Shin-Ichi Manabe

Inouye Eye Hospital, Karita, Fukuoka, Japan

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Publications (19)86.44 Total impact

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    ABSTRACT: Purpose The aim of this study was to examine the recent status of intraocular lens (IOL) dislocation according to a classification system based on vertical dislocation position, as well as the surgical techniques and outcomes of IOL exchange surgery. Methods The medical records of 230 eyes from 214 consecutive patients who experienced IOL dislocation and underwent exchange surgery between 2006 and 2014 were reviewed. Vertical dislocation sites observed preoperatively under operating microscopy were examined, along with the surgical techniques and outcomes of IOL exchange. Results Dislocation sites included (1) the anterior chamber (12.2 %), (2) pseudophakodonesis (19.1 %), (3) the anterior vitreous cavity (47.4 %), (4) trap door-like dislocation (dangling in the peripheral vitreous cavity; 16.1 %), and (5) the retinal surface (5.2 %). The IOL retained in the anterior segment was moved onto the iris by pulling it up through the limbal side ports with an anterior vitrectomy (67.8 %), or by pushing it up from the pars plana with an anterior vitrectomy (26.5 %), while the IOL dropped on the retina was lifting it up from the retina after pars plana vitrectomy (5.7 %). Mean uncorrected and distance-corrected visual acuity significantly improved postoperatively (p < 0.0001). Major complications included a marked elevation in intraocular pressure (7.8 %), pupillary capture (6.5 %), and vitreous hemorrhage (2.6 %). Conclusions Based on the classification system, approximately 95 % of dislocated IOLs were retained in the anterior segment, and these IOLs were exchanged using an anterior approach through limbal incisions with an anterior vitrectomy. Visual acuity improved significantly, and serious complications were uncommon, probably because the IOL exchange techniques were standardized and simplified without pars plana vitrectomy.
    No preview · Article · Jan 2016 · Albrecht von Graæes Archiv für Ophthalmologie
  • Ken Hayashi · Sumie Kawahara · Shin-Ichi Manabe · Akira Hirata
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    ABSTRACT: Purpose: To investigate the changes in irregular and regular corneal astigmatism with age in eyes that underwent cataract surgery (surgery group) and in eyes that did not undergo surgery (nonsurgery group). Methods: We enrolled 120 eyes in each of four age groups in the surgery and nonsurgery groups: (1) 50 to 59 years of age, (2) 60 to 69 years of age, (3) 70 to 79 years of age, and (4) older than or equal to 80 years of age. Eyes in the surgery group underwent videokeratographic examination, at least 6 months postoperatively. Irregular astigmatism components, corneal asymmetry, and higher-order irregularity components were determined using Fourier analysis. The regular astigmatism vector was decomposed into vertical/horizontal (J0) and oblique (J45) components using power vector analysis. Results: Both the mean corneal asymmetry and higher-order irregularity components significantly increased with increasing age in both groups (P < 0.0001). Higher-order irregularity was greater in the surgery group than in the nonsurgery group in all age groups (P ≤ 0.0128). The asymmetry did not differ significantly between groups. Asymmetry and higher-order irregularity were positively correlated with actual age in both the surgery and nonsurgery groups (P < 0.0001). The J0 decreased significantly with age in both groups (P < 0.0001), whereas the J45 did not vary significantly with age. Conclusions: In patients from 50 to 80 years of age who underwent cataract surgery, irregular corneal astigmatism, both the asymmetry and higher-order irregularity components, increased significantly with increasing age, whereas regular astigmatism induces an against-the-rule shift. The higher-order irregularity component persistently increased postoperatively, whereas the asymmetry component did not change significantly.
    No preview · Article · Dec 2015 · Investigative ophthalmology & visual science
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    ABSTRACT: Exfoliation syndrome (XFS) is a common, age-related, systemic fibrillinopathy. XFS greatly increases risk of exfoliation glaucoma (XFG), a major worldwide cause of irreversible blindness. Coding variants in the lysyl oxidase-like 1 (LOXL1) gene are strongly associated with XFS in all studied populations, but a functional role for these variants has not been established. To identify additional candidate functional variants, we sequenced the entire LOXL1 genomic locus (∼40kb) in 50 indigenous, black South African XFS cases and 50 matched controls. The variants with the strongest evidence of association were located in a well-defined 7kb region bounded by the 3 prime end of exon 1 and the adjacent region of intron 1 of LOXL1. We replicated this finding in U.S. Caucasian (91 cases/1031 controls), German (771 cases/1365 controls), and Japanese (1484 cases/1188 controls) populations. The region of peak association lies upstream of LOXL1-AS1, a long non-coding RNA (lncRNA) encoded on the opposite strand of LOXL1. We show that this region contains a promoter and, importantly, that strongly-associated XFS risk alleles in the South African population are functional variants that significantly modulate the activity of this promoter. LOXL1-AS1 expression is also significantly altered in response to oxidative stress in human lens epithelial cells and in response to cyclic mechanical stress in human Schlemm's canal endothelial cells. Taken together, these findings support a functional role for the LOXL1-AS1 lncRNA in cellular stress response and suggest that dysregulation of its expression by genetic risk variants plays a key role in XFS pathogenesis. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
    Full-text · Article · Aug 2015 · Human Molecular Genetics
  • Ken Hayashi · Soichiro Ogawa · Shin-Ichi Manabe · Akira Hirata
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    ABSTRACT: To examine whether long-term corneal astigmatic change with age after cataract surgery depends on patient age at the time of surgery, and to evaluate whether this change is different from that in eyes that did not undergo surgery. Retrospective cohort study. A total of 437 eyes that underwent phacoemulsification with a 4.1-mm horizontal corneoscleral incision more than 11 year ago and 600 control eyes without surgery were divided into four age groups, 1) 60 years or younger, 2) 61-65 years, 3) 66-70 years, and 4) 71 years or older. The corneal astigmatic change between baseline and 5 years after baseline, between 5 and 10 years, and between baseline and 10 years, as calculated using the polar (X-Y) coordinate analysis, were compared among the age groups and between eyes with and without surgery. Corneal astigmatic change, expressed as X- and Y-coordinates, showed an against-the-rule change of 0.2 to 0.4 diopters during the 10 years in all age groups of the surgery and non-surgery groups. Using multivariate analysis of variance, the mean X- and Y-coordinates did not differ significantly among the age groups in either the surgery or nonsurgery groups (P ≥ .4112). Furthermore, the mean X- and Y-coordinates did not differ significantly between the surgery and nonsurgery groups in any age group (P ≥ .1359). Long-term corneal astigmatic change with age after cataract surgery does not differ significantly depending on patient age at the time of surgery, and is comparable to that of eyes without surgery. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Apr 2015 · American Journal of Ophthalmology
  • Ken Hayashi · Soichiro Ogawa · Shin-Ichi Manabe · Akira Hirata
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    ABSTRACT: To compare monocular and binocular visual function between eyes with a distance-dominant diffractive multifocal intraocular lens (IOL) with low addition power (+2.5 dioptres (D)) and eyes with a monofocal IOL. Sixty-four eyes of 32 patients undergoing implantation of a diffractive multifocal IOL (Alcon ReSTOR +2.5 D, SN6AD2) with a +2.5 D addition and 64 eyes of 32 age-matched patients undergoing implantation of a monofocal IOL (SN60WF) were recruited. At 3 months postoperatively, visual acuity (VA) from far to near distances, contrast VA and that with glare (glare VA), glare disability and glare and halo symptoms were evaluated. For monocular and binocular VA, mean uncorrected and distance-corrected near VA at 0.3 m and intermediate VA at 0.5 m were significantly better in the multifocal group than in the monofocal group (p≤0.0412). VA at other distances did not differ significantly between groups. Photopic and mesopic contrast VA and glare VA and glare disability were similar between groups. The percentage of patients who reported glare symptoms did not differ significantly between groups, while the percentage of patients who reported halo symptoms was greater in the multifocal group (p=0.0009). A distance-dominant diffractive multifocal IOL with +2.5 D near addition provided useful VA at far and intermediate distances. Contrast sensitivity with and without glare and glare symptom with this multifocal IOL were comparable between the multifocal and monofocal IOLs, although halo symptoms were more prominent with the multifocal IOL. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    No preview · Article · Apr 2015 · The British journal of ophthalmology
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    ABSTRACT: Exfoliation syndrome (XFS) is the most common recognizable cause of open-angle glaucoma worldwide. To better understand the etiology of XFS, we conducted a genome-wide association study (GWAS) of 1,484 cases and 1,188 controls from Japan and followed up the most significant findings in a further 6,901 cases and 20,727 controls from 17 countries across 6 continents. We discovered a genome-wide significant association between a new locus (CACNA1A rs4926244) and increased susceptibility to XFS (odds ratio (OR) = 1.16, P = 3.36 × 10(-11)). Although we also confirmed overwhelming association at the LOXL1 locus, the key SNP marker (LOXL1 rs4886776) demonstrated allelic reversal depending on the ancestry group (Japanese: ORA allele = 9.87, P = 2.13 × 10(-217); non-Japanese: ORA allele = 0.49, P = 2.35 × 10(-31)). Our findings represent the first genetic locus outside of LOXL1 surpassing genome-wide significance for XFS and provide insight into the biology and pathogenesis of the disease.
    Full-text · Article · Feb 2015 · Nature Genetics
  • Ken Hayashi · Soichiro Ogawa · Shin-Ichi Manabe · Koichi Yoshimura
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    ABSTRACT: PURPOSE: To compare binocular visual function of pseudophakic patients having modified monovision (0.75 diopter [D] anisometropia) with that of patients having conventional monovision (1.75 D anisometropia). DESIGN: Prospective observational study. METHODS: Eighty-two patients that underwent bilateral implantation of a monofocal intraocular lens were recruited at 3 months postoperatively. Modified monovision was simulated by adding a +0.75 D spherical lens to the nondominant eye, while conventional monovision was simulated by adding a +1.75 D spherical lens. Binocular corrected visual acuity (VA) at various distances, binocular contrast VA (contrast VA) and that with glare (glare VA), and stereoacuity were evaluated. RESULTS: With modified monovision, mean binocular corrected intermediate VA at 1.0 m was 20/19 and near VA at 0.3 m was 20/51, and stereoacuity was 125 +/- 100 seconds of arc. Mean binocular intermediate VA at 1.0 m was significantly better with modified monovision than with conventional monovision (P = .0001), while near VA and intermediate VA at 0.5 m were significantly worse (P < .0001). Mean binocular photopic and mesopic contrast VA and glare VA tended to be better with modified monovision than with conventional monovision, but the difference was not significant. Mean stereoacuity was significantly better with modified monovision than with conventional monovision (P = .0020). CONCLUSIONS: Modified pseudophakic monovision provided excellent binocular VA from far to intermediate distances, although near VA was worse than that with conventional monovision. Contrast VA with and without glare tended to be better and stereoacuity was significantly better with modified monovision, suggesting that this method is useful for correcting presbyopia without marked impairment of binocular function.
    No preview · Article · Oct 2014 · American Journal of Ophthalmology
  • Ken Hayashi · Motoaki Yoshida · Shin-Ichi Manabe · Koichi Yoshimura
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    ABSTRACT: Purpose: To compare changes in intraocular pressure (IOP) immediately after clear corneal incision (CCI) cataract surgery between eyes in which IOP was adjusted to a high or normal range at the conclusion of surgery. Setting: Hayashi Eye Hospital, Fukuoka, Japan. Design: Comparative case series. Methods: Either eye of patients scheduled for phacoemulsification was randomized to 1 of 2 groups as follows: eyes that were to be adjusted to (1) high IOP (22 to 40 mm Hg) or (2) normal IOP (10 to 21 mm Hg). The IOP was measured using a rebound tonometer preoperatively; at the conclusion of surgery; and 15, 30, 60, 120, and 180 minutes and 24 hours postoperatively. The Seidel test and anterior segment optical coherence tomography (AS-OCT) were performed. Results: The mean IOP at the conclusion of surgery was 31.3 mm Hg in the high IOP group and 17.1 mm Hg in the normal IOP group. The IOP decreased to approximately 15 mm Hg by 15 minutes and did not change until 60 minutes in either group. The mean IOP did not differ significantly between groups throughout the observation period (P ≥.0634). Hypotony of 5 mm Hg or less was not detected in any eye. The Seidel test was negative and based on AS-OCT, the wound was closed at 60 minutes in all eyes. Conclusions: After adjusting IOP to a high or normal range, the IOP normalized within 15 minutes postoperatively and was stable for 24 hours. The wound was closed within 60 minutes postoperatively.
    No preview · Article · Nov 2013 · Journal of Cataract and Refractive Surgery
  • Ken Hayashi · Shin-Ichi Manabe · Koichi Yoshimura · Akira Hirata
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    ABSTRACT: PURPOSE: To compare binocular visual function in patients with unilateral cataract after monocular implantation of a multifocal intraocular lens (IOL) and after monocular implantation of a monofocal IOL. SETTING: Hayashi Eye Hospital, Fukuoka, Japan. DESIGN: Nonrandomized comparative study. METHODS: Patients with unilateral cataract scheduled for implantation of a diffractive multifocal IOL and age-matched patients scheduled for implantation of a monofocal IOL were recruited. Three months postoperatively, binocular visual acuity from far to near distances, binocular photopic or mesopic high- to low-contrast visual acuity with and without glare, and stereoacuity were examined. RESULTS: The mean binocular uncorrected near visual acuity or corrected near visual acuity at 0.3 m and uncorrected or corrected intermediate visual acuity at 0.5 m were significantly better in the multifocal group than in the monofocal group (P≤.0196), although there was no significant difference in uncorrected or corrected visual acuity at other distances. Binocular photopic contrast visual acuity and glare visual acuity at low contrasts and mesopic glare visual acuity were significantly worse in the multifocal group than in the monofocal group (P≤.0147). Near stereoacuity was similar between groups. Spectacle independence was significantly better in the multifocal group than in the monofocal group (P≤.0006). CONCLUSION: Monocular implantation of a diffractive multifocal IOL in patients with unilateral cataract provided better binocular near and intermediate visual acuity and spectacle independence than monocular implantation of a monofocal IOL, although distance contrast sensitivity was worse with the multifocal IOL. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
    No preview · Article · Jun 2013 · Journal of Cataract and Refractive Surgery
  • Ken Hayashi · Shin-Ichi Manabe · Koichi Yoshimura · Hiroyuki Kondo
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    ABSTRACT: PURPOSE: To compare corneal endothelial cell damage and ocular inflammation after cataract surgery in eyes with and without pseudoexfoliation (PXF). SETTING: Hayashi Eye Hospital, Fukuoka, Japan. DESIGN: Nonrandomized comparative study. METHODS: This study comprised eyes with PXF (PXF group) and age-matched eyes without PXF (non-PXF group) scheduled for phacoemulsification. Preoperatively and 1 and 3 months postoperatively, corneal endothelial cell density (ECD) and central corneal thickness (CCT) were measured using a specular microscope. Flare intensity was measured using a flare meter, and central macular thickness was measured using optical coherence tomography. RESULTS: Each group had 36 eyes. The mean ECD was significantly lower in the PXF group than in the non-PXF group preoperatively and postoperatively (P≤.0250). The percentage of endothelial cell loss was significantly greater in the PXF group than in the non-PXF group (P≤.0216); the percentage was 9.0% in the PXF group and 3.4% in the non-PXF group 3 months postoperatively. The mean CCT was similar between groups throughout the follow-up period; however, the percentage increase in CCT was significantly greater in the PXF group than in the non-PXF group 1 month postoperatively (P=.0152). Flare intensity and foveal thickness did not differ significantly between groups throughout the follow-up period (P≥.3079). CONCLUSIONS: Corneal endothelial cell loss and a transient increase in CCT were greater after cataract surgery in eyes with PXF than in eyes without PXF. Thus, because the corneal endothelium in eyes with PXF is vulnerable to cataract surgery, careful surgical procedures are necessary. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
    No preview · Article · Apr 2013 · Journal of Cataract and Refractive Surgery
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    ABSTRACT: To examine the effects of a toric intraocular lens (IOL) on the correction of preexisting corneal astigmatism after cataract surgery. Fifty eyes that underwent phacoemulsification were enrolled in three group: (1) eyes with corneal astigmatism ≥1.0 diopter (D) that received a toric IOL (Alcon SN6AT) (toric), (2) eyes with astigmatism ≥1.0 D that received a nontoric IOL (high-astigmatism group), and (3) eyes with astigmatism <1.0 D that received the nontoric IOL (low-astigmatism group). Refractive and corneal astigmatism, astigmatic change, and uncorrected visual acuity (UCVA) were examined. The postoperative refractive astigmatism in the toric and low-astigmatism groups was significantly lower than that of the high-astigmatism group (P ≤ 0.0040), and the reduction in the refractive astigmatism was greater in the toric than in the high- and low-astigmatism groups (P < 0.0001), although the corneal astigmatism was greatest in the toric group, followed by the high- and low-astigmatism groups (P < 0.0001). The mean UCVA in the toric and low-astigmatism groups was better than that in the high-astigmatism group (P < 0.0001). The toric IOL proved effective in astigmatism correction, and both the residual astigmatism and UCVA in the eyes with the the toric IOL were better than those in the eyes with high astigmatism and were comparable to those in the eyes with low astigmatism.
    No preview · Article · Aug 2012 · Japanese Journal of Ophthalmology
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    ABSTRACT: To compare higher-order aberrations (HOAs) and visual function in eyes with a toric intraocular lens (IOL) and eyes with a nontoric IOL. Hayashi Eye Hospital, Fukuoka, Japan. Case-control study. Eyes that had phacoemulsification were enrolled in 1 of the following 3 groups: (1) preoperative corneal astigmatism of 1.00 diopter (D) with a toric IOL (toric group), (2) astigmatism of 1.00 D or more with a nontoric IOL (high-astigmatism group), and (3) astigmatism less than 1.00 D with a nontoric IOL (low-astigmatism group). Ocular and corneal HOAs were measured using a wavefront analyzer. Photopic and mesopic visual acuities at high- to low-contrast visual targets were measured using a contrast sensitivity tester. The mean ocular and corneal total HOAs and 3rd-order aberrations in the toric and high-astigmatism groups tended to be greater than in the low-astigmatism group; HOAs and 3rd-order aberrations at 3 months and HOAs at 6 months were significantly different (P ≤.0403). The mean corrected visual acuity did not differ significantly between groups. However, photopic low-contrast visual acuity (LCVA) and mesopic high- to low-contrast visual acuity was significantly worse in the toric and high-astigmatism groups than in the low-astigmatism group (P ≤.0210). Postoperatively, ocular and corneal HOAs were greater in eyes with a toric IOL and in eyes with high preexisting corneal astigmatism than in eyes with low preexisting astigmatism, which impaired photopic LCVA and mesopic visual acuity. No author has a financial or proprietary interest in any material or method mentioned.
    No preview · Article · May 2012 · Journal of Cataract and Refractive Surgery
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    Ken Hayashi · Akira Hirata · Shin-Ichi Manabe · Hideyuki Hayashi

    No preview · Article · Dec 2011 · American Journal of Ophthalmology
  • Ken Hayashi · Motoaki Yoshida · Shin-ichi Manabe · Akira Hirata
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    ABSTRACT: To compare corneal endothelial damage after cataract surgery in eyes with low endothelial cell density (ECD) and eyes with normal ECD. Hayashi Eye Hospital, Fukuoka, Japan. Case-control study. Cataract surgery was performed in eyes with a low ECD (500 to 1000 cells/mm(2)) (low-density group) and control eyes with a normal ECD. The ECD and central corneal thickness (CCT) were measured preoperatively and 1 and 3 months postoperatively, and the percentage cell loss and increase in CCT were compared. The low-density group and control group each comprised 50 eyes. In the low-density group, 39 eyes had nonprogressive endothelial pathology and 11 had Fuchs dystrophy. The mean ECD was significantly less and the CCT significantly greater in the low-density group than in the control group throughout the follow-up (P ≤.0066). However, no significant difference in the percentage of cell loss was found between groups at 1 or 3 months (5.1%, low-density group; 4.2%, control group) (P ≥.1477). The percentage increase in CCT was significantly greater in the low-density group than in the control group at 1 month (P<.0001), although there was no significant difference at 3 months (0.4% and -0.4%, respectively) (P=.2172). Corneal endothelial damage after cataract surgery in eyes with low ECD was slight and comparable to that in healthy eyes, which suggests that cataract surgery alone (without corneal transplantation) should be performed first.
    No preview · Article · Jun 2011 · Journal of Cataract and Refractive Surgery
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    Ken Hayashi · Motoaki Yoshida · Shin-Ichi Manabe · Hideyuki Hayashi
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    ABSTRACT: To determine the optimal target anisometropia for pseudophakic monovision. Thirty-five bilaterally pseudophakic patients who received monofocal intraocular lenses were included in the study. Binocular corrected distance visual acuity (CDVA) and binocular distance-corrected near visual acuity (DCNVA) and stereoacuity were measured after simulating 1.00, 1.50, and 2.00 diopters (D) of monovision by adding the appropriate spherical lens to the nondominant eye. We presumed that mean binocular DCNVA of 20/40, binocular CDVA of 20/25, and stereoacuity <100 seconds of arc (arc sec) were necessary for successful monovision. With no anisometropia, mean binocular DCNVA was 20/97, binocular CDVA was 20/20, and mean stereoacuity was 71 arc sec. With 1.00 D of monovision, mean binocular DCNVA was only 20/60, although binocular CDVA and mean stereoacuity were sufficient. With 1.50 D of monovision, binocular DCNVA was 20/38, binocular CDVA at other distances exceeded 20/21, and stereoacuity was 100 arc sec, which was a 29-arc sec reduction. With 2.00 D of monovision, binocular DCNVA reached 20/31, but stereoacuity was 158 arc sec, which was an 87-arc sec reduction. The number of patients who met the criteria for successful monovision was significantly greater with 1.50 D of monovision than with 1.00 or 2.00 D of monovision (P=.0134). Pseudophakic monovision with anisometropia of 1.50 or 2.00 D provides useful binocular visual acuity from far to near. However, because stereopsis with 2.00 D of monovision is substantially impaired, approximately 1.50 D of anisometropia is thought to be optimal for successful monovision.
    Preview · Article · May 2011 · Journal of refractive surgery (Thorofare, N.J.: 1995)
  • Ken Hayashi · Akira Hirata · Shin-Ichi Manabe · Hideyuki Hayashi
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    ABSTRACT: To compare long-term change in corneal astigmatism with advancing age between eyes that underwent sutureless cataract surgery and those that did not undergo surgery. Case-control study. A total of 153 eyes that underwent phacoemulsification with a horizontal incision more than 11 years ago (surgery group) and 153 age-matched control eyes that did not undergo surgery (nonsurgery group) were enrolled. The keratometric cylinder at baseline (at 1 year or more postoperatively in the surgery group) and at 5 and 10 years after baseline was examined. The corneal astigmatic change, as calculated using polar value analysis and vector decomposition analysis, between baseline and 5 years after baseline and between 5 and 10 years was compared between the groups. The mean corneal astigmatic change, specifically ΔKP (90) in the polar analysis and against-the-rule component in the vector analysis, between baseline and 5 years and between 5 and 10 years showed an against-the-rule change in both groups. Using multivariate analysis, no significant difference was found in the corneal astigmatic change between the 2 groups at either time interval (P ≥ .126). Furthermore, the change between baseline and 5 years was similar to that between 5 and 10 years in both groups (P ≥ .315). Corneal astigmatism after sutureless cataract surgery shows a long-term against-the-rule change with advancing age, and this change is similar to that of normal cornea, suggesting that the against-the-rule change that occurs subsequently should be taken into consideration at the time of cataract surgery.
    No preview · Article · Feb 2011 · American Journal of Ophthalmology
  • Ken Hayashi · Shin-Ichi Manabe · Motoaki Yoshida · Hideyuki Hayashi
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    ABSTRACT: To examine the effect of astigmatism on visual acuity at various distances in eyes with a diffractive multifocal intraocular lens (IOL). Hayashi Eye Hospital, Fukuoka, Japan. In this study, eyes had implantation of a diffractive multifocal IOL with a +3.00 diopter (D) addition (add) (AcrySof ReSTOR SN6AD1), a diffractive multifocal IOL with a +4.00 D add (AcrySof ReSTOR SN6AD3), or a monofocal IOL (AcrySof SN60WF). Astigmatism was simulated by adding cylindrical lenses of various diopters (0.00, 0.50, 1.00, 1.50, 2.00), after which distance-corrected acuity was measured at various distances. At most distances, the mean visual acuity in the multifocal IOL groups decreased in proportion to the added astigmatism. With astigmatism of 0.00 D and 0.50 D, distance-corrected near visual acuity (DCNVA) in the +4.00 D group and distance-corrected intermediate visual acuity (DCIVA) and DCNVA in the +3.00 D group were significantly better than in the monofocal group; the corrected distance visual acuity (CDVA) was similar. The DCNVA with astigmatism of 1.00 D was better in 2 multifocal groups; however, with astigmatism of 1.50 D and 2.00 D, the CDVA and DCIVA at 0.5m in the multifocal groups were significantly worse than in the monofocal group, although the DCNVA was similar. With astigmatism of 1.00 D or greater, the mean CDVA and DCNVA in the multifocal groups reached useful levels (20/40). The presence of astigmatism in eyes with a diffractive multifocal IOL compromised all distance visual acuities, suggesting the need to correct astigmatism of greater than 1.00 D. No author has a financial or proprietary interest in any material or method mentioned.
    No preview · Article · Aug 2010 · Journal of Cataract and Refractive Surgery
  • Ken Hayashi · Motoaki Yoshida · Shin-ichi Manabe · Hideyuki Hayashi
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    ABSTRACT: To compare all-distance visual acuity and contrast visual acuity with and without glare (glare visual acuity) between phakic eyes with a clear lens and pseudophakic eyes with a monofocal intraocular lens. Hayashi Eye Hospital, Fukuoka, Japan. This study comprised phakic), pseudophakic eyes in 4 age groups (40s, 50s, 60s, 70s). Corrected visual acuity from far to near, contrast visual acuity, and glare visual acuity were examined. The mean corrected intermediate and near visual acuities were significantly better in phakic eyes than in pseudophakic eyes in patients in their 40s and 50s (P<or=.0215); corrected distance visual acuity was similar. In the 60s and 70s age groups, there was no statistically significant difference in corrected visual acuity at any distance. The region of accommodation at which eyes achieved a corrected visual acuity of 20/29 or 20/40 was greater in phakic eyes than in pseudophakic eyes in the 40s and 50s age groups (P<or=.0302) but was similar in 60s and 70s age groups. In all age groups, there were no significant differences in photopic or mesopic contrast visual acuity or glare visual acuity. In patients in their 40s and 50s, the region of accommodation in phakic eyes was greater than in pseudophakic eyes; the region was similar in patients in their 60s and 70s. Because contrast sensitivity with and without glare was similar at all ages, visual function appeared to be comparable in patients 60 years and older.
    No preview · Article · Jan 2010 · Journal of Cataract and Refractive Surgery
  • Ken Hayashi · Shin-Ichi Manabe · Hideyuki Hayashi
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    ABSTRACT: To compare visual acuity from far to near, contrast visual acuity, and acuity in the presence of glare (glare visual acuity) between an aspheric diffractive multifocal intraocular lens (IOL) with a low addition (add) power (+3.0 diopters) and a monofocal IOL. Hayashi Eye Hospital, Fukuoka, Japan. This prospective study comprised patients having implantation of an aspheric diffractive multifocal ReSTOR SN6AD1 IOL with a +3.0 D add (multifocal group) or a monofocal AcrySof IQ SN60WF IOL (monofocal group). Visual acuity from far to near distances, contrast acuity, and glare acuity were evaluated 3 months postoperatively. Each IOL group comprised 64 eyes of 32 patients. For monocular and binocular visual acuity, the mean uncorrected and distance-corrected intermediate acuity at 0.5 m and the near acuity at 0.3 m were significantly better in the multifocal group than in the monofocal group (P</=.0035); distance and intermediate acuity at 0.7 m and 1.0 m were similar between the 2 groups. No significant differences were observed between groups in contrast acuity and glare acuity under photopic and mesopic conditions. Furthermore, no significant correlation was found between all-distance acuity and pupil diameter or between visual acuity and IOL decentration and tilt. The diffractive multifocal IOL with a low add power provided significantly better intermediate and near visual acuity than the monofocal IOL. Contrast sensitivity with and without glare was reduced with the multifocal IOL, and all-distance visual acuity was independent of pupil diameter and IOL displacement.
    No preview · Article · Dec 2009 · Journal of Cataract and Refractive Surgery