A Case of Strabismus Fixus With Extremely Long Axial Length Results in Improvement of Limitation of Abduction by the Yokoyama Procedure.

Acquired strabismus in high myopia is typically fixed in the positions of adduction and depression, with restrictions in both abduction and elevation. As a treatment for myopic strabismus fixus, the Yokoyama procedure is effective. We report a case of strabismus fixus with a long axial length (34 mm), in which abduction limitation was improved by the Yokoyama procedure with medial rectus recession. A 68-year-old woman was referred for strabismus fixus in her right eye. Her right eye was fixed in the positions of adduction and depression, with restrictions in both abduction and elevation. The axial length of her right eye was extremely long 33.97mm. Magnetic resonance imaging (MRI) showed that the posterior eyeball of her right eye had dislocated out of the superotemporal muscle cone, and she was diagnosed with strabismus fixus with high myopia. She underwent the Yokoyama procedure in her right eye, and medial rectus recession was performed at the same time because abduction limitations remained at the end of the Yokoyama procedure. After surgery, there was a small residual esotropia, but abduction beyond the midline was possible, and the patient's satisfaction was high. A combination of the Yokoyama procedure and medial rectus recession for a patient with myopic strabismus fixus with long axial length resulted in good improvement of ocular misalignment and limitation of abduction.

Intraocular pressure-lowering effects of ripasudil, a rho-kinase inhibitor, and selective laser trabeculoplasty as adjuvant therapy in patients with uncontrolled glaucoma.

OBJECTIVES: To compare the intraocular pressure (IOP)-lowering effects of ripasudil, a rho-kinase inhibitor, and selective laser trabeculoplasty (SLT) as adjuvant therapy in Japanese glaucoma patients and to identify the factors associated with treatment success. METHODS: We performed a retrospective medical chart review of patients with glaucoma who received ripasudil or SLT as an adjuvant therapy. We collected data on 65 eyes (65 patients) with primary open-angle glaucoma, normal-tension glaucoma, or exfoliation glaucoma with at least 12 months of follow-up. IOP and number of glaucoma medications at 0, 1, 3, 6, 9, and 12 months were compared between and within groups. A repeated-measures mixed model was used to perform statistical analysis. We also investigated factors associated with treatment success, which was defined as ≥ 20% reduction in IOP at all follow-up periods, using univariate and multivariate logistic regression analysis. RESULTS: Significant IOP reduction was observed at all time-points after treatment in the ripasudil group (n = 33) and in the SLT group (n = 32), with no statistically significant difference between the groups before or after treatment. Patients in the SLT group used more anti-glaucoma medications before treatment, but fewer during follow-up, than those in the ripasudil group. Regardless of treatment, higher baseline IOP was associated with treatment success [crude odds ratio: 1.21 (95% confidence interval: 1.06-1.38), adjusted odds ratio: 1.37 (95% confidence interval: 1.06-1.77)]. CONCLUSIONS: Adjuvant SLT or ripasudil in patients with inadequately controlled glaucoma both reduced IOP to a similar degree, but SLT contributed to reducing the number of medications used.

Author Correction: Changes in Distribution of Dry Eye Disease by the New 2016 Diagnostic Criteria from the Asia Dry Eye Society.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.

Changes in Distribution of Dry Eye Disease by the New 2016 Diagnostic Criteria from the Asia Dry Eye Society.

Dry eye disease (DED) is a disorder of the tear film. Here, we delineate the changes in distribution of DED after diagnostic criteria changes from the 2006 Japanese Diagnostic Criteria to the 2016 Asia Dry Eye Society criteria. We included 250 right eyes of 250 patients and all patients completed ophthalmic assessments for DED. The 2006 criteria classified patients into definite DED, probable DED, and non-DED based on subjective symptoms, tear function, and/or vital staining. The 2016 criteria eliminated probable DED and classified patients into definite DED or non-DED based on subjective symptoms and decreased tear break-up time. We examined how probable DED patients were reclassified by the 2016 criteria. By the 2006 criteria, 38.8% (97/250) of patients had definite DED, 35.6% (89/250) had probable DED, and 25.6% (64/250) had non-DED. By the 2016 criteria, 66.8% (167/250) had definite DED and 31.2% (83/250) had non-DED. Among patients with probable DED using the 2006 criteria, 79.8% (71/89) were reclassified as definite DED and 20.2% (18/89) were reclassified as non-DED using the 2016 criteria. Our data revealed that prevalence of definite DED increased because most probable DED patients were reclassified as definite DED after changes in the diagnostic criteria.