Background: Increasing longevity has caused the very old population to become the fastest-growing segment. The number of centenarians (over 100 years old) is increasing rapidly. Fractures in the elderly lead to excessive medical costs and decreased quality of life with socioeconomic burdens. However, little research has thoroughly examined the functional outcomes and mortality of hip fractures in centenarians. Methods: This is a retrospective observational study. Sixty-eight centenarian hip fracture patients were admitted to the 10 institutions from February 2004 to December 2019. Fifty-six patients with 1-year follow-up were finally included. The following data were obtained: sex, age, body mass index, Charlson comorbidity index value on the operation day, Koval’s classification for ambulatory ability, type of fracture, the time interval from trauma to surgery, American Society of Anesthesiologists grade, surgery-related complications, and duration of hospital stay. Postoperative Koval’s classification (at 1 year after surgery) and information about death were also collected. Multivariate analysis was performed to analyze the risk factors affecting mortality 1 year after surgery. Results: Mortality rates were 26.8% at 6 months and 39.3% at 1 year. The 90-day mortality was 19.6%, and one of them (2.1%) died in the hospital. The 1-year mortality rates for the community ambulatory and non-community ambulatory groups were 29% and 52%, respectively. Only 9 (16.1%) were able to walk outdoors 1 year after surgery. The remaining 47 patients (83.9%) had to stay indoors after surgery. Multivariate analysis demonstrated that the pre-injury ambulatory level (adjusted hazard ratio, 2.884; p = 0.034) was associated with the risk of mortality. Conclusions We report a 1-year mortality rate of 39.3% in centenarian patients with hip fractures. The risk factor for mortality was the pre-injury ambulatory status. This could be an important consideration in the planning of treatment for centenarian hip fracture patients.

Objective: Physiologically, the vastus medialis muscle is the first muscle to undergo muscle atrophy, and it was thought that pain in patients with knee osteoarthritis could be reduced if this muscle could be strengthened and stabilized. The purpose of this study was to prove the effectiveness in knee osteoarthritis using polydioxanone sutures that have been tried in other musculoskeletal areas. Method: Forty knee osteoarthritis patients voluntarily participated in the study, and divided into 30 polydioxanone suture needle (MEST-B2375 produced by Ovmedi Co.) and 10 sham needle (without suture). And the needles were inserted into the vastus medialis muscle. In all patients, safety evaluation including blood tests and ultrasonography as well as efficacy evaluation including isometric maximal contractile strength of quadriceps muscle, weight bearing pain, impression of change, quadriceps angle, rescue drug intake were evaluated up to 30 weeks after the procedure. Results: Isometric maximal contractile strength showed a significant improvement at 4 weeks after the procedure in the polydioxanone suture group, and the weight-bearing pain showed a significant improvement at every visit in the polydioxanone suture group compared with baseline values. Patient global impression of change score showed significant improvement at 20 and 30 weeks, and clinical score showed improvement at every visit. Conclusion Insertion of polydioxanone sutures showed improvement in muscle strength and knee pain by supporting and fixation of the vastus medialis muscle in patients with degenerative knee osteoarthritis. Insertion of polydioxanone sutures is considered to have a therapeutic effect in knee osteoarthritis patients.

PURPOSE: To investigate ocular fatigue after the use of a head-mounted display (HMD)-type virtual reality device.METHODS: Healthy adult volunteers were examined for ocular fatigue before and after watching videos for 10 min with an HMD-type virtual reality device. Subjective ocular fatigue was measured using a questionnaire. Objective fatigue was measured using the critical flicker fusion frequency (CFF), high frequency component of accommodative microfluctuation, and accommodation amplitude. The accommodation amplitude was measured using the push-up method and the dynamic measurement mode of the autorefractometer. Changes in the spherical equivalent were also measured.RESULTS: The questionnaire-based subjective ocular fatigue increased (p = 0.020) after use of the HMD device. In the dominant eye, the high frequency component of accommodative microfluctuation increased (p < 0.05). The accommodation amplitude using the push-up method was decreased in the nondominant eye (p = 0.007), and temporary myopia was observed (p < 0.05). However, there was no increase in ocular fatigue in the CFF or the accommodation amplitude using the dynamic measurement mode, which showed no significant difference before and after using the HMD device (p > 0.05).CONCLUSIONS: A subjective test and some objective tests suggested that use of the HMD-type virtual reality display increased ocular fatigue. However, no increase in ocular fatigue was measured using CFF nor in the accommodation amplitude using the dynamic measurement mode which was a limitation of the study. More studies with the aim to alleviate ocular fatigue after using HMD-type virtual reality devices are therefore needed.
Adult ; Asthenopia ; Fatigue ; Flicker Fusion ; Humans ; Methods ; Myopia ; Volunteers

PURPOSE: To evaluate the effectiveness of topically administered 0.05% cyclosporine combined with a topical steroid in the early postoperative period after cataract surgery, and to compare the therapeutic efficacy according to the severity of dry eye. METHODS: One hundred and fifty-six patients who underwent unilateral cataract surgery and received topical cyclosporine 0.05% for 8 weeks combined with a fluorometholone 0.1% steroid for 4-weeks were classified into three groups according to preoperative dry eye level: the control group, non-dry eye (n = 78); group 1, level I dry eye (n = 38); and group 2, level II dry eye (n = 40). The best-corrected distance visual acuity, intraocular pressure, dry eye symptom questionnaire (ocular surface disease index), tear film break-up time (TBUT), and Schirmer test-I (STI) were evaluated. RESULTS: The preoperative score of dry eye symptoms improved significantly at one week postoperatively and continued to improve until postoperative 8-weeks in all groups, especially in group 2 compared with the control. Groups 1 and 2 showed significant improvement in the TBUT at one week, four weeks, and eight weeks postoperatively, compared to eight weeks postoperatively in the control; Group 2, especially, showed significant improvement in TBUT. There was no difference in STI value after cyclosporine-steroid treatment in the control group; however, a significant difference was observed at four weeks postoperatively in dry eyes. No significant differences in STI results were observed among the three groups. CONCLUSIONS: Use of topical cyclosporine 0.05% combined with a topical fluorometholone 0.1% steroid after cataract surgery is more effective in dry eyes level II than in non-dry eyes, especially those with TBUT and dry eye symptoms at eight weeks postoperatively.
Cataract ; Cyclosporine ; Dry Eye Syndromes ; Fluorometholone ; Humans ; Intraocular Pressure ; Postoperative Period ; Sexually Transmitted Diseases ; Tears ; Visual Acuity

No abstract available.
Fatigue*

PURPOSE: In the present study, the visual discomfort induced by smart mobile devices was assessed in normal and healthy adults. METHODS: Fifty-nine volunteers (age, 38.16 ± 10.23 years; male : female = 19 : 40) were exposed to tablet computer screen stimuli (iPad Air, Apple Inc.) for 1 hour. Participants watched a movie or played a computer game on the tablet computer. Visual fatigue and discomfort were assessed using an asthenopia questionnaire, tear film break-up time, and total ocular wavefront aberration before and after viewing smart mobile devices. RESULTS: Based on the questionnaire, viewing smart mobile devices for 1 hour significantly increased mean total asthenopia score from 19.59 ± 8.58 to 22.68 ± 9.39 (p < 0.001). Specifically, the scores for five items (tired eyes, sore/aching eyes, irritated eyes, watery eyes, and hot/burning eye) were significantly increased by viewing smart mobile devices. Tear film break-up time significantly decreased from 5.09 ± 1.52 seconds to 4.63 ± 1.34 seconds (p = 0.003). However, total ocular wavefront aberration was unchanged. CONCLUSIONS: Visual fatigue and discomfort were significantly induced by viewing smart mobile devices, even though the devices were equipped with state-of-the-art display technology.
Adult ; Asthenopia* ; Computers, Handheld* ; Dry Eye Syndromes ; Female ; Humans ; Male ; Tears ; Video Games ; Volunteers

PURPOSE: To evaluate the effect of cataract surgery on subfoveal choroidal thickness (SCT) and investigate the relationship between the variation of SCT and refractive error. METHODS: We retrospectively reviewed the medical records of 47 patients (47 eyes) who underwent uneventful phacoemulsification cataract surgery from March 2012 to February 2014. SCTs were measured using spectral-domain optical coherence tomography performed before surgery and at 1 month, 3 months and 6 months postoperatively. We investigated the differences in target refraction (TR) and postoperative spherical equivalent (SE), intraocular pressure (IOP) and central macular thickness (CMT) at all follow-ups. RESULTS: Compared with preoperative measurements, SCT showed a significant increase of 5.9 ± 13.3 µm at postoperative 1 month and 7.6 ± 18.1 µm at postoperative 3 months (p = 0.004 and p = 0.006, respectively), but no significant differences at postoperative 6 months (p = 0.104). The correlation between the variation of SCT and the differences in postoperative SE and TR were not significant at 1 month and 6 months, but were positively significant at 3 months (r = 0.310, p = 0.034). The variation of SCT showed no significant correlations with the postoperative change in IOP and CMT. CONCLUSIONS: SCT significantly increased up to 3 months after cataract surgery. The variation of SCT may affect the postoperative refractive error.
Cataract* ; Choroid* ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Medical Records ; Phacoemulsification ; Refractive Errors* ; Retrospective Studies ; Tomography, Optical Coherence

PURPOSE: To report transient corneal edema after phacoemulsification as a predictive factor for the development of pseudophakic cystoid macular edema (PCME). METHODS: A total of 150 eyes from 150 patients (59 men and 91 women; mean age, 68.0 ± 10.15 years) were analyzed using spectral domain optical coherence tomography 1 week and 5 weeks after routine phacoemulsification cataract surgery. Transient corneal edema detected 1 week after surgery was analyzed to reveal any significant relationship with the development of PCME 5 weeks after surgery. RESULTS: Transient corneal edema developed in 17 (11.3%) of 150 eyes 1 week after surgery. A history of diabetes mellitus was significantly associated with development of transient corneal edema (odds ratio [OR], 4.04; 95% confidence interval [CI], 1.41 to 11.54; p = 0.011). Both diabetes mellitus and transient corneal edema were significantly associated with PCME development 5 weeks after surgery (OR, 4.58; 95% CI, 1.56 to 13.43; p = 0.007; and OR, 6.71; CI, 2.05 to 21.95; p = 0.003, respectively). In the 8 eyes with both diabetes mellitus and transient corneal edema, 4 (50%) developed PCME 5 weeks after surgery. CONCLUSIONS: Transient corneal edema detected 1 week after routine cataract surgery is a predictive factor for development of PCME. Close postoperative observation and intervention is recommended in patients with transient corneal edema.
Adult ; Aged ; Aged, 80 and over ; Cornea/*pathology ; Corneal Edema/*diagnosis/etiology ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Glucosinolates ; Humans ; Macular Edema/diagnosis/*etiology ; Male ; Middle Aged ; *Phacoemulsification ; Pseudophakia/*complications/diagnosis ; Retrospective Studies ; Tomography, Optical Coherence