Optical Quality and Visual Performance With Different Toric Contact Lens Designs.

OBJECTIVES: To evaluate the optical quality of different toric contact lens (CL) designs and compare their on-eye visual correction performance. METHODS: Twenty soft CL wearers aged 20 to 39 years were enrolled. Two daily disposable silicone-hydrogel toric CLs were tested: the "Eyelid Stabilized Design" (ESD-CL) and prism-ballast design (PB-CL); a spherical daily disposable silicone hydrogel CL (spherical CL) was used as a control. On-eye performance was compared for corrected distance visual acuity (CDVA), astigmatism, and ocular higher-order aberrations (HOAs); astigmatism and ocular HOAs were measured with a wavefront sensor. The subjective quality of vision, rated for "blurred vision" and "double vision," lens rotation, and fitting were also compared. RESULTS: The ESD-CLs, PB-CL, and no-CL provided better CDVA than spherical CL ( P <0.05). Compared with spherical CL and no CL, PB-CL and ESD-CLs caused significantly lesser astigmatism ( P <0.05). Coma was significantly lesser with ESD-CLs than that with PB-CL ( P <0.05); total HOAs did not differ among the four conditions. The subjective ratings for blurred and double vision were significantly lower with ESD-CLs than those with spherical CL ( P <0.05). CONCLUSIONS: Toric CLs provide a better CDVA than spherical CLs. However, differences in coma and subjective symptoms may occur because of the design of toric CLs.

Efficacy and safety of brinzolamide/timolol fixed combination compared with timolol in Japanese patients with open-angle glaucoma or ocular hypertension.

PURPOSE: To evaluate the efficacy and safety of brinzolamide 1%/timolol 0.5% fixed-combination (BRINZ/TIM-FC) therapy compared with timolol 0.5% (TIM) monotherapy in Japanese patients with open-angle glaucoma or ocular hypertension. METHODS: This randomized, double-masked, multicenter study included Japanese patients aged ≥20 years. Patients were treated during a 4-week observation period with TIM monotherapy in advance of randomization to treatment with topical BRINZ/TIM-FC or TIM monotherapy twice daily for 8 weeks. The primary endpoint was mean reduction in intraocular pressure (IOP) from baseline to week 8 at 2 hours postinstillation. Adverse events (AEs) were recorded at each visit. RESULTS: A total of 301 patients (BRINZ/TIM-FC, n=150; TIM, n=151; age [mean ± standard deviation], 61±13 years) were enrolled. Mean IOP reductions from baseline were greater with BRINZ/TIM-FC than with TIM at weeks 4 and 8 at 0 and 2 hours postinstillation (all P≤0.0001), with mean reductions of -3.2 mmHg with BRINZ/TIM-FC and -1.4 mmHg with TIM at week 8, 2 hours postinstillation. Although AEs were observed in 19% of all patients (BRINZ/TIM-FC, 20%; TIM, 19%), all AEs were mild or moderate. CONCLUSION: BRINZ/TIM-FC therapy was associated with significantly greater reductions in IOP compared with TIM, and it was well tolerated in Japanese patients with open-angle glaucoma or ocular hypertension.

[Higher-order aberrations in eye implanted with aspherical intraocular lenses].

PURPOSE: To compare efficacy of aspherical intraocular lenses (IOLs) with spherical IOLs by measuring the ocular and internal higher-order aberrations. METHODS: Two hundred four eyes of 145 patients were evaluated at Kozaki eye clinic after phacoemulsification with implantation of 2 aspherical IOLs (45 eyes with the Hoya FY60AD, and 43 eyes with the Nidek N4-18YG); or 3 spherical IOLs (38 eyes with the Hoya YA60BBR, 32 eyes with the Kowa AU6K and 46 eyes with the Alcon MZ30BD). The 3rd and 4th higher-order aberrations (HOAs) were measured with KR9000PW for a 6-mm-diameter pupil, and then the ocular and internal HOAs were compared between the groups. RESULTS: The mean internal spherical aberrations at 1 month after surgery were significantly lower in the FY60AD (-0.14 +/- 0.07 microm) and the N4-18YG (-0.23 +/- 0.08 microm) than in the MZ30BD (0.17 +/- 0.10 microm), the YA60BBR (0.16 +/- 0.08 microm) and the AU6K (0.04 +/- 0.06 microm). The mean ocular HOAs were significantly lower in the FY60AD and the N4-18YG than in the other spherical IOLs. The negative correlation between IOL power and spherical aberrations after surgery was significant for both the aspherical IOL groups of FY60AD and N4-18YG. CONCLUSIONS: The correlation between the IOL power and spherical aberrations, and the HOAs after surgery varied depending on the type of IOL.

Long-term effect of BAK-free travoprost on ocular surface and intraocular pressure in glaucoma patients after transition from latanoprost.

PURPOSE: To assess the efficacy and tolerability of benzalkonium chloride (BAK)-free travoprost after transition from BAK-preserved latanoprost. METHODS: This was a prospective, open-label, multicenter study in patients with open-angle glaucoma or ocular hypertension who had been treated with latanoprost monotherapy for at least 3 months. The main outcome measures were superficial punctate keratopathy (SPK), hyperemia, and intraocular pressure (IOP). At baseline, 1, 3, and 12 months, hyperemia, SPK, and IOP were consecutively assessed. Hyperemia was assessed using a 4-grade scale. SPK was assessed by fluorescence staining observed by Area-Density classification. The IOP was measured by Goldmann applanation tonometry. RESULTS: One hundred and fourteen patients participated in this study. Twenty-eight patients discontinued medications by 1 month. Sixty-seven patients completed the study. Transition from latanoprost to BAK-free travoprost showed no significant effect on hyperemia at 1 month, but showed significant decreases at 3 and 12 months compared with baseline (P<0.05). The prevalence of SPK, especially its severity score, at all points were significantly reduced compared with baseline (P<0.05). The IOP at baseline and at 12 months after transition was 14.9±3.4 and 14.3±3.3 mm Hg, indicating a significant reduction after the change in regimen compared with baseline (P<0.05). CONCLUSIONS: Treatment for 12 months with BAK-free travoprost after BAK-preserved latanoprost resulted in fewer ocular surface complications, as indicated by the reduced prevalence of SPK and decreased hyperemia, and no clinically relevant changes in IOP. BAK-free travoprost may have beneficial effects on the ocular surface while showing IOP-lowering efficacy comparable with BAK-preserved eye drops.