start-ver=1.4 cd-journal=joma no-vol=5 cd-vols= no-issue= article-no= start-page=2847 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200615 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Superior Conjunctiva-Sparing Intraocular Lens-Suturing Technique with Straight Long Suture Needles Advanced from the Opposite Side en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: The superior conjunctiva has to be preserved in eyes with trabeculectomy or in eyes with exfoliation glaucoma for future surgery. Under the circumstances, surgical approach for spontaneous in-the-bag intraocular lens dislocation should be limited to temporal and nasal area of the conjunctiva. A surgical technique for intraocular lens-suturing was designed to spare the superior conjunctiva.
Methods: Dislocated in-the-bag intraocular lens was removed with 25G or 27G vitreous forceps from sclerocorneal incision on the temporal side after the insertion of 25G or 27G trocars with infusion cannula. A straightened long needle with 10-0 polypropylene was inserted through the sclerocorneal incision and pierced to the nasal sclera. With pulling the suture of the nasal haptic, the optic was inserted with a forceps and then the temporal haptic with polypropylene suture was pushed into the posterior chamber. The needle head of the suture tied with the temporal haptic was inserted through the sclerocorneal incision and pushed out through the limbal side port on the nasal side. The needle head was then held with a needle holder and the needle tip was pierced to the temporal sclera. The sutures were secured on the scleral surface and vitrectomy was done to confirm no retinal detachment.
Results: The surgery was done in 18 eyes of 14 consecutive patients: 11 men and 3 women with the age at surgery ranging from 28 to 89 years (mean, 67 years); 4 patients in both eyes on separate occasions, 3 in the right eye, and 7 in the left eye. Predisposing factors for the dislocation were history of vitrectomy in 5 eyes of 4 patients, exfoliation in 6 eyes of 4 patients, history of uveitis in 6 eyes of 5 patients, and history of trabeculectomy in one eye of one patient. All patients had no surgical complication and gained significantly better visual acuity after the surgery (P=0.0008).
Conclusion: It is technically feasible and easy to advance straight needles for intraocular lenssuturing from the opposite side on the nasal-to-temporal plane to spare the superior conjunctiva. en-copyright= kn-copyright= en-aut-name=MatsuoToshihiko en-aut-sei=Matsuo en-aut-mei=Toshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= affil-num=1 en-affil=Graduate School of Interdisciplinary Science and Engineering in Health Systems kn-affil= en-keyword=Trabeculectomy kn-keyword=Trabeculectomy en-keyword=Filtering surgery kn-keyword=Filtering surgery en-keyword=In-the-bag intraocular lens dislocation kn-keyword=In-the-bag intraocular lens dislocation en-keyword=Intraocular lens-suturing kn-keyword=Intraocular lens-suturing en-keyword=Conjunctiva-sparing kn-keyword=Conjunctiva-sparing END start-ver=1.4 cd-journal=joma no-vol=5 cd-vols= no-issue= article-no= start-page=2842 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200613 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Timing for Diagnosis of Anisometropia in Japanese Children with Congenital Eyelid Ptosis en-subtitle= kn-subtitle= en-abstract= kn-abstract=Purpose: The difference in refractive errors between both eyes, namely, anisometropia, is a known complication in congenital blepharoptosis. This study searched the timing of diagnosis of anisometropia in children with congenital blepharoptosis.
Methods: Retrospective review was made on medical records of 20 consecutive patients with congenital blepharoptosis at Okayama University Hospital from 2004 to 2018.
Results: T he age at the initial visit ranged from 1 month to 5 years 1 month (median, 5.5 months), and the follow-up period from 1 year 8 months to 13 years 5 months (median, 5 years 5 months). Blepharoptosis was on the right side in 6 patients, on the left side in 10, and on both sides in 4. Four patients underwent levator muscle plication at the age ranging from 3 months to 6 years 2 months: One patient on the right side, 2 on the left side, and one on both sides. Nine patients were found to have anisometropia, defined as hyperopic difference of 2 or more diopters between both eyes, or astigmatic difference of 2 or more diopters between both eyes, and astigmatism of 3 or more diopters in both eyes (ametropia), at the age ranging from 1 year 3 months to 3 years 6 months (median, 3 years). Four of the 9 patients with anisometropia showed unilateral amblyopia as the best-corrected visual acuity in decimals ranging from 0.2 to 0.5. The remaining 11 patients without anisometropia had normal levels of visual acuity in both eyes. Anisometropia was found in 3 of 4 patients with surgery and 6 of 16 patients with no surgery (no significant difference at chi-square test).
Conclusion: About a half of children with congenital blepharoptosis was found to have anisometropia at the age of 1 to 3 years. Care must be taken on refraction and glasses prescription at these ages. en-copyright= kn-copyright= en-aut-name=MatsuoToshihiko en-aut-sei=Matsuo en-aut-mei=Toshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= affil-num=1 en-affil=Okayama University Graduate School of Interdisciplinary Science and Engineering in Health Systems kn-affil= en-keyword=Congenital blepharoptosis kn-keyword=Congenital blepharoptosis en-keyword=Anisometropia kn-keyword=Anisometropia en-keyword=Levater muscle placation kn-keyword=Levater muscle placation END start-ver=1.4 cd-journal=joma no-vol=5 cd-vols= no-issue= article-no= start-page=2903 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200810 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Step-by-Step Procedure to Test Photoelectric Dye-Coupled Polyethylene Film as Retinal Prosthesis to Induce Light-Evoked Spikes in Isolated Retinal Dystrophic Tissue of rd1 Mice en-subtitle= kn-subtitle= en-abstract= kn-abstract=Purpose: Multielectrode array recording for electric activity in cardiac and neuronal cells has been developed as preclinical tests for drug screening. This study aims to establish an in vitro assay system, using the multielectrode array, to record light-evoked spikes in isolated degenerative retinal tissues of retinal dystrophic rd1 mouse, as a preclinical test to examine the efficacy of photoelectric dye-coupled thin film retinal prosthesis.
Methods: Light-evoked spike response was tested for 1 min at first step in the isolated degenerative retinal tissue of retinal dystrophic rd1 mouse only on the multielectrode array, tested in the same retinal tissue overlain with a plain control film for light-off and light-on 10 min each at second step, and tested in the same tissue overlain with a dye-coupled film at third step. The retinal tissues which showed light-evoked response at first or second step were not used for evaluation at third step.
Results: Residual light-evoked spikes were recorded at first or second step in 18 of 35 retinal tissues (51%) at 6 weeks of the age in rd1 mice, 16 of 44 tissues (36%) at 7 weeks, and 10 of 39 tissues (25%) at 8 weeks. At third step, light-evoked spikes were recorded with dye-coupled films in 8 of 17 retinal tissues (47%) at 6 weeks, 10 of 28 tissues (35%) at 7 weeks, and 8 of 29 tissues (27%) at 8 weeks.
Conclusion: A step-by-step procedure with internal control was established to measure light-evoked spikes by the multielectrode array in the isolated degenerative retinal tissue to evaluate photoelectric dye-coupled thin films. This preclinical study would present one line of evidence for the efficacy of photoelectric dye-coupled thin film retinal prosthesis towards a first-in-human clinical trial. en-copyright= kn-copyright= en-aut-name=MatsuoToshihiko en-aut-sei=Matsuo en-aut-mei=Toshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TeradaKeiko en-aut-sei=Terada en-aut-mei=Keiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SakuraiMikako en-aut-sei=Sakurai en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=LiuShihu en-aut-sei=Liu en-aut-mei=Shihu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YamashitaKoichiro en-aut-sei=Yamashita en-aut-mei=Koichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=UchidaTetsuya en-aut-sei=Uchida en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Regenerative and Reconstructive Medicine (Ophthalmology), Okayama University Medical School and Graduate School of Interdisciplinary Science and Engineering in Health Systems kn-affil= affil-num=2 en-affil=Research Center, Techno Pro, Inc. kn-affil= affil-num=3 en-affil=Research Center, Techno Pro, Inc. kn-affil= affil-num=4 en-affil=Regenerative and Reconstructive Medicine (Ophthalmology), Okayama University Medical School and Graduate School of Interdisciplinary Science and Engineering in Health Systems kn-affil= affil-num=5 en-affil=Polymer Materials Science, Okayama University Faculty of Engineering and Graduate School of Natural Science and Technology kn-affil= affil-num=6 en-affil=Polymer Materials Science, Okayama University Faculty of Engineering and Graduate School of Natural Science and Technology kn-affil= en-keyword=Photoelectric dye kn-keyword=Photoelectric dye en-keyword=Polyethylene thin film kn-keyword=Polyethylene thin film en-keyword=Spike kn-keyword=Spike en-keyword=Degenerative retina kn-keyword=Degenerative retina en-keyword=Retinal dystrophic rd1 mouse kn-keyword=Retinal dystrophic rd1 mouse END