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Nishi-Tokyo-shi, Japan

Igarashi A.,Kitasato University | Kamiya K.,Kitasato University | Shimizu K.,Kitasato University | Komatsu M.,Sanno Hospital
Journal of Cataract and Refractive Surgery | Year: 2012

Purpose: To assess the time course of refractive and corneal astigmatism after laser in situ keratomileusis (LASIK) in eyes with moderate to high astigmatism. Setting: Department of Ophthalmology, Kitasato University, Kanagawa, Japan. Design: Retrospective case series. Methods: Keratometric readings and corneal astigmatism were determined with an autokeratometer in consecutive patients who had LASIK for moderate to high astigmatism (≥2.00 diopters [D]). Results: The study enrolled 48 eyes of 35 patients with a mean age of 34.0 years ± 8.1 (SD), a mean spherical error of -5.10 ± 2.11 D, and a mean cylindrical error of -2.74 ± 0.99 D. Postoperatively, the mean spherical refraction changed significantly from 0.38 ± 0.80 D at 1 week to -0.13 ± 0.90 D at 1 year (P<.001, Wilcoxon signed-rank test). The mean cylindrical refraction showed no significant change (-0.67 ± 0.54 D at 1 week to -0.63 ± 0.63 D at 1 year) (P=.54). There were significant increases in the flattest and steepest keratometry readings at 1 week and at 1 year. However, no significant change in corneal astigmatism was found at either time point (P=.10). Conclusions: After LASIK, there was significant refractive regression in the spherical component but not in the cylindrical component. This suggests that refractive regression occurs by corneal steepening in the spherical component and that astigmatic regression does not occur, even in moderately to highly astigmatic eyes. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2012 ASCRS and ESCRS.


Kamiya K.,Kitasato University | Shimizu K.,Kitasato University | Igarashi A.,Kitasato University | Kobashi H.,Kitasato University | Komatsu M.,Sanno Hospital
British Journal of Ophthalmology | Year: 2013

Aim: To compare postoperative visual acuity, higher-order aberrations (HOAs) and corneal asphericity after femtosecond lenticule extraction (FLEx) and after wavefront-guided laser-assisted in situ keratomileusis (wfg-LASIK) in myopic eyes. Methods: We examined 43 eyes of 23 patients undergoing FLEx and 34 eyes of 19 patients undergoing wfg-LASIK to correct myopia. Ocular HOAs were measured by Hartmann-Shack aberrometry and corneal asphericity was measured by a rotating Scheimpflug imaging system before and 3 months after surgery. Results: There was no statistically significant difference in uncorrected (p=0.66 Mann-Whitney U-test) or corrected distance visual acuity (p=0.14) after two surgical procedures. For a 6-mm pupil, the changes in fourth-order aberrations after FLEx were statistically significantly less than those after wfg-LASIK (p<0.001). On the other hand, there were no statistically significant differences in the changes in third-order aberrations (p=0.24) and total HOAs (p=0.13). Similar results were obtained for a 4-mm pupil. The positive changes in the Q value after FLEx were statistically significantly less than those after wfg-LASIK (p=0.001). Conclusions: In myopic eyes, FLEx induces significantly fewer ocular fourth-order aberrations than wfg-LASIK, possibly because it causes less oblation in the corneal shape, but there was no statistically significant difference in visual acuity or in the induction of third-order aberrations and total HOAs. It is suggested that FLEx is essentially equivalent to wfg-LASIK in terms of visual acuity and total HOA induction, although the characteristics of HOA induction are different.


Kamiya K.,Kitasato University | Shimizu K.,Kitasato University | Kobashi H.,Kitasato University | Igarashi A.,Kitasato University | Komatsu M.,Sanno Hospital
British Journal of Ophthalmology | Year: 2015

Aim: To assess the clinical outcomes following the use of toric implantable collamer lenses (toric ICL, STAAR Surgical) for the correction of high myopic astigmatism with keratoconus. Methods: This retrospective study evaluated 21 eyes of 11 patients with spherical equivalents of -9.70±2.33 D (mean±SD) and astigmatism of -3.21±1.56 D who underwent toric ICL implantation for keratoconus. Preoperatively, and at 1, 3 and 6 months and 1, 2 and 3 years postoperatively, we assessed the safety, efficacy, predictability, stability and adverse events of the surgery. Results: The logarithm of the minimum angle of resolution (logMAR) uncorrected distance visual acuity (UDVA) and the logMAR corrected distance visual acuity (CDVA) were -0.06±0.11 and -0.12±0.09, respectively, at 3 years postoperatively. At 3 years, 67% and 86% of the eyes were within ±0.5 and ±1.0 D, respectively, of the targeted correction. Manifest refraction changes of 0.04±0.33 D occurred from 1 month to 3 years postoperatively. No significant change in manifest refraction (analysis of variance, p=0.989) or keratometry ( p=0.951), or visionthreatening complications occurred during the observation period. Conclusions: Toric ICL implantation is beneficial according to measures of safety, efficacy, predictability and stability for the correction of refractive errors for keratoconus during a 3-year observation period. The disease did not progress even in the late-postoperative period, suggesting the viability of this procedure as a surgical option for the treatment of such eyes. © 2015, BMJ Publishing Group. All rights reserved.


Iijima K.,Kitasato University | Kamiya K.,Kitasato University | Shimizu K.,Kitasato University | Igarashi A.,Kitasato University | Komatsu M.,Sanno Hospital
Journal of Cataract and Refractive Surgery | Year: 2015

Purpose To retrospectively assess the demographics of patients having cataract surgery in eyes with previous laser in situ keratomileusis (LASIK). Setting Department of Ophthalmology, Kitasato University, Kanagawa, and Sanno Hospital, Tokyo, Japan. Design Retrospective case series. Methods This study evaluated eyes of consecutive patients scheduled for cataract surgery after previous LASIK (Group 1). The control groups comprised eyes with axial lengths (ALs) matched with ALS in Group 1 (Group 2) and all eyes scheduled for cataract surgery (Group 3). Assessed were age, sex, corrected distance visual acuity, manifest refraction, keratometry (K) readings, corneal astigmatism, and corneal higher-order aberrations (HOAs). Results Group 1 comprised 40 eyes of 40 patients; Group 2, 606 eyes of 606 patients; and Group 3, 3642 eyes of 3642 patients. The mean age at cataract surgery of patients in Group 1 was 54.6 years ± 8.1 (SD), which was significantly younger than in Group 2 (by approximately 10 years) and Group 3 (by approximately 15 years) (P <.001, Student t test). In Group 1, 70.0% of patients were men, a significantly higher percentage than in Groups 2 and 3 (P <.05, Fisher exact test). The rate of corneal HOAs was significantly higher in Group 1 than in Groups 2 and 3 (P <.05, Student t test). There were no significant differences in other demographics except in K readings. conclusion A long AL and an increase in corneal HOAs might contribute to a tendency for cataract surgery to be performed earlier in eyes in which LASIK has been performed. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned. © 2015 ASCRS and ESCRS.


Matsubara K.,Nishi Kobe Medical Center | Hoshina K.,Sanno Hospital | Suzuki Y.,Tokyo Womens Medical University
International Journal of Infectious Diseases | Year: 2013

Objectives: To clarify the incidence and prognosis of early-onset (EOD) and late-onset (LOD) GBS disease in Japan. To evaluate the influence of national guidelines issued in 2008 on the epidemiology of GBS disease. Methods: Retrospective nationwide questionnaire surveillance on culture-confirmed GBS infections between 2004 and 2010. Results: Eighty-eight EOD and 162 LOD cases were reported from 152 participating hospitals. The case fatality of EOD was 13.6% and of LOD was 8.0%. Premature birth <37 weeks (. p<. 0.001) and low birth weight <2500. g (. p<. 0.001) were significantly associated with EOD mortality. A high rate of neurological sequelae was noted in meningitis in EOD (8/24) and LOD (29/85) cases. Based on a live-birth number of 438 359 and inborn case numbers of 36 EOD and 42 LOD, the incidence of EOD and LOD were estimated to be 0.08 (95% confidence interval (CI) 0.06-0.11)/1000 and 0.10 (95% CI 0.07-0.12)/1000 live-births, respectively. Before (2004-2008) and after (2009-2010) the issue of guidelines, the mortality of EOD (from 14.8% to 11.8%) and LOD (from 9.8% to 2.5%) improved, but the incidence was unchanged. Conclusions: The incidence of EOD and LOD is apparently low in Japan, but the mortality and morbidity rates remain substantial. The issue of national guidelines did not affect the incidence. © 2012 International Society for Infectious Diseases.

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