Possibility for Prevention of Type 2 Diabetes Mellitus and Dementia Using Three Kinds of Brown Rice Blends after High-Pressure Treatment.

As it has been reported that type 2 diabetes mellitus increases the risk of Alzheimer's disease, we investigated how to prevent type 2 diabetes and dementia using biofunctional boiled rice. We adopted unpolished super-hard rice (SHBR) for diabetes and wax-free unpolished black rice (WFBBR) for dementia and blended those with ordinary non-polished rice (KBR) (blending ratio 4:4:2), adding 2.5% waxy black rice bran (WBB) and 0.3% rice oil after high-pressure treatment (HPT) (WFBSK) to improve its palatability. This boiled rice is rich in dietary fiber, anthocyanin, free ferulic acid and ß-secretase inhibitory activity. A randomized, parallel-group comparison study was conducted for 12 weeks with 24 subjects, using Cognitrax to evaluate their cognitive function primarily. Furthermore, as the secondary purpose, we performed a single-dose test for postprandial blood glucose and insulin secretion at the end of the human intervention test. After 12 weeks, consumers of the WFBSK rice exhibited significant improvement in language memory by cognitive test battery compared with those who consumed the control white rice (p < 0.05). Moreover, subjects who consumed the WFBSK rice had lower insulin secretion levels than those who consumed the control polished rice (p < 0.05).

Conductive keratoplasty for the treatment of presbyopia: comparative study between post- and non-LASIK eyes.

PURPOSE: To evaluate the efficacy and safety of conductive keratoplasty (CK) for the treatment of presbyopia and analyze the differences in the effects between post- and non-laser in situ keratomileusis (LASIK) eyes. Clinical preoperative factors that could affect the predictability of CK were also analyzed. METHODS: The visual and refractive outcomes of CK for the treatment of presbyopia in 14 eyes of 13 post-LASIK patients (post-LASIK group mean age 50.9 ± 3.4 years) and those of 25 eyes of 25 non-LASIK patients (non-LASIK group mean age 52.4 ± 4.0 years) were studied. The clinical efficacy, safety, stability, and predictability of CK were statistically evaluated. RESULTS: The mean (logarithm of the minimum angle of resolution [logMAR] ± standard deviation [SD]) of preoperative uncorrected near visual acuity (UNVA) and manifest refraction spherical equivalent (MRSE) were 0.64 ± 0.25 diopter (D) and 0.35 ± 0.48 D, respectively, in the post-LASIK group, and 0.71 ± 0.20 D and 0.64 ± 0.61 D, respectively, in the non-LASIK group. At 6 months after CK, the mean UNVA and MRSE were 0.07 ± 0.13 D and -1.59 ± 0.86 D, respectively, in the post-LASIK group, and 0.07 ± 0.12 D and -1.06 ± 0.56 D, respectively, in the non-LASIK group. At 1 year after CK, the mean UNVA and MRSE were 0.30 ± 0.17 D and -0.58 ± 0.52 D, respectively, in the post-LASIK group, and 0.28 ± 0.34 D and -1.56 ± 0.62 D, respectively, in the non-LASIK group. There was no significant difference between the two groups in either factor at 6 months postoperative (Student's t-test, P > 0.05). At 1 year after CK, all the treated eyes maintained corrected distance visual acuity better than -0.08 (logMAR). The mean cylindrical errors were within ±1.00 D in 100% of the post-LASIK and non-LASIK patients. As for the preoperative clinical factors evaluated for their potential relationship to the predictability of CK, none showed significant effect on the clinical outcomes. CONCLUSION: CK is demonstrated to be safe for the treatment of presbyopia in post-LASIK patients as well as in non-LASIK patients, though needed longer observation in terms of factors affecting predictability.

Detection of cyclotorsional rotation during excimer laser ablation in LASIK.

PURPOSE: Positionally induced cyclotorsion could be an important factor in the correction of astigmatism during refractive surgery. We analyzed the change in cyclotorsional rotation during excimer laser ablation in LASIK surgery using the NIDEK Torsion Error Detector (TED). METHODS: One hundred ten patients (192 eyes) who underwent LASIK for myopic astigmatism, using the NIDEK Advanced Vision Excimer Laser (NAVEX) were measured for cyclotorsion during surgery using the TED system. The manifest refraction of these patients was -6.80+/-2.74 diopters (D) (range: -1.00 to -13.75 D). The iris pattern of the patient's eyes in the supine position was recorded via a CCD camera in the EC5000CXII excimer laser system, and it was compared to the iris pattern acquired during OPD-Scan measurement in the sitting position. RESULTS: During laser ablation, the degree of cyclotorsional rotation detected by TED was 1.33+/-1.88 degrees (range: -6.33 to 2.99 degrees) clockwise and 1.00+/-1.79 degrees (range: -3.70 to 7.34 degrees) counterclockwise. The absolute degree of torsion error detected by the TED system was 2.33+/-1.16 degrees (range: 0 to 6.21 degrees). CONCLUSIONS: The effectiveness of the cylinder treatment can be reduced due to torsion errors. The degree of cyclotorsion constantly changes during laser ablation. Therefore, a monitoring system should be developed for the measurement of torsion error, and this will enable the maximum possible correction of the error during laser ablation.

Topography-guided ablation for treatment of patients with irregular astigmatism.

PURPOSE: To evaluate the customized aspheric treatment zone (CATz) topography-guided ablation for the correction of irregular astigmatism induced by initial corneal refractive surgery or corneal injury. METHODS: CATz ablation was performed on 32 eyes of 28 patients. Each procedure was performed by photorefractive keratectomy (PRK) or LASIK using a NIDEK EC-5000 excimer laser. The eyes had decentered ablations, small optical zones, decreased best spectacle-corrected visual acuity (BSCVA), and asymmetrical astigmatism. Subjective symptoms, uncorrected visual acuity (UCVA), BSCVA, refraction, corneal topography, and higher order aberrations were measured. Mean follow-up was 161.9 +/- 129.9 days (range: 90 to 492 days). RESULTS: Data obtained at final postoperative follow-up show that UCVA and BSCVA increased by > or = 2 lines after CATz ablation in 17 and 11 eyes and decreased in 4 and 2 eyes, respectively. Higher order aberrations were decreased in 16 eyes and increased in 1 eye. Topographical maps were improved with decreased surface regularity index (20 eyes) and surface asymmetry index (22 eyes). Seven eyes required further enhancement for residual refractive errors. Thirteen patients (15 eyes) claimed they were satisfied with the outcome, 6 patients (7 eyes) stated that the outcome was lower than expected, and 4 patients (4 eyes) stated they were dissatisfied. CONCLUSIONS: CATz topographic ablation effectively improves the quality of vision and symptoms in the majority of patients with irregular corneal astigmatism from previous excimer laser refractive surgery. However, residual or induced refractive errors may need to be corrected with a second operation after CATz.

Comparison of LASIK using the NIDEK EC-5000 optimized aspheric transition zone (OATz) and conventional ablation profile.

PURPOSE: To compare a new ablation algorithm termed the optimized aspheric transition zone (OATz) with the conventional laser ablation profile for correction of myopic astigmatism. METHODS: LASIK using OATz profile #6 or using conventional ablation profile was performed on 98 eyes of 53 patients (OATz #6 group) and 111 eyes of 66 patients (control #6 group), respectively. Further, LASIK using OATz profile #5 or using the conventional ablation profile was performed on 109 eyes of 58 patients (OATz #5 group) and 109 eyes of 75 patients (control #5 group), respectively. The effective optical zone, uncorrected visual acuity, manifest refraction, aberrations, contrast sensitivity, and patient satisfaction at 3 months postoperatively were compared between the OATz #6 and control #6 groups and between the OATz #5 and control #5 groups. RESULTS: The effective optical zones in the OATz #6 group (6.45 +/- 0.29 mm) or OATz #5 group (6.40 +/- 0.21 mm) were significantly larger than those in the control #6 group (6.33 +/- 0.27 mm) or control #5 group (6.26 +/- 0.25 mm) (P < .01), respectively. Uncorrected visual acuity and manifest refraction were similar in all groups. The changes in contrast sensitivity were significant and favored the OATz #6 (P < .01) and OATz #5 groups (P < .05). The patient satisfaction survey found no statistical difference at 3 months postoperatively. CONCLUSIONS: Patients treated with the OATz profiles had better visual quality as measured by contrast sensitivity and also had larger effective optical zones as compared with those treated by the conventional ablation profile.

Ocular integrity after anterior ciliary sclerotomy and scleral ablation by the Er:YAG laser.

PURPOSE: To establish the risk of ocular rupture after proposed surgical reversal of presbyopia by anterior ciliary sclerotomy (ACS) or by the Er:YAG laser (HOYA Continuum, Tokyo, Japan). METHODS: A total of 45 pig eyes (15 control eyes) were examined. Fifteen eyes were placed into one of two study groups and another 15 eyes were used as controls. One group underwent scleral incisions with the use of a diamond knife, and the other group underwent Er:YAG laser scleral incisions. In both study groups, 8 radial incisions, 2 parallel cuts each at 4 quadrants, 2 mm apart, 4 mm long, and starting 2 mm away from the limbus, were made. A 3-kg steel weight was released from a measured height to the pig's eye, and ocular rupture energy (joules) was measured. RESULTS: The mean rupture energy was 26.0 J for control eyes, 15.7 J for the ACS eyes, and 12.2 J for the Er:YAG laser eyes. The ACS and the Er:YAG laser eyes ruptured at significantly lower energies (ACS, P < .001; Er:YAG, P < .001) than the control eyes. Comparison of the ACS group and the Er:YAG laser group showed no statistically significant difference (P = .052) in rupture energy. CONCLUSIONS: Scleral incisions by ACS and the Er:YAG laser significantly weakened ocular integrity compared with control eyes. Any patients undergoing ACS or Er:YAG laser scleral incision should be informed of the attendant potential risk after ocular trauma.

INTACS before or after laser in situ keratomileusis: correction of thin corneas with moderately high myopia.

PURPOSE: Intrastromal corneal ring segments (INTACS Micro-Thin Prescription Inserts by Addition Technologies, Fremont, Calif) were inserted as a combined surgery with laser in situ keratomileusis (LASIK) in six eyes with thin corneas to correct moderately high myopia. METHODS: INTACS were implanted before LASIK (INTACS-LASIK) in three eyes and after LASIK (LASIK-INTACS) in three eyes. Mean preoperative manifest spherical equivalent refraction was -7.88 diopters. Mean follow-up was 306 days. RESULTS: No intraoperative complications occurred. The LASIK-INTACS eyes were slightly more overcorrected than the INTACS-LASIK eyes because of the enhanced performance of INTACS in the thinned corneal tissue. Induced astigmatism by INTACS per se was less in the LASIK-INTACS eyes than in the INTACS-LASIK eyes. At last examination, uncorrected visual acuity was better than 20/25 in all eyes. Best spectacle-corrected visual acuity was within 1 line of the preoperative value in all eyes. CONCLUSION: Both methods resulted in significant improvement in visual acuity and refraction. Based on our limited experience, however, LASIK followed by INTACS is preferred for reasons of safety, convenience, and lower induced cylinder.

Risk factors and retreatment results of intraoperative flap complications in LASIK.

PURPOSE: To evaluate the incidence, type, and risk factors of intraoperative complications leading to abandonment of laser in situ keratomileusis (LASIK), and to compare the safety and efficacy of retreated LASIK with uncomplicated primary LASIK. SETTING: Refractive surgery centers in Tokyo, Yokohama, Nagoya, Osaka, and Fukuoka, Japan. METHODS: A total of 3751 eyes of 2033 patients who were followed for 6 months after primary LASIK, of which 15 eyes were retreated after intraoperative flap complications, were reviewed. In most of the cases, retreatments were performed by recutting a new flap. RESULTS: Intraoperative flap complications occurred in 25 eyes, of which 15 eyes had retreatment at a later date. The overall incidence of complications was independent of the surgeons' experience, although incomplete flaps, in particular, occurred at a higher rate in the hands of inexperienced surgeons. No patient profile was detected as a risk factor for intraoperative flap complications. No flap-related complications occurred at retreatment. Refractive and visual outcomes were comparable to those in the uncomplicated cases within 6 months postoperatively. CONCLUSIONS: Retreatment after microkeratome flap complications by recutting the cornea is safe and effective.