Biomedical subjects

T Oshika

Publications and source records attributed to T Oshika.

At least 73 records · Page 4Linked to original sources

PubMed1999

Comparison of sub-Tenon's anaesthesia by different delivery techniques in cataract surgery.

PURPOSE: To compare the analgesic effects of three different delivery techniques of sub-Tenon's anaesthesia in cataract surgery by assessing patients' response to the visceral stimulus. METHODS: A prospective, randomised study was conducted on 345 eyes of 345 patients undergoing phacoemulsification and posterior chamber intraocular lens implantation. They received anaesthetic infiltration into the sub-Tenon's space through a conjunctival incision (115 eyes), infiltration into the posterior sub-Tenon's space (retrobulbar space) through a conjunctival incision (114 eyes), or injection into the intra-Tenon's space (subconjunctival space) without making a conjunctival incision (116 eyes). Pain scores were recorded when the anterior chamber was irrigated with an acetylcholine chloride solution to achieve miosis after lens implantation. RESULTS: There were no significant differences in pain scores among the three groups (chi-squared test of homogeneity, p = 0.814). Approximately 10-20% of patients reported slight to severe pain at the time of acetylcholine administration. CONCLUSIONS: The three anaesthetic delivery methods of sub-Tenon's anaesthesia possess similar and reasonable analgesic effects in cataract surgery, but may not block visceral stimuli completely.

Acetylcholine↗

PubMed1999

Quantitative analysis of regular and irregular astigmatism induced by pterygium.

PURPOSE: To quantitatively evaluate the influence of pterygium and its removal surgery on both regular and irregular corneal astigmatism. METHODS: In 19 eyes of 19 patients undergoing pterygium surgery, videokeratographic measurements were taken before and 1 month after surgery. Using Fourier harmonic analysis, dioptric data on mire rings were decomposed into spherical, regular astigmatism, and irregular astigmatism (decentration and higher order irregularity) components. The distance between the line of sight and the advancing edge of pterygium was measured, and the eyes were classified into two groups: large pterygium group (the distance <2.0 mm, n = 7) and small pterygium group (> or =2.0 mm, n = 12). Fifteen eyes of 15 subjects served as age-matched normal control eyes. RESULTS: Before surgery, the magnitudes of regular astigmatism and higher order irregular astigmatism showed significant correlation with the size of pterygium. Regular astigmatism, asymmetry, and higher order irregularity in the large pterygium group were significantly greater than those of normal control eyes. The pterygium removal surgery significantly improved these changes, but regular astigmatism and higher order irregularity in the large pterygium group still remained significantly greater than those in the normal control eyes. CONCLUSION: Pterygium induces a significant amount of regular and irregular astigmatism in proportion to its size. The removal surgery can improve these changes, but corneal distortion does not normalize completely in eyes with advanced pterygium.

Aged↗

PubMed1999

[Long-term outcome of topical cyclosporine treatment following penetrating keratoplasty].

PURPOSE: To evaluate the long-term outcome of 2% topical cyclosporine A (CsA) treatment as an adjunct to topical corticosteroid in 86 eyes after penetrating keratoplasty (PK). MATERIAL AND METHODS: The subjects were 86 eyes of 83 patients who had undergone PK and received topical CsA treatments. Ninety-seven eyes of 95 patients who had undergone PK and received similar postoperative treatments except for topical CsA treatments served as control: The clinical outcome of PK was evaluated by rates of graft survival and rejection-free graft survival using Kaplan-Meier's method and compared with the log-rank test. The patients were subdivided into high-risk and low-risk groups. The high-risk patients were those who had corneal vascularization in 2 or more quadrants of the cornea preoperatively or who received regrafting. All other patients were assigned to the low-risk group. Thirty-six eyes of the CsA group and 50 eyes of the control group were high-risk cases. RESULTS: In the high-risk patients, the rejection-free graft survival rate was 69.7% in the CsA group and 45.4% in the control group (p = 0.030). However, there was no significant difference in the graft survival rate between the two groups. In the low-risk patients, there was no significant difference in the rates of rejection-free graft survival and graft survival between the CsA and the control group. CONCLUSION: 2% topical cyclosporine is effective in reducing the risk of allograft rejection in high-risk recipients.

Administration, Topical↗

PubMed1999

Changes in corneal wavefront aberrations with aging.

PURPOSE: To investigate whether corneal wavefront aberrations vary with aging. METHODS: One hundred two eyes of 102 normal subjects were evaluated with videokeratography. The data were decomposed using Taylor and Zernike polynomials to calculate the monochromatic aberrations of the cornea for both small (3-mm) and large (7-mm) pupils. RESULTS: For a 3-mm pupil, the amount of total aberrations (Spearman rank correlation coefficient r(s) = 0.145; P = 0.103) and spherical-like aberrations (r(s) = -0.068; P = 0.448) did not change with aging, whereas comalike aberrations exhibited a weak but statistically significant correlation with age (r(s) = 0.256; P = 0.004). For a 7-mm pupil, total aberrations (r(s) = 0.552; P < 0.001) and comalike aberrations (r(s) = 0.561; P < 0.001) significantly increased with aging, but spherical-like aberrations showed no age-related changes (r(s) = 0.124; P = 0.166). Simulated pupillary dilation from 3 mm to 7 mm caused a 38.0+/-28.5-fold increase in the total aberrations, and the extent of increases significantly correlated with age (r(s) = 0.354; P < 0.001). Pupillary dilation influenced the comalike aberrations more in the older subjects than in the younger subjects (r(s) = 0.243; P = 0.006), but such age dependence was not found for spherical-like aberrations (r(s) = 0.141; P = 0.115). CONCLUSIONS: Comalike aberrations of the cornea correlate with age, implying that the corneas become less symmetrical along with aging. Spherical-like aberrations do not vary significantly with aging. Pupillary dilation markedly increases wavefront aberrations, and those effects are more prominent in older subjects than in younger subjects.

Adolescent↗

PubMed1998

Regular and irregular refractive powers of the front and back surfaces of the cornea.

The refractive status of the posterior corneal surface has not been well studied. The purpose of this study is to quantitatively evaluate the regular and irregular astigmatism of the posterior corneal surface. In 50 normal human eyes, topography of the anterior and posterior corneal surface was measured with the scanning-slit videokeratoscope. Using Fourier series harmonic analysis, dioptric data on a mire ring were decomposed into spherical component, regular astigmatism, asymmetry (tilt or decentration), and higher order irregularity. The obtained values for the central 3.0 mm of the posterior corneal surface were -6.55+/-0.32 D (spherical component), 0.18+/-0.16 D (regular astigmatism), 0.40+/-0.22 D (asymmetry), and 0.02+/-0.02 D (higher order irregularity). The posterior to anterior ratios of these parameters were 13.6+/-0.6%, 35.0+/-41.3%, 45.8+/-56.9%, and 39.9+/-39.8%, respectively. The ratio of the spherical component was significantly lower than the other three parameters (P<0.001, Wilcoxon signed-rank test), indicating that non-spherical components (regular and irregular astigmatism) of the posterior corneal surface are not negligible in the optical quality of the cornea. The current results can serve as the control data and reference for the future clinical studies of optical characteristics of the cornea as a whole.

Adult↗

PubMed1998

Arcuate keratotomy to treat corneal astigmatism after cataract surgery: a prospective evaluation of predictability and effectiveness.

OBJECTIVE: Although several nomograms are available for the incisional keratotomy to correct naturally occurring astigmatism, astigmatic keratotomy in eyes after cataract surgery has not been well analyzed. The predictability and effectiveness of arcuate keratotomy in pseudophakic eyes were studied. DESIGN: A prospective, multicenter study. PARTICIPANTS: One hundred four eyes of 86 patients with residual corneal astigmatism of 1.5 diopters (D) or more after cataract surgery were examined. INTERVENTION: Arcuate keratotomy was performed in nine centers by nine surgeons. MAIN OUTCOME MEASURES: The amount of astigmatic correction was calculated using the vector analysis of preoperative and 6-month postoperative refractive cylinder results. RESULTS: Multiple regression analysis showed that optical zone size, number of incisions, and incision length had significant correlations with the amount of astigmatic correction. The regression equation was expressed as effects = (-0.643 x optical zone size) + (0.998 x incision number) + (0.057 x incision length) + 2.356. The parameter of predictability (r2: 35%) was lower than that reported for congenital astigmatism (48 to approximately 56%). A new nomogram was derived based on the multiple regression equation. CONCLUSIONS: Astigmatic keratotomy in pseudophakic eyes is less predictable than that in eyes with idiopathic astigmatism, but the procedure is sufficiently effective in reducing the residual astigmatism after cataract surgery. Individual nomograms are necessary for astigmatic keratotomy in eyes with naturally occurring and postsurgical astigmatism.

Aged↗

PubMed1998

Anterior shift of zonular insertion onto the anterior surface of human crystalline lens with age.

OBJECTIVE: This study aimed to investigate the age-related changes in the position of zonular insertion onto the anterior lens capsule. DESIGN: The study design was an experimental cadaveric eye study. PARTICIPANTS: Two hundred twenty-three cadaveric eyes (range, 16-100 years old) from eye banks in the United States were studied. INTERVENTION: The zonular insertion onto the anterior capsule was detected using a modified posterior photographic technique. MAIN OUTCOME MEASURES: The distances from the anterior zonular insertion (AZI) to the lens equator and to the ciliary sulcus, size of zonular-free zone, lens diameter, ciliary sulcus diameter, and axial length of the globe were measured. RESULTS: Multiple regression analysis showed that age, lens diameter, and axial length of the globe had significant correlations with AZI (r2 = 0.748), among which age showed the highest relevance with AZI. Multiple regression equation was expressed as AZI = (0.0079 x age) + (0.202 x lens diameter) - (0.041 x axial length of the globe) + 0.0114. The increase in AZI was accompanied by a decrease in the size of zonular-free zone with age (r = -0.206, P < 0.001). CONCLUSION: Aging correlates with an increase in the distance from the anterior zonular insertion to the lens equator and a decrease in zonular-free zone.

Accommodation, Ocular↗

PubMed1998

Topographic assessment of irregular astigmatism after photorefractive keratectomy.

OBJECTIVE: To correlate new quantitative topographic indexes of corneal irregular astigmatism to best spectacle-corrected visual acuity (BSCVA) following excimer laser photorefractive keratectomy (PRK). SETTING: Department of Ophthalmology, LSU Eye Center, and Refractive Surgery Center of the South, Ear, Nose & Throat Hospital, New Orleans, Louisiana; Manhattan Eye, Ear and Throat Hospital, New York, New York, USA. METHODS: Videokeratography data (TMS-1) were obtained preoperatively and 1, 3, 6, 12, 18, and 24 months postoperatively from 100 eyes having PRK for low to mild myopia. Algorithms measured fine local irregularity with the surface regularity index (SRIp), varifocality with the coefficient of variation of corneal power (CVPp), and central islands with the elevation/depression magnitude (EDM). RESULTS: The SRIp and CVPp increased after surgery and remained significantly higher than the preoperative levels throughout the 24 month follow-up (P < .05). The increase in EDM was significant from 1 to 6 months (P < .05) but not thereafter. Multiple regression analysis revealed that variables having a statistically significant relationship with postoperative BSCVA were CVPp and EDM at 1 month, CVPp at 3 months, and CVPp, haze, and age at 6 months. No statistically significant correlation between any measures of irregular astigmatism and BSCVA was found after 1 year of follow-up. CONCLUSION: The quantitative measures used in this study are sensitive methods by which irregular astigmatism after keratorefractive procedures can be classified, evaluated, and compared.

Algorithms↗

PubMed1998

Three year prospective, randomized evaluation of intraocular lens implantation through 3.2 and 5.5 mm incisions.

PURPOSE: To compare the long-term clinical results of two small incision cataract surgery procedures. SETTING: Seven centers in Japan. METHODS: Two hundred eyes were randomly assigned to receive a silicone intraocular lens (IOL) through a 3.2 mm incision or a poly(methyl methacrylate) (PMMA) IOL through a 5.5 mm incision. Except for incision size and implantation technique, the surgical methods were identical. Uncorrected and corrected visual acuity, keratometry, flare-cell intensity, specular microscopy, and neodymium:YAG (Nd:YAG) laser posterior capsulotomy rate were analyzed up to 3 years after surgery. RESULTS: Eyes in the 3.2 mm incision group had significantly better uncorrected and corrected visual acuity in the early postoperative period and lower aqueous flare intensity immediately after surgery, but these differences disappeared after the first postoperative month. However, surgically induced astigmatism was significantly less in the 3.2 mm incision group than in the 5.5 incision group throughout the study. The Nd:YAG laser capsulotomy rate was higher in the silicone IOL group (23.5% at 3 years postoperatively) than in the PMMA IOL group (18.4%) but the difference was not statistically significant. CONCLUSION: Smaller incision cataract surgery led to early recovery of visual function in the short term and less induced astigmatism in the long term.

Aged↗

PubMed1998

Corneal hydration and central islands after excimer laser photorefractive keratectomy.

PURPOSE: To determine whether uneven corneal surface hydration during excimer laser photorefractive keratectomy (PRK) is related to postoperative occurrence of central islands. SETTING: LSU Eye Center, New Orleans, Louisiana, USA. METHODS: A retrospective study reviewed intraoperative videotapes and postoperative videokeratography of 49 eyes of 49 patients who had excimer laser PRK for myopia. The uniformity of corneal hydration within the photoablation zone, particularly the frosty appearance of the ablated zone, was characterized. The presence or absence of a topographic central island (steepening of at least 3.0 diopters and 1.5 mm in diameter) was determined from the 1 month postoperative videokeratographs. RESULTS: Twelve eyes (24.5%) developed central islands postoperatively. A statistically significant association was observed between the uneven surface hydration (central accumulation of fluid) within the ablation zone intraoperatively and the formation of central islands postoperatively (P < .001, Kruskal-Wallis test; Kendall tau rank correlation = 0.534; P < .001). CONCLUSION: Nonuniform fluid distribution during photoablation was a risk factor for central island formation after PRK. Intraoperatively, the presence of excess fluid in the central cornea appeared as a shiny area. This mirror-like surface layer may reduce the rate of central ablation by reflecting and absorbing a significant amount of the incident excimer laser light.

Adult↗

PubMed1998

Inflammatory reaction via arachidonic acid cascade after intravitreal injection of endothelin-1.

PURPOSE: To investigate the characteristics of anterior chamber inflammatory reaction induced by intravitreal injection of endothelin-1 (ET-1). METHODS: The time course of changes in aqueous protein concentration (APC) after intravitreal injection of 10(-4), 10(-5), 10(-6) and 10(-7) M ET-1 into rabbit eyes was measured with a laser flare-cell meter. The influence of a topical diclofenac sodium (DFNa) pre- and post-treatment was assessed. Aqueous prostaglandin E2 and leukotriene B4 concentration was quantified using a radioimmunoassay technique. RESULTS: Intravitreal injection of 10(-4) and 10(-5) M ET-1 significantly increased APC, while 10(-6) and 10(-7) M ET-1 did not induce anterior chamber inflammation. After 10(-5) M ET-1 injection, APC reached a maximum at 4 h post-treatment and returned to a normal level 48 h after injection. Eyes treated with 10(-4) M ET-1 displayed a bi-phasic time course, with peak values observed 4 to 8 h as well as 48 h after administration. Pre- and post-treatment with topical DFNa completely suppressed the APC increase in the 10(-5) M ET-1 preparation, and considerably inhibited it in the 10(-4) M ET-1 preparation. After ET-1 injection, aqueous prostaglandin E2 concentration increased significantly, followed by an increase in APC. There were no changes in leukotriene B4 concentration. CONCLUSIONS: ET-1 induces anterior chamber inflammation via the cyclooxygenase pathway of the arachidonic acid cascade. The lipoxygenase pathway is not involved in this reaction.

Administration, Topical↗

PubMed1998

Corneal astigmatism after scleral buckling surgery assessed by Fourier analysis of videokeratography data.

PURPOSE: To evaluate quantitatively the changes in corneal curvature, including irregular astigmatism, after scleral buckling surgery for retinal detachment. METHODS: In 29 eyes of 29 patients undergoing scleral explant surgery, videokeratographic measurements were carried out before and 1 week, 1 month, and 3 months after surgery. Using Fourier harmonic analysis, dioptric data on mire rings were decomposed into spherical, regular astigmatic, and irregular astigmatic (decentration and higher order irregularity) components. RESULTS: The irregular astigmatic component significantly increased at 1 week postoperatively but returned to the preoperative level 1 month after surgery. The regular astigmatism also displayed a transient increase up to 1 month after surgery. The increases in regular astigmatism were significant in eyes that had scleral buckling of < or =180 degrees but not in eyes with buckles extending >180 degrees. CONCLUSION: Changes in irregular astigmatism after retinal detachment surgery were quantitatively evaluated. The scleral buckling surgery causes a transient increase in irregular astigmatism as well as regular astigmatism.

Adolescent↗

PubMed1998

Adhesion of lens capsule to intraocular lenses of polymethylmethacrylate, silicone, and acrylic foldable materials: an experimental study.

AIMS: To investigate the adhesion characteristics of several intraocular lenses (IOLs) to the simulated and rabbit lens capsule. METHODS: Adhesive force to bovine collagen sheets was measured in water with polymethylmethacrylate (PMMA), three piece silicone, and acrylic foldable IOLs. In rabbit eyes, phacoemulsification and IOL implantation were performed. Three weeks later, adhesion between the anterior/posterior capsules and IOL optic was tested, and the capsule was examined histologically. RESULTS: The mean adhesive force to the collagen sheet was 1697 (SD 286) mg for acrylic foldable, 583 (49) mg for PMMA, and 0 mg for silicone IOLs (p = 0.0003, Kruskal-Wallis test). Scores (0-5) of adhesion between rabbit anterior capsule and IOL optic were 4.50 (0.55) for acrylic foldable, 3.20 (0.84) for PMMA, and 0.40 (0.55) for silicone IOLs (p = 0.004). Scores between rabbit posterior capsule and IOL optic displayed a similar tendency; 4.50 (0.84) for acrylic foldable, 3.00 (1.00) for PMMA, and 0.40 (0.55) for silicone IOLs (p = 0.021). Histological observation indicated that the edge of IOL optic suppressed the migration of lens epithelial cells towards the centre of the posterior capsule. This inhibitory effect was most pronounced with acrylic foldable IOL and least with silicone IOL. CONCLUSIONS: The acrylic foldable IOL adhered to the lens capsule more than the PMMA IOL, and the silicone IOL showed no adhesiveness. These differences seem to play a role in preventing lens epithelial cells from migrating and forming posterior capsule opacification.

Acrylic Resins↗

PubMed1998

Corneal topography in LASIK.

Corneal topography plays an important role in laser in situ keratomileusis (LASIK). Preoperative screening permits the detection of keratoconus and other corneal shape anomalies that may be a contraindication for refractive surgery. Monitoring the progress of the surgical outcome with topography is helpful to detect postoperative complications such as decentration and clinically significant irregular astigmatism. LASIK compares favorably with PRK for the treatment of low to moderate myopia in terms of early achievement of refractive stability, but induction of modest amounts of irregular astigmatism can be a concern.

Astigmatism↗

PubMed1998

Quantitative evaluation of irregular astigmatism by fourier series harmonic analysis of videokeratography data.

PURPOSE: To assess quantitatively corneal irregular astigmatism in association with best spectacle-corrected visual acuity. METHODS: Refractive powers on a mire ring measured with computerized videokeratography were decomposed, using the Fourier series harmonic analysis. Extracting spherical and regular astigmatic components, the remaining irregular astigmatic component was quantified on rings 2 through 9. A weighted average was calculated by using the Stiles-Crawford effect on the basis of the radius of each ring of each eye and was used as an index of the irregular astigmatic component. Data analyses were carried out in 108 eyes, including 53 normal eyes, 34 eyes with keratoconus, and 21 eyes that had undergone penetrating keratoplasty for keratoconus. Keratoconic eyes and eyes after keratoplasty were included in the study only if visual acuity, corrected with a hard contact lens, was 20/20 or better. Logarithm of best spectacle-corrected visual acuity, age, type of disease, refractive astigmatism, irregular astigmatic component, surface regularity index, and surface asymmetry index were analyzed. RESULTS: In results of multiple regression analysis, the irregular astigmatic component was significantly correlated with best spectacle-corrected visual acuity (r = -0.744; adjusted R2 = 0.549; P < 0.001), whereas other explanatory variables showed no correlation with best spectacle-corrected visual acuity. CONCLUSIONS: This model of the irregular astigmatic component seems to be an efficient, quantitative means of describing corneal irregular astigmatism.

Adolescent↗

PubMed1998

[Preventive effects of diclofenac ophthalmic solution on post-cataract-surgical cystoid macular edema].

Using eyes undergoing phacoemulsification followed by implantation of a foldable acrylic intraocular lens (IOL) designed for small-incision cataract surgery, a multi-center study was performed to compare a non-steroidal ophthalmic solution (0.1% diclofenac) to a steroidal ophthalmic solution (0.1% fluorometholone) in preventing cystoid macular edema (CME) and inducing disruption of the blood-aqueous barrier determined by laser flare cellmetry. The incidence of CME, noted in 3 out of 53 eyes (5.7%) receiving diclofenac and in 29 out of 53 eyes (54.7%) receiving fluorometholone, was significantly lower in the diclofenac group. The flare in the anterior chamber was also significantly lower in the diclofenac group; when compared between eyes with and without CME, the amount of flare was significantly higher in the former group. These findings suggest that diclofenac effectively prevents CME following cataract surgery and that CME is closely related to the breakdown of the blood-aqueous barrier.

Aged↗

PubMed1997

Transscleral suture fixation of a subluxated posterior chamber lens within the capsular bag.

A 48-year-old man with cataract had uncomplicated phacoemulsification and implantation of a posterior chamber intraocular lens (IOL) into the continuous capsulorhexis. Three years later, part of the capsular bag and a haptic subluxated into the anterior chamber. At the time of repositioning surgery, partial zonular dehiscence and iridocapsular synechias were found. The IOL was repositioned behind the iris; however, subluxation of the lens recurred 1 year later. The IOL and capsular bag were successfully sutured to the sclera by introducing a double-armed polypropylene suture through a limbal stab incision.

Anterior Chamber↗

PubMed1997

[Anterior chamber inflammation after the injection of endothelin-1 into the vitreous and the effect of an anti-prostaglandin agent].

We measured the time course of aqueous protein concentration (APC) with a laser flare-cell meter after the injection of endothelin-1 (ET-1) into the vitreous cavity of pigmented rabbits and investigated the influence of pre- or post-treatment with an anti-prostaglandin agent on these effects of ET-1. Injection of ET-1 significantly increased APC in a dose-dependent fashion. After 10(-5)M ET-1 injection, APC reached maximum at 4 hours after treatment and returned to the normal level 24 hours after the injection. On the other hand, the 10(-4)M ET-1 model displayed a bi-phase time course, with a peak value observed at 4 approximately 8 hours and 48 hours post-treatment, and APC did not return to normal even 7 days after treatment. Treatment with anti-prostaglandin agents before and after the injection blocked APC increase completely in the 10(-5)M ET-1 model, and partially in the 10(-4)M ET-1 model. These results indicate that ET-1 effects on APC are at least partially mediated by the cyclooxygenase pathway of the arachidonic acid cascade.

Animals↗