Purpose: To evaluate the accuracy of a new intraocular lens power calculation formula using segmental refractive index-based axial length (AL). Setting: Chukyo Eye Clinic, Nagoya, Japan. Design: Retrospective observational study. Methods: This study included patients undergoing preoperative examination for cataract surgery with the new Barrett True AL (BTAL) and Emmetropia Verifying Optical (EVO) formulas using segmental refractive index, and conventional Barrett Universal II (BU II) formula using equivalent refractive index. The predicted refractive error of each formula was compared with the postoperative subjective spherical equivalent. Results: The mean prediction error (MPE) in the short AL group (≤22 mm; 44 eyes) was 0.32 ± 0.40 diopter (D) for BU II, 0.22 ± 0.37 D for BTAL, and 0.10 ± 0.37 D for EVO (P < .0001). MPE in the long AL group (≥26 mm; 92 eyes) was 0.01 ± 0.32 D for BU II, 0.04 ± 0.32 D for BTAL, and 0.09 ± 0.32 D for EVO (P < .0001). In patients with an AL ≥ 28 mm, BU II showed a myopic trend in 57.1% of cases, while BTAL and EVO showed a hyperopic trend in 71.4%. The MPE for patients with an AL ≥ 28 mm was −0.16 ± 0.34 D for BU II, 0.18 ± 0.33 D for BTAL, and 0.16 ± 0.32 D for EVO (P < .0001). Conclusions: The new EVO and BTAL formulas showed higher accuracy than BU II in short eyes, whereas there was no difference in long eyes.

3,5,3′-Triiodo-L-thyronine (T₃) potentiates apoptosis during the all-trans-retinoic acid-induced differentiation of promyeloleukemic HL-60 cells. We examined whether the retinoid receptor-specific thyroid hormone action is present during differentiation of HL-60 cells in this study. We used two distinct retinoid receptor agonists. T₃ potentiates G₁ arrest induced by Am80, a retinoic acid receptor (RAR)-specific agonist, but had no effect on G₁ arrest induced by HX600, a retinoid × receptor (RXR)-specific agonist. Am80 alone induces the apoptosis, and T₃ enhances it. Although HX600 alone fails to increase the apoptotic fraction, T₃ enables the compounds to induce apoptosis. Am80-induced expression of CD11b, a marker for the differentiation, is enhanced by T₃. However, T₃ or HX600 or both do not affect the expression of CD11b. T₃ does not alter the amount of mRNAs of various members of the bcl-2 family. T₃, however, enhances the Am80-induced expression of bfl-1 and suppression of bcl-2. In contrast, T₃ does not alter either bfl-1 and bcl-2 expression in the presence of HX600. Our observations suggest that cooperative action of T₃ with an RXR-specific ligand is different from that with an RAR ligand in cellular apoptotic regulation and that thyroid hormone may be available as a chemotherapeutic agent in acute leukemia.

To investigate sex differences in the titles and lifestyles of Japanese ophthalmologists, we evaluated work places and private lives. Retrospective cross-sectional study. The study included 1721 members (1344 males and 377 females) of the Japanese Society of Cataract and Refractive Surgery. An online, anonymized questionnaire was distributed to the society members. The questionnaire included 40 questions to collect data on profiles, lifestyles, job title, families, spouses, children, household chores, child-rearing, and work satisfaction. In total, 219 members (144 males and 75 females; 53.4 ± 1.0 and 51.3 ± 9.9 years old, respectively) completed the questionnaire. The job title, working time, annual income, marriage rate, and the number of children significantly differed between male and female respondents. Female respondents had greater responsibilities toward house chores, child care, and nursing, whereas several male doctors had spouses who did not work or worked for shorter times, earned a lower income, and contributed greater toward family responsibilities. Female respondents changed their job titles after having children more frequently than male respondents. Both males and females had limited time available for community activities and volunteer work. There were no significant differences in daily sleep duration. Both sexes were equally satisfied with their career choice of ophthalmology; however, fewer females recommended ophthalmology as a career for students and children compared to males. There are significant sex differences among ophthalmologists in Japan in terms of family responsibilities; this topic has received insufficient attention.

Background: To evaluate the safety and efficacy of a new toric intraocular lens (IOL) with anchor-wing haptics. Methods: The new toric IOL with anchor-wing haptics (NS60YT, NIDEK Co., Ltd.) was implanted in eligible patients with age-related cataracts with preoperative corneal astigmatism of 1.0 D or greater at a university hospital and two private hospitals in Japan. The following IOL cylinder powers were evaluated: 1.50 D (NS60YT3), 2.25 D (NS60YT4), 3.00 D (NS60YT5) and 4.50 D (NS60YT7). All patients were assessed out to 12 months postoperatively. The primary endpoint was visual acuity (VA) with spherical addition at 6 months postoperatively, and the primary analysis calculated the proportion of eyes with VA with spherical addition of 0.1 logMAR or better. The magnitude of rotation was compared to the intended axis of IOL implantation at each postoperative examination. Adverse events were evaluated for the safety analysis. Results: This study enrolled 64 eyes of 53 patients. At 6 months postoperatively, for all IOL powers, VA with spherical addition of 0.1 logMAR or better was achieved in 90% [95% confidence interval (CI): 80–96] of eyes. The mean IOL rotation was 5.3 ± 4.3° at 12 months postoperatively. The mean magnitude of rotation ranged from 1.9° to 2.5° between each postoperative examination from 1 day to 12 months. There were no vision-threatening intraoperative or postoperative complications for the duration of the study. Conclusions: The NS60YT IOL remained stable after implantation and was efficacious for treating 1.00 D or greater astigmatism in patients with senile cataracts. Trial registration: This study was registered at ClinicalTrials.gov (NCT03242486) on August 8, 2017 - Retrospectively registered.

The keratometer keratoconus index (KKI) is a diagnostic index for the risk of keratoconus calculated from autokeratometer test values. We partially modified the KKI equation and assessed it without limiting the target age and severity of keratoconus. This retrospective study included 179 eyes of 99 patients with keratoconus and 468 eyes from 235 normal controls. In the modified KKI, oblique astigmatism or against-the-rule astigmatism was defined as ≥1D astigmatism. KKI diagnostic power was analyzed in subgroups of <50 and ≥50-year-old patients, and at different keratoconus stages. Although the sensitivity of modified KKI was comparable with that of original KKI (92.7% vs. 95.5%), modified KKI specificity was significantly higher (79.7% vs. 68.6%) (p = 0.0001). Using the modified KKI, sensitivity reached 100% (4/4) and specificity, 63.5% (33/52), in ≥50-year-old patients, while overall sensitivity in keratoconus ≥stage 2 was 100% (30/30). In conclusion, the modified KKI proved to be effective in keratoconus screening at all stages. However, it should be noted that false-positive frequency is higher in ≥50-year-old patients.

Purpose: To compare three biometers equipped with swept-source optical coherence tomography (OCT), including ARGOS (OCTB1), IOLMaster 700 (OCTB2), and Anterion (AS-OCTB). The primary aim was to assess the axial length (AL) acquisition success rates, and secondary aims included comparing parameters obtained from the three devices and evaluating postoperative refractive prediction errors. Setting: Chukyo Eye Clinic, Nagoya, Japan. Design: Retrospective observational study. Methods: The study included patients undergoing preoperative assessments for cataract surgery using the three biometers. The AL acquisition success rates and parameters obtained from the three devices were compared and the postoperative refractive prediction errors (defined as the difference between subjective refractive error and predicted refractive error) were assessed at one month after surgery. Results: The study included 361 eyes from 361 patients. The AL acquisition success rates for all patients were 100.0% (n=361) (OCTB1), 98.6% (n=356) (OCTB2), and 96.7% (AS-OCTB) (P < .0001), and those for nuclear sclerosis of grade 4 or higher were 100.0%, 87.8%, and 87.8%, respectively (P = .007). The AL of mature cataract was measurable only with OCTB1 using the enhanced retina visualization mode. Although there were significant differences in parameters obtained on the three devices, there were no significant differences in postoperative refractive prediction errors. Conclusions: OCTB1 demonstrated the highest AL acquisition success rate and was able to measure AL even in eyes with dense or mature cataract. AS-OCTB using a wavelength of 1300 nm showed lower AL acquisition success rates compared to the other two devices probably due to reduced light transmission through the vitreous body.