3 months after DSEK. Anterior and posterior corneal elevation data were decomposed into a set of Zernike polynomials up to the 8th order within a 4.0 mm diameter region. Total higher-order root mean square (HO-RMS) and RMS from the 3rd to 8th order were calculated. The effects of anterior and posterior surface irregularity on visual acuity were evaluated. Results: This clinical study comprised 13 consecutive eyes of 12 bullous keratopathy patients. The mean best corrected visual acuity (BCVA) was 1.11 logMAR ± 0.5 (SD) preoperatively, 0.49 ± 0.49 logMAR 1 month postoperatively, and 0.27 ± 0.32 logMAR at 3 months. The HO-RMS of the anterior surface 1 month (P = .040) and 3 months (P = .048) postoperatively was significantly lower than preoperatively. There were no significant differences in posterior surface HO-RMS between preoperatively and 1 month (P = .45) and 3 months (P = .054). The postoperative BCVA was significantly correlated with HO-RMS (P<.001), but not with posterior surface HO-RMS, at 3 months (P = .354). Conclusion: Postoperative BCVA correlated with irregularity of the anterior surface but not the posterior surface. In addition to corneal transparency, regularity of the anterior surface is an important factor in visual acuity after DSEK. © 2009 ASCRS and ESCRS.

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Factors affecting contrast sensitivity with the Artisan phakic intraocular lens for high myopia

Yamaguchi, T., Negishi, K., Kato, N., Arai, H., Toda, I. and Tsubota, K.

J Refract Surg 25 （ 1 ） 25 - 32 2009年01月

ISSN 1081-597X

PURPOSE: To evaluate the factors affecting postoperative visual function in eyes with Artisan phakic intraocular lenses (PIOLs). METHODS: This study examined a retrospective noncomparative case series. Phakic IOLs were implanted in 60 eyes of 36 patients with high myopia. Contrast sensitivity for spatial frequencies of 1.1, 1.7, 2.6, 4.2, 6.6, and 10:4 cycles per degree with and without glare and wavefront aberrations were measured before and 3 months after surgery. The area under the log contrast sensitivity function (AULCSF) was calculated from the contrast sensitivity. Stepwise regression analysis was used to assess the factors that affected the postoperative AULCSF. RESULTS: No significant difference was noted between the preoperative AULCSF without glare and the postoperative AULCSF without glare (P=.886). The mean AULCSF with glare improved significantly after surgery (P=.018). The variables affecting the postoperative AULCSF without glare were axial length (partial regression coefficient B=-0.101, P=.0002) and age (B=-0.008, P=.0063). The variables affecting the postoperative AULCSF with glare were axial length (B=-0.127, P<.0001) and age (B=-0.012, P=.0294). The preoperative refraction showed multicollinearity with the axial length, and coma-like aberration and spherical aberration showed multicollinearity with age. CONCLUSIONS: Contrast sensitivity without glare was the same before and after surgery and contrast sensitivity with glare improved after surgery. Longer axial length and older age predispose patients to degradation of the postoperative visual function in eyes with Artisan PIOLs.

Effect of spherical aberration on visual function under photopic and mesopic conditions after cataract surgery

Yamaguchi Takefumi, Dogru Murat, Yamaguchi Kazuko, Ono Takeshi, Saiki Megumi, Okuyama Hiromi, Tsubota Kazuo, Negishi Kazuno

Journal of Cataract and Refractive Surgery 35 （ 1 ） 57 - 63 2009年01月

ISSN 0886-3350

Purpose: To evaluate the effect of spherical aberration on visual function under natural pupil conditions after cataract surgery. Setting: Keio University Hospital, Tokyo, Japan. Methods: This study comprised cataract patients who had cataract extraction with implantation of an acrylic intraocular lens. Preoperative and postoperative visual acuity, higher-order aberration in the whole eye, contrast sensitivity function, and pupil diameter under photopic and mesopic conditions 1 month after surgery were measured. The area under log contrast sensitivity function (AULCSF) and spherical aberration corresponding to the individual pupil diameter under photopic and mesopic conditions were evaluated. Results: One hundred seven eyes of 79 patients (30 men, 49 women; mean age 68.0 years ± 9.6 [SD]) were evaluated. The mean pupil diameter was 2.9 ± 0.50 mm under photopic conditions and 3.6 ± 0.57 mm under mesopic conditions. The mean spherical aberration was 0.03 ± 0.04 μm (range -0.12 to 0.34 μm) under photopic conditions and 0.05 ± 0.10 μm (range -0.14 to 0.55 μm) under mesopic conditions. The postoperative AULCSF without glare under photopic conditions was significantly negatively correlated with spherical aberration (P = .014). The postoperative AULCSF with and without glare under mesopic conditions was significantly negatively correlated with spherical aberration (P<.001 and P = .01, respectively). Conclusions: Postoperative spherical aberration had a significant effect on visual function under photopic and mesopic conditions. This result indicates that reduced postoperative spherical aberration improves postoperative visual function under photopic and mesopic conditions. © 2009 ASCRS and ESCRS.

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Factors affecting contrast sensitivity with the artisan phakic intraocular lens for high myopia

Yamaguchi Takefumi, Negishi Kazuno, Kato Naoko, Arai Hiroyuki, Toda Ikuko, Tsubota Kazuo

Journal of Refractive Surgery 25 （ 1 ） 25 - 32 2009年01月

ISSN 1081-597X

PURPOSE: To evaluate the factors affecting postoperative visual function in eyes with Artisan phakic intraocular lenses (PIOLs). METHODS: This study examined a retrospective non-comparative case series. Phakic IOLs were implanted in 60 eyes of 36 patients with high myopia. Contrast sensitivity for spatial frequencies of 1.1, 1.7, 2.6, 4.2, 6.6, and 10.4 cycles per degree with and without glare and wavefront aberrations were measured before and 3 months after surgery. The area under the log contrast sensitivity function (AULCSF) was calculated from the contrast sensitivity. Stepwise regression analysis was used to assess the factors that affected the postoperative AULCSF. RESULTS: No significant difference was noted between the preoperative AULCSF without glare and the postoperative AULCSF without glare (P=.886). The mean AULCSF with glare improved significantly after surgery (P=.018). The variables affecting the postoperative AULCSF without glare were axial length (partial regression coefficient B = -0.101, P=.0002) and age (B = -0.008, P=.0063). The variables affecting the postoperative AULCSF with glare were axial length (B=-0.127, P<.0001) and age (B = -0.012, P=.0294). The preoperative refraction showed multi- collinearity with the axial length, and coma-like aberration and spherical aberration showed multicollinearity with age. CONCLUSIONS: Contrast sensitivity without glare was the same before and after surgery and contrast sensitivity with glare improved after surgery. Longer axial length and older age predispose patients to degradation of the postoperative visual function in eyes with Artisan PIOLs. [J Refract Surg. 2009;25:25-32.].

Point spread function analysis in a child with ectopia lentis

Goto Mari, Tachikawa Takako, Negishi Kazuno, Ohnuma Kazuhiko, Shibutani Masahiro, Kobayashi Katsuhiko, Takeuchi Gaku, Ohno Kenji, Matsubara Masao, Noda Toru

Acta Ophthalmologica 87 （ 5 ） 567 - 569 2009年

ISSN 1755-375X

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Alterations in the anterior chamber angle after implantation of iris-fixated phakic intraocular lenses

Yamaguchi Takefumi, Negishi Kazuno, Yuki Kenya, Saiki Megumi, Nishimura Ryo, Kawaguchi Nanae, Tsubota Kazuo

Journal of Cataract and Refractive Surgery 34 （ 8 ） 1300 - 1305 2008年08月

ISSN 0886-3350

Purpose: To evaluate anterior chamber angle alterations after phakic intraocular lens (pIOL) implantation using the Pentacam rotating Scheimpflug camera (Oculus) and the effect on intraocular pressure (IOP) and anterior chamber inflammation. Setting: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. Methods: Twenty eyes of 11 patients with high myopia who had implantation of pIOLs (Artisan/Verisyse, model 204, Ophtec BV) were included. All pIOLs were fixated on the iris near the 3 o'clock and 9 o'clock positions. Angles at the 2, 3, 4, 8, 9, and 10 o'clock positions, IOP, and postoperative flare were evaluated retrospectively. Results: The mean angle degree at 2, 3, 4, 8, 9, and 10 o'clock was 40.3 degrees ± 3.3 (SD) preoperatively and 36.5 ± 5.8 degrees postoperatively; the postoperative angles were significantly narrower than the preoperative angles (P<.001). The mean angles at 3 o'clock and 9 o'clock were 39.8 ± 3.7 degrees and 40.6 ± 3.5 degrees, respectively, preoperatively and 32.7 ± 6.0 degrees and 31.3 ± 5.4 degrees, respectively, postoperatively. The postoperative angles at 3 o'clock and 9 o'clock were narrower than the preoperative angles (P<.001). There was no significant difference between preoperative IOP and postoperative IOP (P = .22). The flare at 1 month (r = 0.573, P = .0071) and 1 year (r = 0.700, P = .004) was significantly correlated with the angle change. Conclusion: Partial localized narrowing of anterior chamber angles that occurred after pIOL implantation induced acute and chronic anterior chamber inflammation in patients with large angle alterations. © 2008 ASCRS and ESCRS.

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Diagnosis of steroid-induced glaucoma after photorefractive keratectomy

Yamaguchi Takefumi, Murat Dogru, Kimura Itaru, Negishi Kazuno, Yuki Kenya, Tsubota Kazuo, Ohtake Yuichiro

Journal of Refractive Surgery 24 （ 4 ） 413 - 415 2008年04月

ISSN 1081-597X

PURPOSE: To report steroid-induced glaucoma after photorefractive keratectomy (PRK). METHODS: A 50-year-old Japanese woman was referred for end-stage glaucoma 9 months after PRK. Topical fluorometholone 0.1% was administered for corneal subepithelial haze in both eyes for 9 months after PRK. Pneumatic non-contact tonometry values of intraocular pressure (IOP) remained normal (range: 11 to 17 mmHg), until she was diagnosed with end-stage steroid-induced glaucoma with extensive restriction in visual fields. At the patient's initial examination in our hospital, IOP measured by Goldmann applanation tonometry was 34 mmHg in the right eye and 32 mmHg in the left eye, but the estimated IOP as corrected by central corneal thickness measurement was >40 mmHg in both eyes. RESULTS: The patient underwent uneventful bilateral trabeculectomies, resulting in reduction of IOP to <10 mmHg in both eyes. CONCLUSIONS: The underestimation of IOP after PRK led to advanced visual field loss. Careful evaluation of IOP, optic disc, and visual field tests are indispensable to avoid such a devastating outcome after PRK.

Author reply

Nishimura Ryo, Negishi Kazuno, Saiki Megumi, Tsubota Kazuo

Ophthalmology 115 （ 3 ） 588 2008年03月

ISSN 0161-6420

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Author reply

Nishimura Ryo, Negishi Kazuno, Saiki Megumi, Tsubota Kazuo

Ophthalmology 115 （ 3 ） 589 2008年03月

ISSN 0161-6420

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両眼同時自覚他覚検眼装置の屈折弱視、不同視弱視眼への検討

太刀川貴子、後藤郁子、松原正男、根岸一乃、大野建治、野田徹、林健史、西尾幸治、福間康文

視覚の科学（日本眼光学学会誌） 29 26 - 31 2008年

研究論文（学術雑誌）, 共著

Effect of Higher-Order Aberrations on Visual Function in Keratoconic Eyes with a Rigid Gas Permeable Contact Lens

Negishi Kazuno, Kumanomido Takashi, Utsumi Yoshikazu, Tsubota Kazuo

American Journal of Ophthalmology 144 （ 6 ） 2007年12月

ISSN 0002-9394

Purpose: To study the effect of higher-order aberrations (HOAs) on visual function in keratoconus with a rigid gas permeable (RGP) contact lens (CLs). Design: Retrospective nonrandomized study. Methods: Thirteen eyes of 10 subjects with keratoconus who wore a RGP CLs (KC-RGP group), 15 eyes of nine normal subjects (normal group), and 14 eyes of nine subjects who wore a RGP CLs (RGP group) who had no ocular diseases except for refractive errors and had 20/20 or better-corrected visual acuity were included in this study. The root-mean-square (RMS) of the third-, fourth-, fifth-, and sixth-order Zernike coefficients (total HOAs), the RMS of the third-order Zernike coefficients (S3) (coma-like aberration), the RMS of the fourth-order coefficients (S4) (spherical-like aberrations), and the area under the log contrast sensitivity function (AULCSF) were evaluated. Results: The AULCSF in the KC-RGP group was significantly lower than in the other two groups. The total HOAs, S3, and S4 in the KC-RGP group were significantly higher than in the other two groups. There were significant negative correlations between the area under the log contrast sensitivity function and the total HOAs, S3, and S4. Conclusions: The visual performance in a keratoconic eye with a RGP CLs degrades compared with normal eyes with and without RGP CLs, even if the corrected VA is good. The degradation is assumed to be related to residual HOAs in a keratoconic eye with a RGP CLs. © 2007 Elsevier Inc. All rights reserved.

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No Forward Shifting of Posterior Corneal Surface in Eyes Undergoing LASIK

Nishimura Ryo, Negishi Kazuno, Saiki Megumi, Arai Hiroyuki, Shimizu Satomi, Toda Ikuko, Tsubota Kazuo

Ophthalmology 114 （ 6 ） 1104 - 1110 2007年06月

ISSN 0161-6420

Purpose: To evaluate structural changes in the cornea and anterior chamber (AC) after LASIK for myopia. Design: Retrospective nonrandomized study. Participants: One hundred sixty-one eyes of 83 patients (mean age, 34.5±8.3 years) who underwent uneventful LASIK for myopia and myopic astigmatism. The preoperative refractive error (spherical equivalent) and corneal thickness were -6.02±2.10 diopters (D) and 549.9±29.3 μm, respectively. Methods: The AC volume (ACV), AC depth (ACD), corneal thickness, central corneal true net power, and posterior corneal tangential curvature were measured using a rotating Scheimpflug camera before and 1 week and 1 month after surgery. In 84 eyes of 42 cases, anterior and posterior corneal elevations and corneal thicknesses also were measured by scanning-slit topography before and 1 month after surgery. Main Outcome Measures: Time course of the ACV, ACD (central, midperiphery, periphery), corneal thickness, central corneal true net power, posterior corneal tangential curvature using the Scheimpflug camera, and amount of forward shifting of the posterior corneal surface at the center of the difference map using scanning-slit topography. Results: Preoperative and 1-month postoperative mean ACVs were 198.1 mm³ and 196.4 mm³, respectively, and preoperative and postoperative mean ACDs (center, midperiphery, periphery) were 3.24, 2.65, and 1.89 mm, and 3.21, 2.63, and 1.87 mm, respectively. The corneal thickness within the optical zone, subjective refraction, and central corneal true net power significantly changed by tissue subtraction after LASIK (P<0.0001). There were no significant differences in the ACV, ACDs (center, midperiphery, periphery), peripheral corneal thickness, and posterior corneal tangential curvature from preoperatively to 1 month after LASIK. However, using scanning-slit topography, the posterior corneal surface displayed a mean forward shift of 29.0±19.0 μm 1 month after surgery. Conclusion: The posterior corneal curvature, peripheral corneal thickness, ACDs, and ACV were consistent. These observations indicated that neither forward shifting of the central posterior corneal surface (bulging) nor backward shifting of the peripheral posterior corneal surface due to corneal swelling after ablation occurred after LASIK. © 2007 American Academy of Ophthalmology.

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Indication and limits of monovision

Negishi Kazuno

Nippon Ganka Gakkai zasshi 111 （ 6 ） 431 - 433 2007年06月

ISSN 0029-0203

Intraoperative dehiscence of laser subepithelial keratomileusis (LASEK) flap during retinal detachment surgery [1]

Kawamura Ryosuke, Noda Kousuke, Negishi Kazuno, Shinoda Kei, Ishida Susumu, Inoue Makoto, Tsubota Kazuo

Acta Ophthalmologica Scandinavica 85 （ 4 ） 459 2007年06月

ISSN 1395-3907

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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 61 （ 9 ） 1635 - 1639 2007年

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.

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（医学書院） 61 1635 - 1639 2007年

研究論文（学術雑誌）, 共著

Evaluation of optical function using a new point spread function analysis system in cataractous and pseudophakic eyes

Negishi Kazuno, Kobayashi Katsuhiko, Ohnuma Kazuhiko, Ohno Kenji, Noda Toru

Japanese Journal of Ophthalmology 50 （ 1 ） 12 - 19 2006年01月

ISSN 0021-5155

Purpose: To evaluate optical function in cataractous and pseudophakic eyes using the new point spread function (PSF) analysis system in a clinical setting. Methods: We applied this new analysis system in the study of two cataractous eyes and one pseudophakic eye of two patients. Using a PSF analyzer, double-pass PSF was measured directly for each subject, and the single-pass modulation transfer function (MTF) and single-pass PSF were calculated. The simulated retinal images of various sizes of Landolt's rings and their contrast characteristics were also calculated by the PSF analyzer. Results: The MTF and the contrast of the simulated retinal images degraded in cataractous eyes were compared with data for normal eyes; the degradation pattern depended on the opacification pattern. The MTF and the contrast of the simulated retinal images in the pseudophakic eye improved significantly compared with the cataractous eyes, although both values were lower in the pseudophakic eye than in young normal eyes. Conclusions: Our data showed degradation of optical function in cataractous and pseudophakic eyes in comparison with optical function in young normal eyes. If further accumulations of PSF data are made, it may be possible to establish an objective standard by which to measure the progression of cataract, as well as an objective indication for treatment in the future. © Japanese Ophthalmological Society 2006.

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眼科手術後の屈折異常に対するエキシマレーザー屈折矯正手術の後の術後成績

河口奈々恵、根岸一乃、佐伯めぐみ、清水美里、黒坂大次郎、真島行彦、坪田一男

IOL&RS （日本白内障屈折矯正手術学会学会誌） 20 151 - 157 2006年

研究論文（学術雑誌）, 共著

眼球光学系の波長ごとの波面収差測定

大沼一彦、小笠原典行、池田卓、山口剛史、根岸一乃、大野建治、藤池圭子、野田徹

視覚の科学（日本眼光学学会誌） 27 59 - 64 2006年

研究論文（学術雑誌）, 共著

Visual simulation of retinal images through a decentered monofocal and a refractive multifocal intraocular lens

Negishi Kazuno, Ohnuma Kazuhiko, Ikeda Takashi, Noda Toru

Japanese Journal of Ophthalmology 49 （ 4 ） 281 - 286 2005年07月

ISSN 0021-5155

Purpose: To evaluate the effect of decentration of a monofocal intraocular lens (IOL) and a refractive multifocal IOL on retinal image quality using a new visual simulation system. Methods: Using a new visual simulation system, we performed visual simulation of a monofocal and a multifocal IOL at 5, 4, 3, 2, 1, and 0.4 m with several decentered IOL positions from 0 to 1.0 mm through a 3- or 4-mm aperture using Landolt visual acuity (VA) charts. The VA was estimated under each condition from the simulated retinal image. Results: With a monofocal IOL, the image was affected minimally by decentration at 4 and 5 m; at 2 and 3 m, the image contrast decreased slightly with increased decentration. With the multifocal IOL, some loss of image contrast developed at all distances compared with the monofocal IOL; however, the images of the Landolt's rings were still recognizable under all conditions. Conclusions: Our results suggest that up to 1.0 mm of decentration of a monofocal and multifocal IOL would not greatly affect the retinal image quality. © Japanese Ophthalmological Society 2005.

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Laser In Situ Keratomileusis追加矯正症例の検討

内野裕一、根岸一乃、山崎重典、清水美里、黒坂大次郎、真島行彦

眼科手術（メディカル葵出版） 18 421 - 424 2005年

研究論文（学術雑誌）, 共著

後発白内障切開後に水晶体細胞が後嚢切開辺縁より眼内レンズ後面上へ進展した2症例

西村僚,　黒坂大次郎,　山崎重典,　吉野真未,　中村邦彦,　加藤克彦,　根岸一乃,　真島行彦

眼科（金原出版） 47 1125 - 1129 2005年

Early results of laser in situ keratomileusis (LASIK) using a new ablation program, Optimized Aspherical Transition Zone (OATZ)

Shigeyasu Chika, Yamazaki Shigenori, Shimizu Satomi, Negishi Kazuno, Kurosaka Daijiro, Mashima Yukihiko

Folia Ophthalmologica Japonica 55 （ 10 ） 777 - 782 2004年10月

ISSN 0015-5667

Purpose: To evaluate the early results of laser in situ keratomileusis (LASIK) using a new ablation program, Optimized Aspherical Transition Zone (OATZ). Methods: The results at 3 months after surgery in 16 eyes of 8 patients who underwent LASIK using the OATZ program (OATZ group) for myopia or myopic astigmatism were compared with those in 40 eyes of 22 patients who underwent LASIK using the conventional program (Conventional group). Results: There was no significant difference in postoperative uncorrected visual acuity, best-corrected visual acuity, or refraction (spherical equivalent) between the 2 groups. Contrast sensitivity and contrast visual acuity were also comparable between the groups. The safety index and the efficacy index were 0.94 and 0.71 in the OATZ group and 1.00 and 0.85 in the Conventional group, respectively. The proportion of eyes with postoperative coma-like, spherical, and higher-order aberrations in the OATZ group was significantly smaller than the proportion in the Conventional group. Conclusions: In this study, the early results of LASIK using the OATZ program were good. Further investigations into the usefulness of the OATZ program should be conducted using various settings for optical zone, transitional zone, and profile number.

Accuracy of intraocular lens power calculation after phototherapeutic keratectomy using different methods of determining corneal refractive power

Kaneda Eiko, Negishi Kazuno, Yamazaki Shigenori, Shimizu Satomi, Kurosaka Daijiro, Yamada Masakazu, Mashima Yukihiko

Folia Ophthalmologica Japonica 55 （ 9 ） 706 - 710 2004年09月

ISSN 0015-5667

Purpose: To evaluate the predictability of intraocular lens (IOL) power calculation after phototherapeutic keratectomy (PTK). Methods: In this study, 12 eyes of 8 patients who underwent cataract surgery after PTK (PTK group), and 63 eyes of 55 patients who underwent only cataract surgery (control group) were compared. The main outcome measure was the difference between the target and actual refraction achieved 1 month after cataract surgery. IOL power was determined using 4 measurements for the PTK group: standard keratometric power, total optical power and total axial power (central 3mm) analyzed using a slit-scan corneal topographic analysis system, and pre-PTK measurements of keratometric power. Results: Measurements of corneal power by the 4 different methods in the PTK group did not differ significantly, nor did errors in postoperative refractive power differ for the different methods. The refractive errors after cataract surgery were within ±1.0 D of the targeted value in about 50% of the PTK groups using any measurement method, and all of the predicted values were lower than values in the control group. There was no significant difference in predictability of achieving the target refraction as a function of the 4 different keratometric values used to calculate IOL power. Conclusions: The predictability of IOL power needed to achieve postoperative refraction within a target range is lower for eyes undergoing both PTK and cataract surgery than for eyes undergoing cataract surgery alone, which suggests that informed consent to cataract surgery with IOL implantation should include the information that the range of possible refractive error after cataract surgery is greater in eyes that have undergone PTK.

開放型手持ち電子瞳孔計による明室および準暗室の瞳孔径測定

小坂晃一、根岸一乃、大沼一彦、小口芳久

あたらしい眼科 21 （ 9 ） 1281-1284 2004年09月

研究論文（学術雑誌）, 共著

Time course of lens capsule staining using trypan blue and indocyanine green

Satofuka Shingo, Nakamura Kunihiko, Negishi Kazuno, Kato Katsuhiko, Kurosaka Daijiro, Yoshino Mami

Journal of Cataract and Refractive Surgery 30 （ 8 ） 1751 - 1754 2004年08月

ISSN 0886-3350

Purpose: To determine whether staining of the lens capsule with trypan blue 0.1% and indocyanine green (ICG) 0.5% diminishes with time and whether it differs between the anterior and posterior capsules. Setting: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. Methods: Crystalline lenses removed from porcine eyes were stained for 10 seconds with 0.1 mL of trypan blue 0.1% or indocyanine green 0.5%. They were then placed in distilled water and observed for the persistence of staining over time. In a second experiment, the anterior chamber and internal aspects of the anterior capsule and internal and vitreous aspects of the posterior capsule were gently irrigated with 0.1 mL of trypan blue 0.1% or ICG 0.5%. After 10 seconds, the capsules were irrigated with distilled water and the staining intensities were compared. Results: Staining was not diminished 30 seconds, 5 minutes, or 1 hour after application of either dye. No difference was evident in staining intensity or diminution with time between the anterior and posterior capsules, but the external aspects were stained more than the internal aspects with both dyes. Trypan blue produced more intense staining than ICG. Conclusions: Since the intensity of capsule staining in the intact lens did not change during a 1-hour immersion in water, capsule dyes may not dissipate fully during cataract surgery. As possible long-term adverse effects have not been ruled out, capsule dyes should be used in a low concentration for a short exposure time. © 2004 ASCRS and ESCRS.

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Time course of lens capsule staining using trypan blue and indocyanine green: in vitro study in porcine eyes

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J Cataract Refract Surg 30 （ 8 ） 1751-1754 2004年08月

研究論文（学術雑誌）, 共著

Calculation of ocular single-pass modulation transfer function and retinal image simulation from measurements of the polarized double-pass ocular point spread function

Kobayashi Katsuhiko, Shibutani Masahiro, Takeuchi Gaku, Ohnuma Kazuhiko, Miyake Yoichi, Negishi Kazuno, Ohno Kenji, Noda Toru

Journal of Biomedical Optics 9 （ 1 ） 154 - 161 2004年01月

ISSN 1083-3668

The single-pass modulation transfer function (MTF_sgl) is an important numerical parameter that can help elucidate the performance and some processes of the human visual system. In previous studies, the MTF _sglwas calculated from double-pass point spread function (PSF) measurements. These measurements include a depolarized reflection component from the retina that introduces a measurement artifact, and they require long acquisition times to allow averaging to reduce speckle. To solve these problems, we developed a new ocular PSF analysis system (PSFAS) that uses polarization optics to eliminate the depolarized retinal reflection component, and a rotating prism to increase measurement speed. Validation experiments on one patient showed that the MTF_sglmeasured by PSFAS agrees closely with the MTF calculated from contrast sensitivity measurements. A simulated retinal image was calculated by convolution of Landolt rings with the calculated single-pass PSF provided by the PSFAS. The contrast characteristic then was calculated from the simulated retinal images. These results indicate that the MTF _sglobtained using the PS-FAS may be a reliable measure of visual performance of the optics of the eye, including the optical effects of the retina. The simulated retinal images and contrast characteristics are useful for evaluating visual performance. © 2004 Society of Photo-Optical Instrumentation Engineers.

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Simulated retinal images of Landolt rings in human eyes including asymmetric aberrations on the point spread function analysis system

Shibutani Masahiro, Kobayashi Katsuhiko, Takeuchi Gaku, Kubotera Yumi, Ohnuma Kazuhiko, Negishi Kazuno, Ohno Kenji, Noda Tom

229 - 236 2004年

We newly developed a Point Spread Function Analysis System (PSFAS) to study the optical system of the human eye. In this system, an infrared point light source is projected onto the subject's eye and the reflected image at the retina is captured by the charge coupled device (CCD) (i.e., double-pass formula). The single-pass modulation transfer function (MTF) is calculated from the captured image with equal sized apertures of the entrance and exit pupils, and the phase transfer function (PTF) is calculated from the captured image with unequal sized apertures of them. The optical transfer function (OTF) is deduced from this MTF and PTF, then retinal images can be simulated with both this OTF and the original charts. The smaller aperture of the incident ray is determined so as to give a diffraction limit, then the simulated retinal images include the information of asymmetric aberrations. The simulated retinal images of the Landolt's rings were compared with subjective sensations in the same subject with keratoconus. The PSFAS can objectively evaluate the characteristics of the human optical system and therefore is very useful in an ophthalmology clinic setting.

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Calculation of ocular single-pass modulation transfer function and retinal image simulation from measurements of the polarized double-pass ocular point spread function.

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J Biomed Opt 9 （ 1 ） 154-161 2004年

研究論文（学術雑誌）, 共著

Simulated retinal images of Landolt rings in human eyes including asymmetric aberrations on the point spread function analysis system.

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Proceeding of SPIE 5314 （ **** ） 39090 2004年

研究論文（学術雑誌）, 共著

治療的レーザー角膜切除術施行眼に対する白内障手術における術後屈折値予測精度

兼田英子、根岸一乃、山崎重典、清水里美、黒坂大次郎、山田昌和、真島行彦

日本眼科紀要 55 （ *** ） 706-710 2004年

研究論文（学術雑誌）, 共著

新しい照射プログラムOptimized Aspherical Transition Zone(OATZ)によるLaser In Situ Keratomileusis(LASIK)の術後早期成績

重安千花、山崎重典、清水里美、根岸一乃、黒坂大次郎、真島行彦

日本眼科紀要 55 777 - 782 2004年

研究論文（学術雑誌）, 共著

コントラスト感度測定の臨床的有用性

根岸一乃

第４回眼科臨床機器研究会シンポジウム 2003年11月

単著

LASIK術後の夜間コントラスト感度と瞳孔径

小坂晃一、根岸一乃、吉野真未、中村邦彦、黒坂大次郎、真島行彦

眼科手術 16 （ 3 ） 375-378 2003年07月

研究論文（学術雑誌）, 共著

PSFアナライザーによるコンタクトレンズ装着眼の網膜像評価

横山康弘，平松宏一，大沼一彦，小林克彦，根岸一乃，野田徹

あたらしい眼科 20 （ 2 ） 263-269 2003年02月

研究論文（学術雑誌）, 共著

Measurement of the single-pass modulation transfer function and simulation of the retinal image of the human eye with a newly developed point spread function analysis system

Kobayashi Katsuhiko, Shibutani Masahiro, Takeuchi Gaku, Ohnuma Kazuhiko, Miyake Yoichi, Negishi Kazuno, Ohno Kenji, Noda Tohru

112 - 119 2003年

We developed a new point spread function (PSF) analysis system (PSFAS) to study the optical system of the human eye. An infrared point light source is projected on the retina, then the single-pass modulation transfer function (MTF) is derived from the image of incoherent polarized reflection double-pass PSF measured by PSFAS: The retinal images and the contrast characteristics of various sized Landolt's rings then are simulated with the single-pass PSF calculated by the single-pass MTF. The visual acuity (VA) is predicted from the retinal images. The single-pass MTF and the contrast characteristics of aged subjects were clearly lower than those of a young subject in mid-frequency, though the cut-off frequency was similar in the two subjects. The predicted VA from the simulated retinal images agreed with the actual VA in normal subjects and in those with myopic astigmatism. This becomes a useful system for elucidating the optical characteristics of the human eye. In addition, the visual simulation obtained using this system is clinically useful for objectively evaluating visual function.

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慶應義塾大学病院における屈折矯正手術の診療システムと患者満足度

山崎重典、根岸一乃、清水里美、黒坂大次郎、真島行彦

眼科（金原出版） 45 1307 - 1311 2003年

研究論文（学術雑誌）, 共著

Measurement of the single-pass modulation transfer function and simulation of the retinal image of the human eye with a newly developed point spread function analysis system.

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Proceeding of SPIE 4951 （ **** ） 112-119 2003年

研究論文（学術雑誌）, 共著

各種眼内レンズのNd:YAGレーザー後嚢切開術施行率に与える影響

内野裕一、黒坂大次郎、吉野真未、中村邦彦、加藤克彦、根岸一乃

あたらしい眼科（メディカル葵出版） 20 1297 - 1300 2003年

研究論文（学術雑誌）, 共著

波面収差と波面センサー

根岸一乃

東京都眼科医会報 181 3-9 2002年10月

研究論文（学術雑誌）, 単著

Elschinig pearl formation along the neodymium:YAG laser posterior capsulotomy margin

Kurosaka D, Kato K, Kurosaka H, Yoshino M, Nakamura K, Negishi K

Journal of Cataract and Refractive Surgery 28 1809-1813 2002年10月

研究論文（学術雑誌）, 共著

Elschnig pearl formation along the neodymium

Kurosaka Daijiro, Kato Katsuhiko, Kurosaka Hiroyo, Yoshino Mami, Nakamura Kunihiko, Negishi Kazuno

Journal of Cataract and Refractive Surgery 28 （ 10 ） 1809 - 1813 2002年10月

ISSN 0886-3350

Purpose: To examine the long-term occurrence and course of Elschnig pearl (string of pearls) formation along neodymium:YAG (Nd:YAG) laser posterior capsulotomy margins. Setting: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. Methods: The clinical records of eyes having an Nd:YAG posterior capsulotomy to treat posterior capsule opacification after cataract surgery were retrospectively reviewed. Kaplan-Meier and Cox proportional hazards analysis were performed. Results: Among 201 eyes, string of pearls developed in 139 (69.2%). The mean follow-up after the Nd:YAG posterior capsulotomy was 32.1 months ± 25.3 (SD)(SID). At 2 years, the cumulative probability of developing string of pearls was 77.0% (95% confidence interval [CI], 70.6%-83.4%), after which it reached a plateau. Among the 139 eyes, 100 had sufficient data to be reviewed to assess the long-term outcome (mean follow-up from Nd:YAG posterior capsulotomy, 43.7 ± 26.0 months). A second Nd:YAG posterior capsulotomy was performed in 18 eyes (18.0%) to treat progression of string of pearls, typically within 2 years after the initial Nd:YAG capsulotomy. The string of pearls disappeared spontaneously in 31 eyes (31.0%). The probability of disappearance was 80.4% (95% CI, 63.4%-97.4%) 8 years after the Nd:YAG posterior capsulotomy. Cox proportional hazards analysis identified no factor significantly favoring the disappearance of the string of pearls. Conclusions: String of pearls was a common complication after Nd:YAG laser posterior capsulotomy. About 20% of cases were progressive and required a second capsulotomy; however, most regressed over several years. © 2002 ASCRS and ESCRS.

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Elschnig pearl formation along the neodymium:YAG laser posterior capsulotomy margin. Long-term follow-up

Kurosaka, D., Kato, K., Kurosaka, H., Yoshino, M., Nakamura, K. and Negishi, K.

J Cataract Refract Surg 28 （ 10 ） 1809 - 13 2002年10月

ISSN 0886-3350

PURPOSE: To examine the long-term occurrence and course of Elschnig pearl (string of pearls) formation along neodymium:YAG (Nd:YAG) laser posterior capsulotomy margins. SETTING: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. METHODS: The clinical records of eyes having an Nd:YAG posterior capsulotomy to treat posterior capsule opacification after cataract surgery were retrospectively reviewed. Kaplan-Meier and Cox proportional hazards analysis were performed. RESULTS: Among 201 eyes, string of pearls developed in 139 (69.2%). The mean follow-up after the Nd:YAG posterior capsulotomy was 32.1 months +/- 25.3 (SD). At 2 years, the cumulative probability of developing string of pearls was 77.0% (95% confidence interval [CI], 70.6%-83.4%), after which it reached a plateau. Among the 139 eyes, 100 had sufficient data to be reviewed to assess the long-term outcome (mean follow-up from Nd:YAG posterior capsulotomy, 43.7 +/- 26.0 months). A second Nd:YAG posterior capsulotomy was performed in 18 eyes (18.0%) to treat progression of string of pearls, typically within 2 years after the initial Nd:YAG capsulotomy. The string of pearls disappeared spontaneously in 31 eyes (31.0%). The probability of disappearance was 80.4% (95% CI, 63.4%-97.4%) 8 years after the Nd:YAG posterior capsulotomy. Cox proportional hazards analysis identified no factor significantly favoring the disappearance of the string of pearls. CONCLUSIONS: String of pearls was a common complication after Nd:YAG laser posterior capsulotomy. About 20% of cases were progressive and required a second capsulotomy; however, most regressed over several years.

角膜収差

根岸一乃

日本眼内レンズ屈折手術学会誌 16 （ 3 ） 294-297 2002年09月

研究論文（学術雑誌）, 単著

夜間のグレア

山崎重典，根岸一乃

眼科診療プラクティス 15 （ 6 ） 58-59 2002年06月

研究論文（学術雑誌）, 共著

眼科学の臨床からみたレーザーの安全

根岸一乃

日本レーザー治療学会誌 1 （ 1 ） 29 2002年06月

研究論文（学術雑誌）, 単著

第55回日本臨床眼科学会印象記「屈折矯正1〜5」

根岸一乃

眼科 44 （ 4 ） 619-624 2002年04月

研究論文（学術雑誌）, 単著

LASIKの職員教育

根岸一乃

日本眼内レンズ屈折手術学会誌 16 （ 1 ） 87-89 2002年04月

研究論文（学術雑誌）, 単著

眼内レンズ挿入眼の視機能

根岸一乃

あたらしい眼科 19 （ 3 ） 305-310 2002年04月

研究論文（学術雑誌）, 単著

レーザーによる近視・乱視の治療

根岸一乃

KAST　Report 14 （ 1 ） 28-33 2002年04月

研究論文（学術雑誌）, 単著

眼内レンズ挿入眼の視機能

根岸一乃

あたらしい眼科 19 （ 3 ） 305-310 2002年03月

研究論文（学術雑誌）, 単著

マイクロケラトームの使い方

根岸一乃

眼科 44 （ 2 ） 173-177 2002年02月

研究論文（学術雑誌）, 単著

Measurement of the single-pass MTF and simulation of the retinal image of the human eye developed Point Spread Function Analysis System

Kobayashi Katsuhiko, Shibutani Masahiro, Takeuchi Gaku, Ohnuma Kazuhiko, Miyake Yuichi, Noda Toru, Negishi Kazuno, Ohno Kenji

Proceeding of SPIE, Opthalmic technologies XIII 4951 1-8 2002年01月

研究論文（学術雑誌）, 共著

Efficacy and safty of an ozonated solution used preoperatively to disinfect the ocular surface, and to irrigate the corneal flap in laser in situ keratomileusis

Negishi Kazuno, Takahashi Keiko, Izumi Kanako, Ohno Kenji, Hirai Kaori, Noda Toru, Hayashi Tatsutoshi

Folia Ophthalmologica Japonica 53 （ 2 ） 108 - 112 2002年

ISSN 0015-5667

Purpose: To evaluate the efficacy and safety of an ozonated solution used as a preoperative disinfectant and to irrigate the corneal flap in laser in situ keratomileusis. Methods: In normal human eyes, the rates of positive bacterial culture before and after irrigation were compared for 3 kinds of solutions: a 1:16 solution of povidone-iodine, a hypotonic-ozonated solution, and an isotonic-ozonated solution. In white rabbit eyes, the conjunctival fomix of the eye was irrigated with one of the 3 solutions before a corneal flap was made. Then the flap was irrigated with one of these 3 solutions: a hypotonic-ozonated solution, an isotonicozonated solution, or a balanced salt solution (BSS). The degree of corneal epithelial damage, the degree of edema in the flap after irrigation, and postoperative wound healing were compared in rabbit eyes exposed to the 3 solutions. Results: In human eyes, all 3 solutions were effective preoperative disinfectants. In rabbit eyes, the degree of corneal damage was more severe in the eyes irrigated with povidone iodine solution than in those irrigated with other solutions. There was no noticeable difference in the degree of flap edema after irrigation under the flap or in wound healing among eyes irrigated with BSS or an ozonated solution. Conclusions: An ozonated solution is an effective preoperative disinfectant and causes less corneal damage than a povidone iodine solution. An isotonic ozonated solution could be used to irrigate under the corneal flap during laser in situ keratomileusis.

オゾン水によるLaser in situ keratomileusisの術前消毒とフラップ下洗浄

根岸一乃，高橋慶子，泉香奈子，大野建治，平井香織，野田徹，林達敏

日本眼科紀要 53 108-112 2002年

研究論文（学術雑誌）, 共著

前眼部解析装置

根岸一乃

臨床検査 45 （ 12 ） 1579-1582 2001年12月

研究論文（学術雑誌）, 単著

Point spread functionを利用した人眼網膜像のシミュレーションと視力の予測

小林克彦，渋谷雅博，竹内楽，大沼一彦，三宅洋一，根岸一乃，大野建治，野田徹

視覚の科学 22 （ 3 ） 85-92 2001年09月

研究論文（学術雑誌）, 共著

術後視機能の評価法　PSFアナライザーによる術後網膜像の評価

小林克彦，根岸一乃

日本眼内レンズ屈折手術学会誌 15 205-210 2001年09月

研究論文（学術雑誌）, 共著

Effect of chromatic aberration on contrast sensitivity in pseudophakic eyes

Negishi, K., Ohnuma, K., Hirayama, N. and Noda, T.

Arch Ophthalmol 119 （ 8 ） 1154 - 8 2001年08月

ISSN 0003-9950

OBJECTIVE: To evaluate the effect of chromatic aberrations in pseudophakic eyes with various types of intraocular lenses (IOLs). PATIENTS AND METHODS: The study included 51 eyes of 33 patients who underwent cataract surgery. The eyes were divided into 3 groups according to the material from which their IOL was made: group 1, polymethyl methacrylate; group 2, silicone; and group 3, an acrylate/methacrylate copolymer. Ten normal phakic control eyes (group 4) underwent the same examination. Best-corrected distance visual acuity and contrast sensitivity were measured under white light and monochromatic light with wavelengths of 470 nm, 549 nm, and 630 nm, with the best correction under white light. RESULTS: There were no significant differences in best-corrected visual acuity and contrast sensitivity under the 549-nm monochromatic light in any group. However, under both white multichromatic light and 470- and 630-nm monochromatic light, the mean contrast sensitivity in group 3 tended to be lower, sometimes significantly, than in the other IOL groups. CONCLUSIONS: Our results showed that longitudinal chromatic aberrations of some IOLs may degrade the quality of the retinal image. Attention must be paid to the detailed optical performance of IOL materials to achieve good visual function.

Effect of chromatic aberration on ontrast sensitivity in pseudophakic eyes

Negishi Kazuno, Ohnuma Kazuhiko, Hirayama Norio, Noda Toru

Archives of Ophthalmology 119 （ 8 ） 1154-1158 2001年08月

研究論文（学術雑誌）, 共著

含水ゲル眼内レンズ挿入眼の術後早期コントラスト感度

阿部聡，平井香織，黒川直行，野田航介，細田ひろみ，林康司，小西美奈子，田中靖彦，根岸一乃

臨床眼科（医学書院） 55 （ 4 ） 565-567 2001年04月

研究論文（学術雑誌）, 共著

Effect of chromatic aberration on contrast sensitivity in pseudophakic eyes

Negishi K., Ohnuma K., Hirayama N., Noda T.

Archives of Ophthalmology 119 （ 8 ） 1154 - 1158 2001年

ISSN 0003-9950

Objective: To evaluate the effect of chromatic aberrations in pseudophakic eyes with various types of intraocular lenses (IOLs). Patients and Methods: The study included 51 eyes of 33 patients who underwent cataract surgery. The eyes were divided into 3 groups according to the material from which their IOL was made: group 1, polymethyl methacrylate; group 2, silicone; and group 3, an acrylate/methacrylate copolymer. Ten normal phakic control eyes (group 4) underwent the same examination. Best-corrected distance visual acuity and contrast sensitivity were measured under white light and monochromatic light with wavelengths of 470 nm, 549 nm, and 630 nm, with the best correction under white light. Results: There were no significant differences in best-corrected visual acuity and contrast sensitivity under the 549-nm monochromatic light in any group. However, under both white multichromatic light and 470- and 630-nm monochromatic light, the mean contrast sensitivity in group 3 tended to be lower, sometimes significantly, than in the other IOL groups. Conclusions: Our results showed that longitudinal chromatic aberrations of some IOLs may degrade the quality of the retinal image. Attention must be paid to the detailed optical performance of IOL materials to achieve good visual function.

患者選択はどのように行うのですか？

根岸一乃

あたらしい眼科 18 （臨増） 15-18 2001年

研究論文（学術雑誌）, 単著

Outcome of intraocular lens implantation in children

Nishiyama T., Kurosaka D., Nakamura K., Negishi K., Kato K.

Japanese Journal of Clinical Ophthalmology 54 （ 4 ） 525 - 529 2000年

ISSN 0370-5579

We performed intraocular lens (IOL) implantation in 6 eyes of 5 children using a new procedure. The ages ranged from 4 years 8 month to 8 years 10 months, average 6 years 1 month. The follow-up period ranged from 6 months to 3 years 9 months, average 17.5 months. Following circular capsulorhexis and aspiration of lens material, anterior vitrectomy and posterior capsulorhexis were performed. The optics of IOL fixated in the bag was then luxated posteriorly to create optic capture. There were no serious complications either intra- or postoperatively. Aftercataract was slight in degree and did not affect the visual acuity. All the eyes increased visual acuity by 2 lines or more. The endothelial cell loss averaged 2.9%. The postoperative myopic shift averaged 0.69 diopters. The present surgical modality promises to be safe and effective in treating cataract or posterior lenticonus in children after the axial length has stabilized after 2 years 6 months of age.

小児に対する眼内レンズ挿入術後の術後成績

西山隆恒、黒坂大次郎、中村邦彦、根岸一乃、加藤克彦

臨床眼科（医学書院） 54 525 - 529 2000年

研究論文（学術雑誌）, 共著

Various phenotypic expressions of familial aniridia with a PAX6 mutation [6]

Negishi K., Azuma N., Yamada M.

British Journal of Ophthalmology 83 （ 8 ） 991 - 992 1999年

ISSN 0007-1161

点眼麻酔白内障手術における鎮静剤（ジアゼパム）内服の必要性

江下忠彦、根岸一乃、蔵石さつき

あたらしい眼科（メディカル葵出版） 15 1587 - 1591 1998年

研究論文（学術雑誌）, 共著

5ゾーン屈折型多焦点眼内レンズ移植眼の術後視機能

根岸一乃

慶應医学 75 （ 1 ） T49 - T61 1998年

学位論文（博士）, 単著

Elschnig pearl formation along the posterior capsulotomy margin after neodymium:YAG capsulotomy

Kato, K., Kurosaka, D., Bissen-Miyajima, H., Negishi, K., Hara, E. and Nagamoto, T.

J Cataract Refract Surg 23 （ 10 ） 1556 - 60 1997年12月

ISSN 0886-3350

PURPOSE: To determine the incidence of Elschnig pearl formation along the capsulotomy margin (string of pearls) after neodymium:YAG (Nd:YAG) laser posterior capsulotomy and to elucidate its clinical features, predisposing factors, effect on visual function, and association with additional capsulotomy. SETTING: Keio University Hospital, Tokyo, Japan. METHODS: The records of 418 eyes that had had Nd:YAG posterior capsulotomy after cataract surgery were retrospectively reviewed. Of those, 315 were excluded for short follow-up (fewer than 12 months) or insufficient clinical examination data. In the remaining 103 eyes, the incidence of string of pearls was calculated, and its clinical features, predisposing factors, effect on visual function, and correlation with additional capsulotomy were evaluated. RESULTS: String of pearls was identified in 49 eyes (47.6%); 37 (75.5%) developed pearls within 1 year after Nd:YAG capsulotomy. The incidence was significantly higher in patients having intraocular lens implantation and continuous curvilinear capsulorhexis (CCC) than in those without (95.9 versus 61.1% and 97.9 versus 55.6%, respectively). No significant differences were found in patient age and sex, total Nd:YAG energy, and the presence of diabetes mellitus or high myopia. String of pearls caused visual disturbances in 17 eyes (34.7%). The rate of repeat capsulotomy was higher in patients with string of pearls than in those without (36.7 and 9.3%, respectively). CONCLUSIONS: String of pearls formation was a common and significant complication after Nd:YAG posterior capsulotomy. Intraocular lens implantation and CCC may promote its formation.

多目的眼内レンズの支持部強度

根岸一乃，蔵石さつき，松崎忠幸

臨眼 51 （ 13 ） 1909-1912 1997年12月

研究論文（学術雑誌）, 共著

Elschnig pearl formation along the posterior capsulotomy margin after neodymium : YAG Capsulotomy

Kato Katsuhiko, Kurosaka Daijiro, Miyajima-Bissen Hiroko, Negishi Kazuno, Hara Emiko, Nagamoto Toshiyuki

J Catoract Refract Surg 23 （ 10 ） 1556-1560 1997年12月

研究論文（学術雑誌）, 共著

Evaluation of a zonal-progressive multifocal intraocular lens

Negishi, K., Bissen-Miyajima, H., Kato, K., Kurosaka, D. and Nagamoto, T.

Am J Ophthalmol 124 （ 3 ） 321 - 30 1997年09月

ISSN 0002-9394

PURPOSE: To determine the clinical usefulness of a five-zone refractive multifocal intraocular lens. METHODS: After more than 1 year of follow-up, we evaluated the visual function of 22 patients (36 eyes) who had received the MPC-25NB intraocular lens for distance and near visual acuity, kinetic visual acuity, and near contrast sensitivity, and for patient satisfaction. RESULTS: Of 31 study eyes with less than 1.5 diopters of preoperative keratometric astigmatism, 28 (90.3%) achieved an uncorrected distance visual acuity of 20/40 or better; best-corrected distance visual acuity was 20/20 or better in 31 (86.1%) of 36 eyes. Near visual acuity with distance correction was 20/40 or better in 20 (60.6%) of 33 eyes. Kinetic visual acuity in these patients was comparable to that in patients with monofocal intraocular lenses. Distance visual acuity and near contrast sensitivity were below normal or within the low normal range. There was no significant difference in contrast visual acuity measured by variable contrast visual acuity charts between MPC-25NB and monofocal intraocular lens-implanted eyes (P > .05). Four (22.2%) of 18 patients did not require spectacles when the intraocular lens was implanted for emmetropia. Despite some complaints about near or night vision, all patients expressed satisfaction. CONCLUSIONS: The MPC-25NB lens provides a level of distance vision comparable to that of a monofocal intraocular lens and a useful level of near visual acuity without spectacles. However, we should carefully evaluate the indication for use of MPC-25NB in patients who require good near vision or night vision.

毛様溝縫着術中に破損したdimple付き眼内レンズの1例

松崎忠幸，根岸一乃，林康司，野田徹

眼科（金原出版） 39 （ 9 ） 1113-1117 1997年09月

研究論文（学術雑誌）, 共著

自己閉鎖創白内障術後早期のコントラスト視力と不正乱視

根岸一乃，ビッセン宮島弘子，富所敦男，大鹿哲郎，松崎忠幸，林康司

臨眼 50 （ 6 ） 1133-1136 1997年06月

研究論文（学術雑誌）, 共著

白内障手術--術後炎症--

根岸一乃

眼科手術 10 （ 1 ） 5-13 1997年01月

研究論文（学術雑誌）, 単著

Evaluation of a zonal-progressive multifocal intraocular lens

Negishi K., Bissen-Miyajima H., Kato K., Kurosaka D., Nagamoto T.

American Journal of Ophthalmology 124 （ 3 ） 321 - 330 1997年

ISSN 0002-9394

PURPOSE: To determine the clinical usefulness of a five-zone refractive multifocal intraocular lens. METHODS: After more than 1 year of follow-up, we evaluated the visual function of 22 patients (36 eyes) who had received the MPC 25NB intraocular tens for distance and near visual acuity, kinetic visual acuity, and near contrast sensitivity, and for patient satisfaction. RESULTS: Of 31 study eyes with less than 1.5 diopters of preoperative keratometric astigmatism, 28 (90.3%) achieved an uncorrected distance visual acuity of 20/40 or better; best-corrected distance visual acuity was 20/20 or better in 31 (86.1%) of 36 eyes. Near visual acuity with distance correction was 20/40 or better in 20 (60.6%) of 33 eyes. Kinetic visual acuity in these patients was comparable to that in patients with monofocal intraocular lenses. Distance visual acuity and near contrast sensitivity were below normal or within the low normal range. There was no significant difference in contrast visual acuity measured by variable contrast visual acuity charts between MPC- 25NB and monofocal intraocular lens-implanted eyes (P > .05). Four (22.2%) of 18 patients did not require spectacles when the intraocular lens was implanted for emmetropia. Despite some complaints about near or night vision, all patients expressed satisfaction. CONCLUSIONS: The MPC-25NB lens provides a level of distance vision comparable to that of a monofocal intraocular lens and a useful level of near visual acuity without spectacles. However, we should carefully evaluate the indication for use of MPC-25NB in patients who require good near vision or night vision.

Elschnig pearl formation along the posterior capsulotomy margin after neodymium

Kato K., Kurosaka D., Bissen-Miyajima H., Negishi K., Hara E., Nagamoto T.

Journal of Cataract and Refractive Surgery 23 （ 10 ） 1556 - 1560 1997年

ISSN 0886-3350

Purpose: To determine the incidence of Elschnig pearl formation along the capsulotomy margin (string of pearls) after neodymium:YAG (Nd:YAG) laser posterior capsulotomy and to elucidate its clinical features, predisposing factors, effect on visual function, and association with additional capsulotomy. Setting: Keio University Hospital, Tokyo, Japan. Methods: The records of 418 eyes that had Nd:YAG posterior capsulotomy after cataract surgery were retrospectively reviewed. Of those, 315 were excluded for short follow-up (fewer than 12 months) or insufficient clinical examination data. In the remaining 103 eyes, the incidence of string of pearls was calculated, and its clinical features, predisposing factors, effect on visual function, and correlation with additional capsulotomy were evaluated. Results: String of pearls was identified in 49 eyes (47.6%); 37 (75.5%) developed pearls within 1 year after Nd:YAG capsulotomy. The incidence was significantly higher in patients having intraocular lens implantation and continuous curvilinear capsulorhexis (CCC) than in those without (95.9 versus 61.1% and 97.9 versus 55.6%, respectively). No significant differences were found in patient age and sex, total Nd:YAG energy, and the presence of diabetes mellitus or high myopia. String of pearls caused visual disturbances in 17 eyes (34.7%). The rate of repeat capsulotomy was higher in patients with string of pearls than in those without (36.7 and 9.3%, respectively). Conclusions: String of pearls formation was a common and significant complication after Nd:YAG posterior capsulotomy. Intraocular lens implantation and CCC may promote its formation.

Strength of haptics of multipurpose intraocular lens

Negishi K., Kuraishi S., Matsuzaki T.

Japanese Journal of Clinical Ophthalmology 51 （ 13 ） 1909 - 1912 1997年

ISSN 0370-5579

We measured the strength of haptics of two types of intraocular lens (IOL) made by Nidek Co. One has equal haptics in diameter (NR-84C) and the other unequal ones (NR-84K). We used a digital force guage to which the optics of each IOL was fixed. The end of haptics was pulled either parallel or vertical to the optics at the speed of 40 mm/min. We recorded the strength of the force at the break point of the haptics. When the power was applied parallel to the optics, the breaking power was significantly less for NR-84K than NR-84C (p < 0.05). The haptics broke at their end for either type of IOL. When the power was applied vertical to the optics, the breaking power was the same for both types of IOL. The haptics broke at the end of haptics for NR-84K and near the root for NR-84C. The findings show that haptics unequal in diameter are weaker than those with equal ones. Standardization in the strength of haptics is desired in order to avoid their break during transscleral fixation of IOL.

乱視矯正角膜切開術後の視機能と不正乱視

根岸一乃、ビッセン弘子（宮島）、島崎潤、大和香織、富所敦男、大鹿哲郎

眼科手術（メディカル葵出版） 10 265 - 268 1997年

研究論文（学術雑誌）, 共著

水晶体の展望--1994年度(II)--

根岸一乃

眼科 38 （ 5 ） 541-560 1996年05月

研究論文（学術雑誌）, 単著

多焦点眼内レンズ挿入眼における視機能検査と自己評価の関連

根岸一乃，ビッセン宮島弘子，加藤克彦，黒坂大次郎，永本敏之

眼科手術 9 （ 2 ） 211-216 1996年04月

研究論文（学術雑誌）, 共著

水晶体の展望--1994年度(I)--

根岸一乃

眼科 38 （ 4 ） 341-355 1996年04月

研究論文（学術雑誌）, 単著

多焦点眼内レンズにおける視機能検査と患者の満足度の関連

根岸一乃，ビッセン弘子（宮島），加藤克彦，黒坂大次郎，永本敏之

眼科手術 9 （ 2 ） 211-216 1996年04月

研究論文（学術雑誌）, 共著

Irregular astigmatism and contrast visual acuity after small incision cataract surgery

Bissen-Miyajima H., Negishi K., Tomidokoro A., Oshika Tetsuro, Katsumi O., Tsubota K.

Investigative Ophthalmology and Visual Science 37 （ 3 ） 1996年02月

ISSN 0146-0404

Purpose. Small incision cataract surgery resulted in early postoperative recovery of visual function because of less intraocular inflammation and irregular astigmatism. Using the Variable Contrast Visual Acuity Charts (VCVAC), we reported that improved visual acuities (VAs) with intermediate- and low-contrast charts correlated negatively with the postoperative level of intraocular inflammation (ARVO 1995). In the present study we observed changes in contrast VA and irregular astigmatism at several time points postoperatively. Methods. Sixteen patients (22 eyes) aged 41-89 years (mean, 65.5) with no ocular pathologies except for cataract were selected as study patients. Phacoemulsification and intraocular lens implantation were performed through a 3-5 mm self-sealing incision. The irregular corneal astigmatism was quantified from the difference between the actual refractive power and the sine curve that approximates the refractive power of the regular cornea. The contrast VA was measured using the VCVAC, which consists of low- (2.5%), intermediate- (15%), and high- (90%) contrast charts. Those measurements were performed preoperatively and at 3 and 5 days, 2 weeks, and 1 month postoperatively. Results. The degree of regular astigmatism was not statistically different at any time postoperatively. However, the degree of irregular astigmatism within the central 2 mm of the cornea was 0.59D at 3 days and 0.51D at 5 days, and improved to 0.38D at 2 weeks postoperatively. The irregular astigmatism at 3 and 5 days postoperatively, which was statistically higher than that preoperatively (0.31D), was negatively correlated with the recovery of VAs with intermediate and low contrast. Conclusions. The irregular astigmatism may also influence the early postoperative VA with intermediate- and low-contrast charts as well as intraocular inflammation.

Comparison of protective efficacy in different molecular weight of sodium hyaluronates on the corneal endothelium during phacoemulsification

Negishi K., Bissen-Miyajima H., Tsubota K.

Investigative Ophthalmology and Visual Science 37 （ 3 ） 1996年02月

ISSN 0146-0404

Purpose.In cataract surgery, sodium hyaluronate(Na-HA) is used not only to maintain the anterior chamber but also to protect ocular tissue such as the corneal endothelium. We compared the protective effects of different molecular weights of Na-HA during phacoemulsification(PEA). Methods.78 postmortem porcine eyes and Na-HA of three different molecular weights labeled with fluorescenct amine (FA-HA) were used: 42×10⁴(group A) , 113×10⁴(group B), and 167×10⁴(group C). 500 μ1 of Na-HA was injected into the anterior chamber and irrigation and aspiration (I/A) or PEA was performed. To measure the endothelial damage, the cornea was dissected at the limbus, and using 0.25% trypan blue, the stained area, i.e., the damaged area was analysed using a video system (Pias LA-555). To evaluate the amount of FA-HA binding to the corneal endothelium, the corneal section was digested by acetate buffer, including 0.25% actinase, fluorescence was measured. Results. Following I/A, a mean area of staining(mm²) was 0.008± 0.016 in group A (4 eyes), 0.00± 0.00 in group B (4 eyes) and C (4 eyes). Following PEA, a mean area of staining (mm²) was 0.364 ± 0.328 in group A (4 eyes), 0.428± 0.841 in group B (4 eyes) and 0.074± 0.086 in group C (4 eyes). The average amount of residual FA-HA (μ g/mg dry Wt.) after PEA was 0.386+ 0.959 in group A(8 eyes), 23.9± 5.66 in group B(7 eyes), and 3.59± 1.38 in group C(7 eyes). The residual level in group B was statistically greater than the other groups (P<0.01). Conclusion Compared with different molecular weight of Na-HA, the residual level of Na-HA after PEA was significantly different, however, the protective effect was not clinically different.

Clinical evaluation of a five-zone refractive multifocal intraocular lens

Negishi, K., Nagamoto, T., Hara, E., Kurosaka, D. and Bissen-Miyajima, H.

J Cataract Refract Surg 22 （ 1 ） 110 - 5 1996年01月

ISSN 0886-3350

PURPOSE: To evaluate the clinical performance of a five-zone refractive multifocal intraocular lens (AMO, model MPC-25NB, Array). METHODS: We performed a retrospective clinical trial of 31 cataract patients (mean age 64.3 years). The parameters studied were intraoperative and postoperative complications, distance and near visual acuity, spectacle use, decreased number of corneal endothelial cells, contrast sensitivity, percentage of glare disability, near binocular vision, and depth of focus. RESULTS: Intraoperatively, iris damage occurred in two eyes (4.2%), vitreous loss in one eye (2.1%), and consecutive rupture of Zinn's zonule and vitreous in one eye (2.1%). Postoperatively, posterior capsule opacification was observed in two eyes (4.2%), temporary intraocular pressure increase in one eye (2.1%), and cystoid macular edema in one eye (2.1%). Uncorrected distance visual acuity of 20/40 or better was achieved by 34 of 37 eyes (91.9%) with less than 1.5 diopters of preoperative keratometric astigmatism; best corrected distance acuity of 20/20 or better was achieved by 41 of 45 eyes (91.1%). Near visual acuity with distance correction of 20/40 or better was achieved by 29 of 43 eyes (67.4%). These data were compared retrospectively with data from control patients who received monofocal lenses, and no significant differences in the decreased number of corneal endothelial cells were found. Mean contrast sensitivities were within normal range for all spatial frequencies. Percentage of glare disability and near binocular vision were within normal limits. CONCLUSIONS: Eyes implanted with the five-zone refractive multifocal lens showed better near visual acuity than control eyes and compared favorably in other aspects of visual function, indicating that these lenses are effective and safe.

Clinical evaluation of a five-zone refractive multifocal intraocular lens

Negishi K, Nagamoto T, Hara E, Kurosaka D, Bissen-Miyajima H

J Cataract Refract Surg 22 （ 1 ） 110-115 1996年01月

研究論文（学術雑誌）, 共著

Irregular astigmatism and contrast visual acuity during early stage after self sealing small incision cataract surgery

Negishi K., Miyajima H. B., Tomidokoro A., Oshika T., Matsuzaki T., Hayashi K.

Japanese Journal of Clinical Ophthalmology 50 （ 6 ） 1133 - 1136 1996年

ISSN 0370-5579

We evaluated contrast visual acuity and irregular astigmatism during the early stage after self-sealing small incision cataract surgery in 22 eyes. Three days after surgery, the corrected visual acuity and visual acuity for high contrast chart reached the average values 3 months after surgery. It took 2 weeks for the visual acuity for medium and low contrast chart to reach the average value 3 months after surgery. Irregular corneal astigmatism showed significant increases 3 and 5 days after surgery from preoperative values. It returned to the preoperative value 2 weeks after surgery. There were no differences before and after surgery in regular astigmatism, surface regularity index and surface asymmetry index. The findings show that irregular astigmatism may be a factor in the recovery of visual acuity for medium and low-contrast chart during the early stage after self-sealing small incision cataract surgery.

Retinal detachment in a case of homocystinuria

Noda T., Abe S., Ando Y., Shimizu K., Tani M., Negishi K., Akiyama K. I.

Japanese Journal of Clinical Ophthalmology 50 （ 1 ） 23 - 27 1996年

ISSN 0370-5579

A 21 year old male presented with bilateral lens dislocation. He showed skeletal abnormalities simulating Marfan syndrome, mental retardation and history of convulsion during childhood. He was diagnosed as homocystinuria by laboratory studies. After five years of follow-up, rhegmatogenous retinal detachment developed in the right eye, which was brought to cure by multiple surgeries. Retinal detachment in homocystinuria was difficult to detect and treat because of concomitant systemic and mental problems.

Lipid keratopathy - Lipid deposition and serum cholesterol level

Shimizu Keiichiro, Tani Mizuko, Noda Toru, Negishi Kazuno, Abe Satoru, Yozawa Hisami, Nakamura Mariko

Folia Ophthalmologica Japonica 47 （ 1 ） 69 - 73 1996年

ISSN 0015-5667

Light and electron microscopy were used to examine yellow-white opacities around the area of abnormal corneal stromal vascularization from the limbus in 2 patients with hypercholesterolemia. Intracellular lipid droplets were noted in keratocytes near capillaries, and needle-shaped crystals of cholesterol were seen extracellularly, evidence that the opacities resulted from deposition of lipid in the stroma. On the basis of clinical findings in these 2 patients, we hypothesized that accumulation of lipid was responsible for 19 opacities in 32 patients with abnormal corneal stromal vessels. Correlations were found between lipid deposition and serum cholesterol levels in these patients, suggesting that hypercholesterolemia (>200 mg total cholesterol/dl) and abnormal corneal vascularization place a patient at high risk of developing lipid keratopathy (LK). In the early stage of LK, ablation of vascular channels or normalization of serum cholesterol levels could prevent progression of lipid deposition and helped lipid infiltrate to resolve. In this way, early treatment can be effective in preventing the occurrence of LK itself or progression of opacity.

Clinical evaluation of a five-zone refractive multifocal intraocular lens

Negishi K., Nagamoto T., Hara E., Kurosaka D., Bissen-Miyajima H.

Journal of Cataract and Refractive Surgery 22 （ 1 ） 110 - 115 1996年

ISSN 0886-3350

Purpose: To evaluate the clinical performance of a five-zone refractive multifocal intraocular lens (AMO, model MPC-25NB, Array®). Methods: We performed a retrospective clinical trial of 31 cataract patients (mean age 64.3 years). The parameters studied were intraoperative and postoperative complications, distance and near visual acuity, spectacle use, decreased number of corneal endothelial cells, contrast sensitivity, percentage of glare disability, near binocular vision, and depth of focus. Results: Intraoperatively, iris damage occurred in two eyes (4.2%), vitreous loss in one eye (2.1%), and consecutive rupture of Zinn's zonule and vitreous in one eye (2.1%). Postoperatively, posterior capsule opacification was observed in two eyes (4.2%), temporary intraocular pressure increase in one eye (2.1%), and cystoid macular edema in one eye (2.1%). Uncorrected distance visual acuity of 20/40 or better was achieved by 34 of 37 eyes (91.9%) with less than 1.5 diopters of preoperative keratometric astigmatism; best corrected distance acuity of 20/20 or better was achieved by 41 of 45 eyes (91.1%). Near visual acuity with distance correction of 20/40 or better was achieved by 29 of 43 eyes (67.4%). These data were compared retrospectively with data from control patients who received monofocal lenses, and no significant differences in the decreased number of corneal endothelial cells were found. Mean contrast sensitivities were within normal range for all spatial frequencies. Percentage of glare disability and near binocular vision were within normal limits. Conclusions: Eyes implanted with the five-zone refractive multifocal lens showed better near visual acuity than control eyes and compared favorably in other aspects of visual function, indicating that these lenses are effective and safe.

Growth factors influence contractility and alpha-smooth muscle actin expression in bovine lens epithelial cells

Kurosaka, D., Kato, K., Nagamoto, T. and Negishi, K.

Invest Ophthalmol Vis Sci 36 （ 8 ） 1701 - 8 1995年07月

ISSN 0146-0404

PURPOSE: To determine whether basic fibroblast growth factor (bFGF) and transforming growth factor-beta 2 (TGF-beta 2) influence the contractile activity and the expression of alpha-smooth muscle actin (alpha-SMA) in bovine lens epithelial cells (LECs). To examine whether modulation of contractile activity by these growth factors depends on changes of alpha-SMA expression. METHODS: Bovine LECs were cultured in collagen gel in MED 5 medium (F-12 nutrient mixture supplemented with 5% fetal bovine serum) with or without bFGF (1 to 100 ng/ml) or TGF-beta 2 (0.01 to 10 ng/ml). To evaluate collagen gel contraction, the longest and shortest diameters of the gels were measured daily for 7 days, and the area was determined. Detection of alpha-SMA in the gels was performed immunohistochemically using a mouse monoclonal antibody against alpha-SMA. The percentage of alpha-SMA-positive cells to the total number of cells was determined. RESULTS: Control gels cultured with MED 5 medium alone contracted to 15.8% +/- 3.4% of their original area after 7 days. TGF-beta 2 significantly increased this contraction in a dose-dependent manner, whereas bFGF significantly decreased it. Approximately 30% of cells in the control gels were alpha-SMA positive. TGF-beta 2 significantly increased the alpha-SMA positivity dose dependently, whereas bFGF significantly decreased it. The percent positivity for alpha-SMA and the gel area showed a significant negative correlation. CONCLUSIONS: TGF-beta 2 increased collagen gel contraction and alpha-SMA expression in bovine LECs, whereas bFGF decreased these parameters. Because collagen gel contraction was correlated with alpha-SMA expression, the modulation of LEC contractile activity by growth factors may be related to an effect on alpha-SMA.

急性前部ぶどう膜炎を初発症状としたライター症候群の1例

安藤祐子，野田徹，阿部聡，根岸一乃，谷瑞子，清水敬一郎

眼科 37 （ 7 ） 779-782 1995年07月

研究論文（学術雑誌）, 共著

Growth factors influence contractility and α-smooth muscle actin expression in bovine lens epithelial cells

Kurosaka D, Kato K, Negishi K, Nagamoto T

Invest Ophthalmol Vis Sci 36 （ 8 ） 1701-1708 1995年07月

研究論文（学術雑誌）, 共著

Growth factors influence contractility and α-smooth muscle actin expression in bovine lens epithelial cells

Kurosaka D., Kato K., Nagamoto T., Negishi K.

Investigative Ophthalmology and Visual Science 36 （ 8 ） 1701 - 1708 1995年

ISSN 0146-0404

Purpose. To determine whether basic fibroblast growth factor (bFGF) and transforming growth factor-β2 (TGF-β2) influence the contractile activity and the expression of α-smooth muscle actin (α-SMA) in bovine lens epithelial cells (LECs). To examine whether modulation of contractile activity by these growth factors depends on changes of α-SMA expression. Methods. Bovine LECs were cultured in collagen gel in MED 5 medium (F-12 nutrient mixture supplemented with 5% fatal bovine scrimp) with or without bFGF (1 to 100 ng/ml) or TGF-β2 (0.01 to 10 ng/ml). To evaluate collagen gel contraction, the longest and shortest diameters of the gels were measured daily for 7 days, and the area was determined. Detection of α-SMA in the gels was performed immunohistochemically using a mouse monoclonal antibody against α-SMA. The percentage of α-SMA-positive cells to the total number of cells was determined. Results. Control gels cultured with MED 5 medium alone contracted to 15.8% ± 3.4% of their original area after 7 days. TGF- β2 significantly increased this contraction in a dose-dependent manner, whereas bFGF significantly decreased it. Approximately 30% of cells in the control gels were α-SMA positive. TGF-β2 significantly increased the α- SMA positivity dose dependently, whereas bFGF significantly decreased it. The percent positivity for α-SMA and the gel area showed a significant negative correlation. Conclusions. TGF-β2 increased collagen gel contraction and α- SMA expression in bovine LECs, whereas bFGF decreased these parameters. Because collagen gel contraction was correlated with α-SMA expression, the modulation of LEC contractile activity by growth factors may be related to an effect on α-SMA.

Reconstructive conjunctival surgery for epiphora caused by conjunctivochalasis

Negishi K., Noda T., Tani M., Shimizu K., Akiyama K.

Folia Ophthalmologica Japonica 45 （ 2 ） 174 - 177 1994年

ISSN 0015-5667

We report 3 cases of 3 eyes in which conjunctival reconstructive surgery was performed as treatment for epiphora caused by conjunctivochalasis. Case 1, a 58-year-old male with a previous history of surgeries for pterygium, came to our clinic complaining of epiphora in his right eye. Case 2, a 51-year-old female, began to complain of epiphora in her right eye after trabeculectomy. Case 3, a 70-year-old male, diagnosed as having allergic conjunctivitis, complained of epiphora even after relief from conjunctivitis. All had neither malposition of the lacrimal puncta or eyelid, nor inflammation or tumor of the lacrimal system. Nor had they any disease that could cause overproduction of tears. Drainage of the lacrimal system was normal, with easy passage to the nose, but conjunctivochalasis was found around the inferior puncta in all cases. Following surgical resection and reconstruction of the redundant conjunctiva, the symptoms of epiphora disappeared. Conjunctivochalasis is important as a cause of epiphora; reconstructive surgery for redundant conjunctiva may be useful in relieving the symptom.

流涙症に対する結膜形成術

根岸一乃、野田徹、谷瑞子、清水敬一郎、秋山健一

日本眼科紀要 45 174 - 177 1994年

研究論文（学術雑誌）, 共著

アトピー性白内障の術後経過について

根岸一乃、永本敏之、黒坂大次郎、桂弘

眼科手術（メディカル葵出版） 7 269 - 272 1994年

研究論文（学術雑誌）, 共著

AMO社製5ゾーン屈折型多焦点レンズ（Array(R))の臨床成績（第1報）

根岸一乃、森麻子、原恵美子、黒坂大次郎、永本敏之、ビッセン宮島弘子

あたらしい眼科（メディカル葵出版） 11 445 - 450 1994年

研究論文（学術雑誌）, 共著

アトピー性皮膚炎患児にみられたmadarosisの2例

根岸一乃,　秋山健一

眼科臨床医報 88 1688 - 1690 1994年

Human lens pathology on the first postoperative day of extracapsular extraction

Ayaki M., Negishi K., Fujimura H., Yagi Y.

Folia Ophthalmologica Japonica 44 （ 3 ） 263 - 267 1993年

ISSN 0015-5667

Changes in corneal topography following scleral cauterization in rabbit eyes

Negishi K., Miyajima H., Miki E., Nagamoto T.

Japanese Journal of Clinical Ophthalmology 47 （ 13 ） 1921 - 1924 1993年

ISSN 0370-5579

シリコンIOLの着色

安藤祐子、根岸一乃、野田徹、阿部聡、谷瑞子、秋山健一

眼科手術（メディカル葵出版） 6 115 - 117 1993年

研究論文（学術雑誌）, 共著

白色家兎眼における強膜cauterization施行後の経時的角膜形状変化

根岸一乃、宮島弘子、三木恵美子、永本敏之

臨床眼科（医学書院） 47 1921 - 1924 1993年

研究論文（学術雑誌）, 共著

Nd:YAGレーザー後嚢切開術後の切開縁における特異なElschnig's Pearlsについて

加藤克彦、根岸一乃、三木恵美子、黒坂大次郎、宮島弘子、永本敏之

眼科手術（メディカル葵出版） 6 445 - 448 1993年

研究論文（学術雑誌）, 共著

強膜Cauterization施行前後の角膜形状変化

根岸一乃、宮島弘子、三木恵美子

IOL 7 33 1993年

研究論文（学術雑誌）, 共著

水晶体嚢外摘出術翌日のヒト水晶体嚢の組織所見

綾木雅彦、根岸一乃、藤村博美、八木弥八

日本眼科紀要 44 263 - 267 1993年

研究論文（学術雑誌）, 共著

Longterm changes of the corneal epithelium following penetrating keratoplasty

Negishi K., Murata H., Shinazaki J., Mashima Y., Tsubota K.

Japanese Journal of Clinical Ophthalmology 46 （ 9 ） 1285 - 1288 1992年

ISSN 0370-5579

Benign abducens palsy in a child

Fujimura H., Ayaki M., Negishi K., Ohde H., Oguchi Y.

Japanese Journal of Clinical Ophthalmology 46 （ 12 ） 1611 - 1613 1992年

ISSN 0370-5579

角膜移植術後長期観察例での角膜上皮の形態変化

根岸一乃、村田博之、島崎潤、坪田一男、真島行彦

臨床眼科（医学書院） 46 1285 - 1288 1992年

研究論文（学術雑誌）

Electrophysiological features in optic nerve hypoplasia

Negishi K., Azuma N., Oguchi Y., Uemura Y.

Folia Ophthalmologica Japonica 41 （ 8 ） 1556 - 1560 1990年

ISSN 0015-5667

視神経低形成の電気生理学検討

根岸一乃、東範行、小口芳久、植村恭夫

日本眼科紀要 41 1556 - 1560 1990年

共著

全層角膜移植術後のRelaxing Incision.

根岸一乃、谷野富彦、島崎潤、真島行彦

あたらしい眼科（メディカル葵出版） 7 1843 - 1846 1990年

共著

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