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PurposeTo compare the visual performance of multifocal intraocular lenses (IOLs) and monofocal IOLs made of the same material.MethodsThe subjects included patients implanted with either Tecnis® monofocal IOLs (ZA9003 or ZCB00) or Tecnis® multifocal IOLs (ZMA00 or ZMB00) bilaterally. We conducted a retrospective study comparing the two types of IOLs. The multifocal group included 46 patients who were implanted with Tecnis® multifocal IOLs bilaterally. The monofocal group was an age- and sex-matched control group, and included 85 patients who were implanted with Tecnis® monofocal IOLs bilaterally. Lens opacity grading, the radius of corneal curvature, corneal astigmatism, axial length and the refractive status were measured preoperatively. Pupil size, ocular aberrometry, distance, intermediate and near visual acuity, contrast sensitivity with and without glare and the responses to a quality-of-vision questionnaire were evaluated pre- and postoperatively.ResultsThe uncorrected near visual acuity was significantly better in the multifocal group, whereas both the corrected intermediate and near visual acuity were better in the monofocal group. Contrast sensitivity (with and without glare) was significantly better in the monofocal group. The rate of spectacle dependency was significantly lower in the multifocal group. There were no significant differences between the two groups regarding most items of the postoperative quality-of-vision questionnaire (VFQ-25), with the exception that the patients in the monofocal group reported fewer problems with nighttime driving.ConclusionsThe multifocal IOLs used in this study reduced spectacle dependency more so than monofocal IOLs and did not compromise the subjective visual function, with the exception of nighttime driving.

To compare the visual performance of a monofocal intraocular lens (IOL) (ZCB00) and a multifocal IOL (ZMB00) of the same material and basic design, we evaluated postoperative parameters at 10 weeks after the last surgery in cataract patients who underwent bilateral ZCB00 or ZMB00 implantation from December 13, 2010, to July 29, 2019, with the right and left lenses implanted within 3 months of each other. The study enrolled 2,230 eyes of 1,115 patients. The monofocal group comprised 904 eyes of 452 patients (72.3 ± 6.8 years; females/males, 268/184), and the multifocal group comprised 1,326 eyes of 663 patients (67.0 ± 7.8 years; females/males, 518/145). Contrast sensitivity (4.0/2.5/1.6/1.0/0.7 degrees), contrast sensitivity with glare (1.6/1.0/0.7 degrees), and the VFQ-25 score for driving at night were significantly better in the monofocal group (p < 0.00068, Wald test). Uncorrected intermediate/near visual acuity and near spectacle independence were significantly better in the multifocal group (p < 0.00068, Wald test). The two IOL groups had different characteristics in terms of contrast sensitivity, night-time driving, uncorrected intermediate/near visual acuity and near spectacle independence.

These results suggest that BK and diazoxide protect retinal neurons against glutamate excitotoxicity by opening the Mit K (ATP) channel. It is suggested that opening of the Mit K (ATP) channel inhibited glutamate-induced generation of superoxide.

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ABSTRACT.Purpose: To confirm the usefulness of direct silicone intubation using a Nunchaku-style tube (NST-DSI) for the treatment of lacrimal passage obstruction. Methods: Included in this retrospective study were 54 cases (45 patients) of adult-onset lacrimal passage obstruction on which NST-DSI was performed. The cases were subdivided into two groups: 29 cases of common canalicular obstruction (the canalicular obstruction group) and 25 cases of nasolacrimal duct obstruction (the duct obstruction group). Results: At the final examination, irrigating fluid passed readily through the lacrimal passage in 39 (72.2%) of the 54 cases. Twenty-two cases (75.9%) were successful in the canalicular obstruction group (29 cases) whereas 17 cases (68.0%) were successful in the duct obstruction group (25 cases). Conclusion: NST-DSI is an effective alternative to treat both common canalicular obstruction and nasolacrimal duct obstruction. We regard NST-DSI as the first choice for the treatment of lacrimal passage obstruction.

The present study aimed to conduct a real-time automatic analysis of two important surgical phases, which are continuous curvilinear capsulorrhexis (CCC), nuclear extraction, and three other surgical phases of cataract surgery using artificial intelligence technology. A total of 303 cases of cataract surgery registered in the clinical database of the Ophthalmology Department of Tsukazaki Hospital were used as a dataset. Surgical videos were downsampled to a resolution of 299 × 168 at 1 FPS to image each frame. Next, based on the start and end times of each surgical phase recorded by an ophthalmologist, the obtained images were labeled correctly. Using the data, a neural network model, known as InceptionV3, was developed to identify the given surgical phase for each image. Then, the obtained images were processed in chronological order using the neural network model, where the moving average of the output result of five consecutive images was derived. The class with the maximum output value was defined as the surgical phase. For each surgical phase, the time at which a phase was first identified was defined as the start time, and the time at which a phase was last identified was defined as the end time. The performance was evaluated by finding the mean absolute error between the start and end times of each important phase recorded by the ophthalmologist as well as the start and end times determined by the model. The correct response rate of the cataract surgical phase classification was 90.7% for CCC, 94.5% for nuclear extraction, and 97.9% for other phases, with a mean correct response rate of 96.5%. The errors between each phase’s start and end times recorded by the ophthalmologist and those determined by the neural network model were as follows: CCC’s start and end times, 3.34 seconds and 4.43 seconds, respectively and nuclear extraction’s start and end times, 7.21 seconds and 6.04 seconds, respectively, with a mean of 5.25 seconds. The neural network model used in this study was able to perform the classification of the surgical phase by only referring to the last 5 seconds of video images. Therefore, our method has performed like a real-time classification.

We compared the visual performance of a diffractive bifocal intraocular lens (IOL) with +4.0 D near addition (ZMB00 [Johnson & Johnson Surgical Vision]) and a rotationally asymmetric refractive IOL with +1.5 D near addition (LS-313 MF15 [Teleon Surgical BV]) 10 weeks after cataract patients’ last surgery for bilateral ZMB00 or LS-313 MF15 implantation, with the lenses of each eye implanted within 3 months of each other. The ZMB00 and LS-313 MF15 groups comprised 1326 eyes of 663 patients (age: 67.0±7.8 years; females/males, 518/145) and 448 eyes of 224 patients (73.6±7.0 years; females/males, 125/99) respectively; patients underwent surgery between 2011 and 2020. A linear mixed-effects model using data for both eyes, with strict adjustments for sex, age, subjective refraction spherical equivalent, subjective refraction cylinder, corneal astigmatism, axial length, corneal higher-order aberrations, and pupil diameter, ensured statistical validity. Compared to the LS-313 MF15 group, the ZMB00 group had significantly superior uncorrected near visual acuity, reduced higher-order aberrations (ocular/internal, scaled to a 4-mm pupil; WF_4_post_O_TotalHOA/Third/Fourth/Trefoil/Coma/Tetrafoil/Spherical, WF_4_post_I_Astigmatism/TotalHOA/Third/Trefoil/Coma/Tetrafoil/Spherical), and superior distance and near spectacle independence (p<0.00068, Wald test). Contrast sensitivity, measured without (6.3°/4.0°/2.5°/1.6°/1.0°/0.7°) or with glare (4.0°/2.5°/1.6°/1.0°/0.7), was significantly better in the LS-313 MF15 group than in the ZMB00 group (p<0.00068, Wald test).