We evaluated systemic contribution of cataract surgery in terms of gait speed, quality of sleep, and quality of life. Two hundred and twenty six patients undergoing cataract/IOL surgery participated and 4-meter gait speed, Pittsburg Sleep Quality Index (PSQI), and NEI Visual Function Questionnaire (VFQ-25) were measured before and two and seven months after surgery. All indices improved after surgery. Gait speed of 11 simulated patients for visual impairment was correlated to visual function. We concluded cataract surgery is beneficial for systemic health and cataract research and clinical practice should play important role in geriatric medicine.

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We reported a case of dislocation of Soemmering's ring, which might have been located at peripheral portion behind iris, into the anterior chamber about 20 years after operation for dislocated lens. In pathological examinations, lens bow was recognized around equator area. The arrangement of nuclei around adhesion area of anterior and posterior capsule indicated a formation of lens bow. Moreover, the membrane, which showed the new formation of lens capsule, was recognized around adhesion area. These findings suggest that lens epithelial cells continue to grow and differentiate in the dislocated Soemmering's ring during about 20 years.

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Purpose : To evaluate incision sizes for intraocular lenses (IOLs) implanted with different surgical techniques using a motorized IOL injector (Autosert) in microincision cataract surgery. Method : IOLs were implanted with wound-assisted method (WA group ; 12 eyes of 9 patients) or contact method that the cartridge of IOL was contacted to the wound without pressure (CM group ; 17 eyes of 15 patients). Incision sizes were measured before and after IOL implantation. Result : Mean enlargements before and after IOL implantation in CM group (0.03±0.05 mm) were significantly less than those in WA group (0.09±0.05 mm ; p<0.01). There was no complications or difficulties related to IOL implantation in both groups. Conclusion : The way of contact of cartridge to the wound may influence the enlargements of wound before and after IOL implantation. There is a possibility that contact of cartridge to the wound without pressure may reduce wound damages related to IOL implantation.

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Purpose : To investigate the type of the cataract after the implantable collamer lens insertion. Methods : The cataract type in patients after ICL implantation was investigated. Results : The anterior subcapsular cataract, nuclear cataract, cortical cataract and posterior subcapsular cataract were 16 eye (72.7%), 4 eye (18.2%), 1 eye (4.6%) and none, respectively. We found 1 eye forming both anterior subcapsular cataract and posterior subcapsular cataract. In all eyes forming cataract, ICL without central hole was implanted. Discussion : The majority of cataract type that occurred after the ICL insertion was anterior subcapsular cataract. These results suggested that poor supply of the nutrition by aqueous humor could be the cause of cataract formation. Using the ICL with central hole, which keeps physiological flow of aqueous humor, may prevent cataract formation after ICL implantation.

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In this study, we evaluated the inhibitory effects of the Kampo medicines Rokumigan and Hachimijiogan on cataract formation in a rat model of streptozotocin (STZ)-induced type 1 diabetes. Model rats received feed containing 3.1% Rokumigan (mixture of Rehmannia Root, Cornus Fruit, Dioscorea Rhizome, Alisma Tuber, Poria Sclerotium, and Moutan Bark) or 3.3% Hachimijiogan (all ingredients of Rokumigan, plus Cinnamon Bark and Aconite Root), both in powder form. Lens glucose and sorbitol levels significantly increased, whereas lens glutathione (GSH) and ascorbic acid levels significantly decreased, in rats receiving STZ. Among the STZ-treated groups, lens ascorbic acid levels were significantly higher in rats receiving feed containing Rokumigan or Hachimijiogan powder than in rats receiving normal feed. By contrast, Hachimijiogan extract formulation had no significant effect on ascorbic acid or GSH levels in STZ-treated rats. The presence of Rokumigan or Hachimijiogan in feed suppressed the increase in sorbitol level, but not the decrease in GSH level, the increase in blood glucose level, or weight loss. Rokumigan and Hachimijiogan in feed clearly suppressed lens opacification in STZ-treated rats, and this suppression was particularly marked in the Hachimijiogan group. Hachimijiogan exerted a stronger pharmacological effect than Rokumigan, suggesting that the mixture of eight kinds of crude drugs in the former was more effective than the mixture of only six kinds of crude drugs in the latter.

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In the basic study of the crystalline lens regeneration, we tried the manufacture of the three-dimensional crystalline lens reconstruction model using the immortalized human lens epithelial cell (iHLEC). We manufactured the iHLEC cell aggregation at the standstill culture method (static culture model) or at the combination fo standstill and rotation culture method (static + rotary culture model), made the section from cell block, and stained hematoxylin and eosin (H.E.) staining, immunostaining of αA-crystalline, βB2-crystalline, type-IV collagen, GAPDH. In the cell aggregation of the static + rotary culture model, the cell concentration was higher than that of the static culture model. In addition, the expression of αA-crystalline, βB2-crystalline, type-IV collagen and GAPDH in the static + rotary culture model were higher than those of the static culture model. These results show that the static + rotary culture model provide the high viability of cell and aggregation.

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