Background: The importance of evaluating the outcomes of health care from the standpoint of the patient is now widely recognized. The purpose of this study is to develop and test a Japanese version of the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). Methods: A Japanese version was developed with a previously standardized method. The questionnaire and optional items were completed by 245 patients with cataracts, glaucoma, or age-related macular degeneration, by 110 others before and after cataract surgery, and by a reference group (n = 31). We computed rates of missing data, measured reproducibility and internal consistency reliability, and tested for convergent and discriminant validity, concurrent validity, known-groups validity, factor structure, and responsiveness to change. Results: Based on information from the participants, some items were changed to 2-step items (asking if an activity was done, and if it was done, then asking how difficult it was). The near-vision and distance-vision subscales each had 1 item that was endorsed by very few participants, so these items were replaced with items that were optional in the English version. For example, more than 60% of participants did not drive, so the driving question was excluded. Reliability and validity were adequate for all subscales except driving, ocular pain, color vision, and peripheral vision. With cataract surgery, most scores improved by at least 20 points. Conclusion: With minor modifications from the English version, the Japanese NEI VFQ-25 can give reliable, valid, responsive data on vision-related quality of life, for group-level comparisons or for tracking therapeutic outcomes.

Aims: To compare central corneal thickness measurements of three pachymetry devices in eyes after laser in situ keratomileusis (LASIK). Methods: Central corneal thickness was measured in 203 eyes after myopic LASIK. Orbscan II scanning slit topography (Bausch & Lomb), SP-2000P non-contact specular microscopy (Topcon), and ultrasonic pachymetry (Tomey) were used in this sequence. Results: Three devices gave significantly different corneal thickness readings (p<0.0001, repeated measure analysis of variance). The measurements of Orbscan II (445.6 (SD 60.0) μm) were significantly smaller than those of noncontact specular microscopy (467.9 (SD 40.2) μm; p<0.0001, Tukey multiple comparison) and ultrasonic pachymetry (478.8 (SD 41.9) μm; p<0.0001). The value obtained with SP-2000P non-contact specular microscopy was significantly smaller than that taken with ultrasonic pachymetry (p<0.001). There were significant linear correlations between scanning slit topography and non-contact specular microscopy (Pearson’s correlation coefficient r = 0.912, p<0.0001), non-contact specular microscopy and ultrasonic pachymetry (r = 0.968, p<0.0001), and ultrasonic pachymetry and scanning slit topography (r = 0.933, p<0.0001). Conclusion: In post-LASIK eyes, Orbscan II scanning slit topography significantly underestimated corneal thickness. Non-contact specular microscopy gave smaller thickness readings than ultrasonic pachymetry, but these two units showed an excellent linear correlation.

Purpose. To investigate the influence of pupil diameter on the relation between induced changes in ocular higher-order wavefront aberrations and changes in contrast sensitivity by conventional laser in situ keratomileusis (LASIK) for myopia. methods. In 215 eyes of 117 patients (age, 33.2 ± 8.3 years) undergoing LASIK for myopia of −1.25 to −13.5 D (−5.28 ± 2.55 D), ocular wavefront aberrations and contrast sensitivity function were determined before and 1 month after surgery. Preoperative photopic pupil diameter was measured with a digital camera. Ocular higher-order aberrations were measured for a 4-mm pupil with a Hartmann-Shack wavefront analyzer. The root-mean-square (RMS) of the third- and fourth-order Zernike coefficients was used to represent coma- and spherical-like aberration, respectively. From the contrast-sensitivity data, the area under the log contrast sensitivity function (AULCSF) was calculated. results. One hundred five eyes had a photopic pupil diameter of 4 mm or larger, and the remaining 110 had a photopic pupil diameter smaller than 4 mm. There were no statistically significant differences in the background clinical data between these two groups. In the eyes with a photopic pupil diameter of 4 mm or larger, the changes in third-order comalike aberrations did not correlate with the changes in AULCSF (Pearson correlation coefficient, r = −0.037, P = 0.723) and 10% low-contrast visual acuity (r = 0.125, P = 0.224), but fourth-order spherical-like aberrations correlated significantly with the changes in AULCSF (r = −0.229, P = 0.024) and 10% low-contrast visual acuity (r = 0.221, P = 0.038). In the eyes with photopic pupil size smaller than 4 mm, there were significant correlations between the changes in comalike aberrations and the changes in AULCSF (r = −0.487, P < 0.001) and 10% low-contrast visual acuity (r = 0.310, P = 0.003), but spherical-like aberrations showed no correlation with the changes in AULCSF (r = −0.078, P = 0.485) and 10% low-contrast visual acuity (r = 0.208, P = 0.158). conclusions. In eyes with larger photopic pupil diameter, increases in spherical-like aberration dominantly affect contrast sensitivity, whereas in eyes with smaller pupil size, changes in comalike aberration exert greater influence on visual performance.

Aim: To investigate the influence of tilt and decentration of scleral-sutured intraocular lenses (IOLs) on ocular higher-order wavefront aberrations. Methods: In 45 eyes of 36 patients who had undergone scleral suture fixation of posterior chamber IOL, tilt and decentration of IOLs were determined by Scheimpflug videophotography, and higher-order aberration for a 4-mm pupil was measured using the Hartmann–Shack aberrometer. In another 100 eyes of 100 patients after standard cataract surgery with posterior chamber IOL implantation, ocular higher-order aberration was measured. Results: In eyes with scleral-sutured IOL, the mean (SD) tilt angle and decentration were 4.43° (3.02°) and 0.279 (0.162) mm, respectively. Ocular coma-like aberration in the sutured IOL group was 0.324 (0.170) µm, which was significantly greater than that of the standard cataract surgery group (0.169 (0.061) µm, p<0.001, Student’s t test). No significant difference was found in ocular spherical-like aberration between the sutured IOL group (0.142 (0.065) µm) and standard surgery group (0.126 (0.033) µm; p = 0.254). In the sutured IOL group, IOL tilt significantly correlated with ocular coma-like aberration (Pearson’s correlation coefficient r = 0.628, p<0.001), but no significant correlation was found between IOL tilt and ocular spherical-like aberration (r = 0.222, p = 0.175). The IOL tilt did not correlate with corneal coma-like (r = 0.289, p = 0.171) and spherical-like (r = 0.150, p = 0.356) aberrations. The IOL decentration did not correlate with any higher-order aberrations. Conclusion: In eyes with scleral-sutured posterior chamber IOL, tilting of the lens induces considerable amount of ocular coma-like aberrations.