Accuracy of new intraocular lens power calculation formula for short and long eyes using segmental refractive indices.

PURPOSE: To evaluate the accuracy of a new intraocular lens power calculation formula using segmental refractive index-based axial length (AL). SETTING: Chukyo Eye Clinic, Nagoya, Japan. DESIGN: Retrospective observational study. METHODS: This study included patients undergoing preoperative examination for cataract surgery with the new Barrett True AL (BTAL) and Emmetropia Verifying Optical (EVO) formulas using segmental refractive index, and conventional Barrett Universal II (BU II) formula using equivalent refractive index. The predicted refractive error of each formula was compared with the postoperative subjective spherical equivalent. RESULTS: The mean prediction error (MPE) in the short AL group (≤22 mm; 44 eyes) was 0.32 ± 0.40 diopter (D) for BU II, 0.22 ± 0.37 D for BTAL, and 0.10 ± 0.37 D for EVO ( P < .0001). MPE in the long AL group (≥26 mm; 92 eyes) was 0.01 ± 0.32 D for BU II, 0.04 ± 0.32 D for BTAL, and 0.09 ± 0.32 D for EVO ( P < .0001). In patients with an AL ≥ 28 mm, BU II showed a myopic trend in 57.1% of cases, while BTAL and EVO showed a hyperopic trend in 71.4%. The MPE for patients with an AL ≥ 28 mm was -0.16 ± 0.34 D for BU II, 0.18 ± 0.33 D for BTAL, and 0.16 ± 0.32 D for EVO ( P < .0001). CONCLUSIONS: The new EVO and BTAL formulas showed higher accuracy than BU II in short eyes, whereas there was no difference in long eyes.

Accuracy of the Majority Voting Method with Multiple IOL Power Formulae.

Purpose: This study aimed to evaluate the efficacy of a majority decision algorithm that integrates intraoperative aberrometry (IA) and two intraocular lens (IOL) frequency formulas. The primary objective was to compare the accuracy of three formulas (IA; Sanders, Retzlaff, and Kraff/Theoretical (SRK/T); and Barrett Universal II (BUII)), in achieving emmetropia in eyes implanted with TFNT lenses (Alcon). Patients and Methods: A total of 145 eyes of 145 patients were included in the evaluation. Preoperative data were obtained from IOLMaster 700, while intraoperative data were collected from ORA SYSTEMTM. Visual acuity ≥0.8 at the 3-month post-surgery mark was confirmed. We assessed refractive prediction error (RPE), which is the difference between predicted refraction (PR) and postoperative subjective refraction. This evaluation aimed to identify the optimal IOL power with the implemented algorithm. Results: Among the 145 eyes evaluated, 55.9%, 78.7%, and 97.2% achieved postoperative subjective refraction within ±0.13 Diopters (D), ±0.25 D, and ±0.50 D, respectively. The percentages of eyes within ±0.25 D of PR varied by formula type, with values of 57%, 57%, and 54% for IA, BUII, and SRK/T, respectively. For eyes with short to medium axial length (AL<26.00 mm), the percentages within ±0.25 D of RPE were 52%, 58%, and 58% for IA, SRK/T, and BUII, respectively. In contrast, for eyes with long axial length (≥26.00 mm) the percentages were 68%, 52%, and 45% for IA, BUII, and SRK/T, respectively. Conclusion: The proposed majority decision algorithm incorporating IA and two IOL frequency formulas was effective in reducing postoperative refractive error. IA was particularly beneficial for eyes with long axial length. These findings suggest the algorithm has potential to optimize IOL power selection to improve quality of life of patients and clinical practice outcomes.

Gender-based differences in the job titles and lifestyles in the cataract and refractive surgery society in Japan.

To investigate sex differences in the titles and lifestyles of Japanese ophthalmologists, we evaluated work places and private lives. Retrospective cross-sectional study. The study included 1721 members (1344 males and 377 females) of the Japanese Society of Cataract and Refractive Surgery. An online, anonymized questionnaire was distributed to the society members. The questionnaire included 40 questions to collect data on profiles, lifestyles, job title, families, spouses, children, household chores, child-rearing, and work satisfaction. In total, 219 members (144 males and 75 females; 53.4 ±â€…1.0 and 51.3 ±â€…9.9 years old, respectively) completed the questionnaire. The job title, working time, annual income, marriage rate, and the number of children significantly differed between male and female respondents. Female respondents had greater responsibilities toward house chores, child care, and nursing, whereas several male doctors had spouses who did not work or worked for shorter times, earned a lower income, and contributed greater toward family responsibilities. Female respondents changed their job titles after having children more frequently than male respondents. Both males and females had limited time available for community activities and volunteer work. There were no significant differences in daily sleep duration. Both sexes were equally satisfied with their career choice of ophthalmology; however, fewer females recommended ophthalmology as a career for students and children compared to males. There are significant sex differences among ophthalmologists in Japan in terms of family responsibilities; this topic has received insufficient attention.

Comparison of INTREPID® balanced and hybrid tips on anterior capsule rupture in ex vivo porcine eyes.

Phacoemulsification has emerged as the global standard for cataract surgery, and various novel methods, tools, and agents have promoted surgical efficiency and reduced complications. Conventionally, the phaco tip, which cleaves and aspirates the cataractous lens, has been mainly constructed of metal. In this study, the risk of anterior capsule rupture was evaluated under conditions of different power modes, longitudinal (Mode-L), torsional (Mode-T), or both (Mode-LT), and different aspiration powers (0 or 200 mmHg), using a traditional metal phaco tip (Group-M) or a new phaco tip with a high-strength polymer overmold on the needle edge (Group-P), which was developed to reduce the risk of capsule rupture. One hundred twenty porcine eyes were used for experiments within a setting of typical human physiological intraocular pressure. We found that Group-M showed capsule rupture with a smaller ultrasound power than did Group-P, regardless of power mode or aspiration power. In Group-M, there was no significant difference in risk of capsule rupture among power modes, however in Group-P, capsule rupture was least likely to occur with Mode-T. These results provide useful information for inexperienced ophthalmologists to improve surgical safety.

Flexural and Cell Adhesion Characteristic of Phakic Implantable Lenses.

Background and Objectives: In this study, we aimed to compare the physical properties of hole-implantable collamer lenses (H-ICLs) and implantable phakic contact lenses (IPCLs) and investigate their flexural and cell adhesion characteristics. Materials and Methods: Transverse compression load to achieve lens flexion and static Young's modulus were measured in H-ICLs and IPCLs using designated equipment. Load was measured both with and without restraining the optic section of the lenses. Adhesion of iHLEC-NY2 cells to the lens surfaces was examined using phase-contrast microscopy, and cell proliferation activity was evaluated using WST-8 assay. Results: The H-ICL showed a greater tendency for transverse compression load compared to IPCL, while the IPCL showed a higher Young's modulus with respect to the force exerted on the center of the anterior surface of the optic section. The joint between the optic section and haptic support in the IPCL was found to mitigate the effects of transverse compression load. Both lens types showed minimal cell adhesion. Conclusions: Our findings indicate that H-ICLs and IPCLs exhibit distinct physical properties and adhesive characteristics. The IPCL demonstrated higher Young's modulus and unique structural features, while the H-ICL required greater transverse compression load to achieve the flexion required to tuck the haptic supports into place behind the iris to fix the lens. The observed cell non-adhesive properties for both lens types are promising in terms of reducing complications related to cell adhesion. However, further investigation and long-term observation of IPCL are warranted to assess its stability and potential impact on the iris. These findings contribute to a better understanding of the performance and potential applications of H-ICLs and IPCLs in ophthalmology.

Comparison of the efficacy and invasiveness of manual and automated gonioscopy.

PURPOSE: To compare the efficacy and invasiveness of manual gonioscopy and automated 360-degree gonioscopy. METHOD: Manual and automated gonioscopy were performed on 70 patients with glaucoma. Manual gonioscopy was performed by a glaucoma specialist and an ophthalmology resident, and automated gonioscopy (GS-1) was performed by orthoptists. We compared the examination time for acquiring gonioscopic images (GS-1: 16 directions; manual gonioscopy: 8 directions). Furthermore, we compared the pain and discomfort scores during the examination using the Individualized Numeric Rating Scale. Among the images acquired by automated gonioscopy, we also evaluated the percentages of acquired images that could be used to determine the angle opening condition. RESULTS: The examination time was not significantly different between manual (80.2±28.7) and automated gonioscopy (94.7±82.8) (p = 0.105). The pain score of automated gonioscopy (0.22±0.59) was significantly lower than that of manual gonioscopy (0.55±1.11) (p = 0.025). The discomfort score was not significantly different between manual (1.34±1.90) and automated gonioscopy (1.06±1.50) (p = 0.165). Automated gonioscopy successfully acquired clear gonioscopic images in 93.4% of the total images. CONCLUSION: Automated gonioscopy is comparable in examination time and invasiveness to manual gonioscopy and may be useful for 360-degree iridocorneal angle evaluation.

Clinical Performance of a Hydrophobic Acrylic Diffractive Trifocal Intraocular Lens in a Japanese Population.

INTRODUCTION: In this study, clinical performance of a hydrophobic acrylic diffractive trifocal intraocular lens (IOL) with double C-loop haptics was evaluated in Japanese cataract eyes. METHODS: Twenty-three patients had bilateral cataract surgery with the implantation of a trifocal IOL with double C-loop haptics. Postoperative examinations at 6 months included assessing uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA) at 5 m, uncorrected intermediate visual acuity (UIVA), distance-corrected intermediate visual acuity (DCIVA) at 80 cm, uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) at 40 cm. Binocular defocus, contrast sensitivity, spectacle independence, symptoms of photic phenomena and quality of vision (QOV) were also observed. RESULTS: Twenty-three patients received 46 IOLs binocularly. Manifest refraction spherical equivalent was - 0.227 ± 0.385 D (mean ± standard deviation) at 6 months postoperatively. Binocular UDVA, binocular UIVA and binocular UNVA were - 0.101 ± 0.065, - 0.021 ± 0.079 and 0.022 ± 0.095 logMAR units, respectively. Binocular CDVA, binocular DCIVA and binocular DCNVA were - 0.151 ± 0.044, - 0.042 ± 0.067 and - 0.011 ± 0.080 logMAR, respectively. Binocular CDVA of 0.00 logMAR or better was obtained in the defocus from - 3.0 D until + 0.5 D. Only 8.7% of patients required the use of spectacles postoperatively. There were no symptoms of glare, halo and light disturbance in 78.3%, 56.5% and 69.6% of patients, respectively. QOV scores significantly improved postoperatively (P < 0.0001). CONCLUSION: The hydrophobic acrylic trifocal IOL with double C-loop haptics provides good visual performance at all distances and produces high spectacle independence rate and patient satisfaction. TRIAL REGISTRATION NUMBER: NCT04699266 (Clinicaltrials.gov).

SUBRETINAL ENDOSCOPIC SURGERY FOR METASTATIC CHOROIDAL TUMOR.

PURPOSE: To report a case of a metastatic choroidal tumor treated with subretinal endoscopic surgery. METHODS: A single case report. RESULTS: A 68-year-old woman presented with a metastatic choroidal tumor in the right eye and an intraocular pressure of 54 mmHg. Chemotherapy and radiotherapy were ineffective in eliminating her eye pain. Subretinal endoscopic surgery was performed to remove the metastatic choroidal tumor with the complex retinal detachment attached to the posterior surface of the lens. The day after subretinal endoscopic surgery, the patient's intraocular pressure decreased to 7 mmHg and her pain subsided. The chemotherapeutic strategy was modified according to the pathological findings. Survival prognosis improved from 3 to 18 months. Twenty-one months after the surgery, the retinal detachment was reattached under silicone oil with a best-corrected visual acuity of 20/1,000 and an intraocular pressure of 15 mmHg. CONCLUSION: In this case, subretinal endoscopic surgery preserved visual function, eliminating the need for enucleation.

A Nationwide Multicenter Study on 1-Year Outcomes of Posterior Chamber Phakic Intraocular Lens Implantation for Low Myopia.

Purpose: To assess the nationwide multicenter outcomes of posterior chamber phakic intraocular lens implantation with a central hole (EVO-ICL, STAAR Surgical) for patients with low myopia. Methods: This multicenter study comprised 172 eyes of 111 consecutive patients undergoing hole ICL implantation to correct low myopia and myopic astigmatism [manifest spherical equivalent (MSE);-3 diopters (D) or less] at seven nationwide major surgical facilities. We retrospectively determined safety, efficacy, predictability, stability, and adverse events at 1 week, 1, 3, 6, and 12 months postoperatively, and at the final visit. Results: The mean follow-up period was 1.4 ± 1.0 years. Uncorrected and corrected visual acuities at 1 year postoperatively were -0.17 ± 0.12 and -0.24 ± 0.07 logarithm of the minimal angle of resolution (logMAR), respectively. At 1 year postoperatively, 91% and 100% of eyes were within 0.5 and 1.0 D of the target correction, respectively. No significant manifest refraction changes of -0.07 ± 0.26 D occurred from 1 week to 1 year. No vision-threatening complications occurred at any time in this series. Conclusions: According to our experience, the EVO-ICL performed well without significant complications throughout the 1-year observation period, even for the correction of low myopia. It is suggested that current ICL implantation is one of the viable surgical options for correcting low myopia.

Posterior chamber phakic intraocular lens implantation after laser in situ keratomileusis.

BACKGROUND: To assess the multicenter outcomes of posterior chamber phakic intraocular lens implantation with a central hole (EVO-ICL, STAAR Surgical) for patients undergoing previous laser in situ keratomileusis (LASIK). METHODS: This case series enrolled 31 eyes of 21 consecutive patients undergoing EVO-ICL implantation to correct residual refractive errors after LASIK at 7 nationwide major surgical sites. We investigated safety, efficacy, predictability, stability, and adverse events at 1 week, 1, 3, and 6 months postoperatively, and at the final visit. RESULTS: The mean observation period was 1.6 ± 1.8 years. Uncorrected and corrected visual acuities were - 0.14 ± 0.11 and - 0.22 ± 0.09 logMAR at 6 months postoperatively. At 6 months postoperatively, 81% and 100% of eyes were within ± 0.5 D and ± 1.0 D, respectively, of the targeted correction. We found neither significant manifest refraction changes of 0.05 ± 0.38 D from 1 week to 6 months nor apparent intraoperative or postoperative complications in any case. CONCLUSIONS: Our multicenter study confirmed that the EVO-ICL provided good outcomes in safety, efficacy, predictability, and stability, even in post-LASIK eyes. Therefore, EVO-ICL implantation may be a viable surgical option, even for correcting residual refractive errors after LASIK. Trial registration University Hospital Medical Information Network Clinical Trial Registry (000045295).

Multicenter clinical outcomes of hole implantable collamer lens implantation in middle-aged patients.

To assess the multicenter clinical outcomes of the implantation of hole implantable collamer lens (Hole ICL, ICL KS-AquaPORTTM; STAAR Surgical, Nidau, Switzerland) in patients of 45 years or more. We retrospectively assessed the surgery's safety, efficacy, predictability, stability, and adverse events before surgery and after the surgery at 1 week; 1, 3, and 6 months; and 1 year, followed by once every year for approximately 2.2 years. A total of 118 eyes of 65 patients aged 45-65 years with myopic refractive errors ranging from - 2.13 to - 18.75 diopters (D) underwent hole ICL implantation and routine postoperative examinations. The average observation period was 2.2 ± 1.0 years. The safety and efficacy indices were 1.08 ±  0.21 and 0.87 ± 0.25, respectively. Manifest refraction changes of - 0.20 ± 0.43 D occurred from 1 month to the final visit after ICL implantation. Eight eyes (6.8%) developed asymptomatic anterior subcapsular cataract (ASC) immediately after surgery, and three eyes (2.5%) developed clinically significant symptomatic nuclear cataracts during the follow-up period. According to our experience, hole ICL implantation offered favorable outcomes in all measures of safety, efficacy, predictability, and stability, even in middle-aged patients, during the 2.2-year observation period.

Multicenter survey on implantable collamer lens dislocation.

This study aimed to investigate the incidence, patient background, and postoperative prognosis of implantable collamer lens (ICL) dislocation. We retrospectively reviewed all cases of ICL dislocation at four major refractive surgery centers in Japan until December 2019. The incidence, patient background, cause of dislocation, complications of repositioning surgery, and postoperative visual function were investigated. Seven ICL dislocations [0.072% of total ICL-implanted eyes (9775 eyes)] occurred at an average of 28.6 months (11-82 months) postoperatively. All patients were male. Five eyes were injured during sports activities, one due to a fall from a bicycle, and another due to ocular blunt trauma caused by a mortuary tablet. Two patients had re-dislocation in the same eye. Retinal detachment occurred after repositioning surgery in one patient, and scleral buckling surgery was performed without ICL removal. ICL dislocation is a rare complication of ICL surgery; repositioning surgery is effective, but retinal complications may occur.

Treatment of old submacular hemorrhage by subretinal endoscopic surgery and intraoperative subretinal endoscopic findings.

PURPOSE: We report a case of old submacular hemorrhage (SMH) due to polypoidal choroidal vasculopathy (PCV). Subretinal endoscopic surgery (SES) was performed, which improved visual function. In addition, we show the intraoperative findings of subretinal aberrant PCV vessels as seen under endoscopic observation, which cannot be observed by microscopic surgery. OBSERVATIONS: A 71-year-old Japanese man presented with an old dehemoglobinized SMH due to PCV in his left eye. At the time of presentation, three weeks had already passed after the onset of the patient's symptoms, and the best-corrected visual acuity (BCVA) was 20/200. SES was performed to remove the SMH and treat the subretinal PCV lesions. After creating retinal detachment using a 38-gauge cannula, three subretinal 25-gauge trocars were inserted from the sclera to the subretinal space. Then, SES was performed under ophthalmic endoscopic observation with continued subretinal irrigation for maintaining the retinal detachment. After removal of the SMH, subretinal polyp-shaped nodular vascular lesions (polyps) and a branching vascular network, which is located inside the retinal pigmented epithelium, were identified. The sites that presumably originated from the aberrant vessels of the PCV and the associated polyps were coagulated using endodiathermy. After the subretinal procedure, the retina was flattened with fluid/air exchange, and silicone oil (SO) was injected into the vitreous cavity. The SMH completely disappeared after surgery. Although at one-month follow-up BCVA (20/250) was slightly worse than that before surgery, there was an improvement in postoperative retinal sensitivity in the macula compared to that before surgery. At the three-month follow-up, the SO was removed. The BCVA was 20/200 one month after SO removal. No postoperative complications occurred. Additional treatment was not required, including anti-vascular endothelial growth factor therapy, for PCV progression or SMH recurrence in the left eye till the final visit two years after surgery. CONCLUSION AND IMPORTANCE: SES could effectively remove the old SMH, and the activity of PCV was suppressed by intraoperative subretinal coagulation. The retinal sensitivity of the macula improved after the SES. In addition, we observed subretinal polyps and a branching vascular network located internal to the retinal pigmented epithelium under intraoperative subretinal endoscopic observation. SES is a good surgical option for the removal of old SMH or treatment of subretinal lesions.

Rotational stability and clinical outcomes of a new one piece toric intraocular lens with anchor-wing haptics.

BACKGROUND: To evaluate the safety and efficacy of a new toric intraocular lens (IOL) with anchor-wing haptics. METHODS: The new toric IOL with anchor-wing haptics (NS60YT, NIDEK Co., Ltd.) was implanted in eligible patients with age-related cataracts with preoperative corneal astigmatism of 1.0 D or greater at a university hospital and two private hospitals in Japan. The following IOL cylinder powers were evaluated: 1.50 D (NS60YT3), 2.25 D (NS60YT4), 3.00 D (NS60YT5) and 4.50 D (NS60YT7). All patients were assessed out to 12 months postoperatively. The primary endpoint was visual acuity (VA) with spherical addition at 6 months postoperatively, and the primary analysis calculated the proportion of eyes with VA with spherical addition of 0.1 logMAR or better. The magnitude of rotation was compared to the intended axis of IOL implantation at each postoperative examination. Adverse events were evaluated for the safety analysis. RESULTS: This study enrolled 64 eyes of 53 patients. At 6 months postoperatively, for all IOL powers, VA with spherical addition of 0.1 logMAR or better was achieved in 90% [95% confidence interval (CI): 80-96] of eyes. The mean IOL rotation was 5.3 ± 4.3° at 12 months postoperatively. The mean magnitude of rotation ranged from 1.9° to 2.5° between each postoperative examination from 1 day to 12 months. There were no vision-threatening intraoperative or postoperative complications for the duration of the study. CONCLUSIONS: The NS60YT IOL remained stable after implantation and was efficacious for treating 1.00 D or greater astigmatism in patients with senile cataracts. TRIAL REGISTRATION: This study was registered at ClinicalTrials.gov ( NCT03242486 ) on August 8, 2017 - Retrospectively registered.

Refractive prediction error in cataract surgery using an optical biometer equipped with anterior segment OCT.

PURPOSE: To evaluate refractive error after cataract surgery using an optical biometer equipped with anterior segment optical coherence tomography (AS-OCT). SETTING: Chukyo Eye Clinic, Nagoya, Japan. DESIGN: Retrospective observational design. METHODS: In total, 150 patients with cataract (150 eyes, mean age 73.4 ± 8.2 years, men 76, women 74), who underwent measurement of parameters with the AS-OCT scanners ANTERION (AS-OCTB) and IOLMaster 700 (OCTB) before cataract surgery, were enrolled in the study. Refractive prediction error was compared between the 2 devices using the SRK/T, Haigis, and Barrett Universal II (UII) formulas for intraocular lens (IOL) power calculation. RESULTS: There were significant differences between AS-OCTB and OCTB in axial length, mean corneal refractive power, anterior chamber depth, lens thickness, and corneal diameter (n = 150). In the SRK/T formula, the arithmetic means of refractive prediction errors for AS-OCTB and OCTB were -0.06 ± 0.46 diopters (D) and 0.02 ± 0.42 D, respectively. In the Haigis formula, the arithmetic means of refractive prediction errors for AS-OCTB and OCTB were -0.23 ± 0.40 D and -0.08 ± 0.35 D, respectively. In the Barrett UII formula, the arithmetic means of refractive prediction errors for AS-OCTB and OCTB were -0.02 ± 0.38 D and 0.11 ± 0.36 D, respectively. AS-OCTB showed significantly larger refractive prediction error toward myopia than OCTB in all 3 formulas (P < .0001). CONCLUSIONS: The refractive prediction error using AS-OCTB showed a small difference from that using OCTB. While clinically comparable, the 2 methods could drive meaningful differences in IOL selection.

Screening of Keratoconus Using Autokeratometer and Keratometer Keratoconus Index.

The keratometer keratoconus index (KKI) is a diagnostic index for the risk of keratoconus calculated from autokeratometer test values. We partially modified the KKI equation and assessed it without limiting the target age and severity of keratoconus. This retrospective study included 179 eyes of 99 patients with keratoconus and 468 eyes from 235 normal controls. In the modified KKI, oblique astigmatism or against-the-rule astigmatism was defined as ≥1D astigmatism. KKI diagnostic power was analyzed in subgroups of <50 and ≥50-year-old patients, and at different keratoconus stages. Although the sensitivity of modified KKI was comparable with that of original KKI (92.7% vs. 95.5%), modified KKI specificity was significantly higher (79.7% vs. 68.6%) (p = 0.0001). Using the modified KKI, sensitivity reached 100% (4/4) and specificity, 63.5% (33/52), in ≥50-year-old patients, while overall sensitivity in keratoconus ≥stage 2 was 100% (30/30). In conclusion, the modified KKI proved to be effective in keratoconus screening at all stages. However, it should be noted that false-positive frequency is higher in ≥50-year-old patients.

Age-related changes of color visual acuity in normal eyes.

PURPOSE: To evaluate the age-related change in color visual acuity (CVA) in normal eyes. METHODS: In total, 162 normal eyes (162 subjects, women: 52, men: 110, age range: 15-68 years) with best-corrected visual acuity (BCVA) ≥20/13 were enrolled. Fifteen colors from the New Color Test (chroma 6) were applied to Landolt "C" rings, white point D65 was applied as background, and a luminance of 30 cd/m2 was set for both the rings and the background. These rings were used to measure the chromatic spatial discrimination acuity as the CVA value, while changing the stimulus size. Correlations of the CVA value of each color and age were evaluated. Mean CVA values of all 15 colors (logarithm of the minimum angle of resolution) were compared between age groups in 10-year increments. RESULTS: Nine CVA values (red, yellow-red, red-yellow, green, blue-green, green-blue, purple, red-purple, and purple-red) were negatively correlated with age (all p<0.05); the remaining six (yellow, green-yellow, yellow-green, blue, purple-blue, and blue-purple), as well as BCVA were not. The age groups with the best to worst mean CVA values of 15 colors were as follows: 20-29 (mean ± standard deviation, 0.303 ± 0.113), 30-39 (0.324 ± 0.096), 10-19 (0.333 ± 0.022), 50-59 (0.335 ± 0.078), 40-49 (0.339 ± 0.096), and 60-69 (0.379 ± 0.125) years. There were statistically significant differences between mean CVA values of the following groups: 20-29 and 40-49 years; 20-29 and 60-69 years; 30-39 and 60-69 years (all p<0.01). CONCLUSIONS: The CVA values related to the medium/long-wavelength-sensitive cones were more susceptible to aging than those related to the short-wavelength-sensitive cones. This differed from previous reports, and may be related to the difference in the range of foveal cone function evaluated with each examination.

Early Clinical Outcomes of Intrascleral Fixation Using an Intraocular Lens with Hook-Shaped Haptics.

PURPOSE: In this study, we aimed to report on the early results of intrascleral intraocular lens (IOL) fixation using a hook-shaped haptic IOL (hsh-IOL). PATIENTS AND METHODS: We enrolled 27 consecutive eyes of 27 patients (mean age, 74±11.4 years) who underwent intrascleral IOL fixation with an hsh-IOL and were followed-up for 3 months postoperatively. The reasons for surgery included insufficient capsular support, including IOL dislocation, aphakia, or dislocated crystalline lens. The haptic of the hsh-IOL was externalized from the eye using forceps, and the hook was buried in the scleral tunnel. We investigated the preoperative and 3-month postoperative corrected visual acuity (VA), intraocular pressure (IOP), corneal endothelial cell density, refractive prediction error, postoperative intraocular astigmatism, surgically induced astigmatism, and intraoperative and postoperative complications. RESULTS: The mean postoperative corrected VA (logMAR, 0.083±0.18) was significantly better than the mean preoperative value (0.42±0.60, p=0.0007). The 3-month postoperative mean absolute prediction error was 1.00±0.96 D. The mean IOL-induced astigmatism was 0.95±0.70 D. Further, the mean postoperative corneal endothelial cell count (2036±644 cells/mm2) was significantly lower than the preoperative value (2316±527 cells/mm2) (p=0.009). No patient had a 1-month postoperative IOP <5 mmHg or >25 mmHg. There were no intraoperative or vision-threatening complications, such as retinal detachment, endophthalmitis, or IOL dislocation, due to postoperative haptics misalignment. CONCLUSION: Intrascleral IOL fixation using hsh-IOL is an effective option for eyes with insufficient capsular support.

Clinical Outcomes of Endoscope-Assisted Vitreous Surgery for Giant Retinal Tear Detachment.

INTRODUCTION: With the advent of perfluorocarbon liquid (PFCL), the success rate of refractory giant retinal tear (GRT) detachment has dramatically improved. PFCL is a very effective tool when used properly, but in GRT detachment, it may move under the retina through the tear, so it is necessary to devise ways to prevent PFCL from migrating under the retina. Ophthalmic endoscope-assisted vitrectomy may reduce the risk of subretinal migration of PFCL, facilitate safer use of PFCL, and increase the success rate of GRT detachment. The present study aimed to describe the clinical outcomes of endoscope-assisted vitreous surgery for giant retinal detachment. METHODS: Twenty consecutive eyes from 19 patients who had undergone endoscope-assisted vitreous surgery for treatment of a GRT detachment were enrolled. Subretinal fluid drainage, extension of the rolled GRT, and endophotocoagulation under air were performed with the aid of an endoscope, without the use of PFCL. Where necessary, extension of a fixed retinal fold and internal limiting membrane peeling was performed with PFCL. RESULTS: The initial and final retinal reattachment rates were 90 and 95%, respectively. In 3 eyes, a small amount of PFCL was used, and there were no PFCL remnants. The mean follow-up duration was 18 months (range, 3-69 months). After surgery, the mean best-correlated visual acuity significantly improved from 20/514 to 20/41 (p = 0.0008). DISCUSSION/CONCLUSION: Endoscope-assisted vitreous surgery for giant retinal detachment has favourable clinical outcomes for visual acuity and retinal detachment.