Ophthalmology

Overview of the department

We are responsible for the treatment of patients with various ophthalmological diseases as a core hospital in Fukui Prefecture. In particular, surgery for glaucoma and diabetic retinopathy is positively promoted. Using the most advanced examination instruments, treatment is provided based on accurate, precise diagnoses.

Consultation system/therapeutic strategies

In our hospital, disease-based, specialized outpatient clinics have been established. Diagnosis and treatment based on the most advanced medical knowledge are conducted by physicians specializing in each disease.
The specialized outpatient clinics of our hospital are as follows:
-Strabismus/Amblyopia Outpatient Clinic, -Macular Disease Outpatient Clinic
-Glaucoma Outpatient Clinic, -Low-Vision Outpatient Clinic
-Diabetic Eye Disease Outpatient Clinic, -Palpebral Disease Outpatient Clinic.
The following procedures are performed in our hospital:
-Palpebral surgery (blepharoptosis, inversion, and palpebral tumors)
-Surgery for strabismus (Surgery for ophthalmoplegia, such as abducens nerve paralysis, is also performed.)
-Corneal grafting
-Surgery for cataract
-Surgery for glaucoma (trabeculectomy, trabeculotomy, and tube shunt)
-Surgery for retinal detachment
-Vitreous surgery (diabetic retinopathy, macular hole, epiretinal membrane, retinal detachment, vitreous hemorrhage, and intraocular inflammation).
There are five orthoptists (national qualifications). Specific ophthalmological examinations with the latest diagnostic instruments, which have been developed with advances in medicine, are conducted. The Low-Vision Outpatient Clinic has been established. For patients with vision disorder even on using glasses, we are making efforts to reduce difficulty in daily life activities by utilizing their remaining visual functions.

Advanced medical practice

As advanced surgery, tube shunting for glaucoma and vitreous body surgery using a 27-gauze system and non-contact-type ultra-wide-field fundus-monitoring system are performed in our hospital.
Tube shunt surgery for glaucoma is a new technique using a Baerveldt glaucoma implant. It is selected for patients with a type of glaucoma that is difficult to treat using conventional trabeculectomy. Furthermore, new EXPRESS glaucoma filtration surgery, which may replace trabeculectomy, is also performed.
For vitrectomy, the use of a non-contact-type ultra-wide-field fundus-monitoring system facilitates safer surgery. Furthermore, the concurrent use of a 27-gauze system, which allows the wound size to be smaller, may achieve recovery earlier after surgery. The most advanced device for vitrectomy (Constellation), which provides the greatest benefits for patients, was introduced. For cataract surgery, the most advanced, minimal incision-matched device, which allows the wound size to be smaller, was introduced, facilitating the prevention of postoperative astigmatism and earlier vision recovery. Advanced cataract surgery with a multi-focal intraocular lens is also performed. To treat patients with diabetic retinopathy, retinal venous occlusion, and ischemic retinochoroidal diseases such as neovascular glaucoma, a revolutionary drug, anti-vascular-endothelial-growth-factor antibody, was first introduced in this prefecture after approval by the Ethics Review Board. It is safe and effective for retinal edema and hemorrhage/neovascularization.
Crystalline lens reconstruction with a multi-focal intraocular lens is conducted as advanced medical practice. Patients can focus on both distal and proximal areas without glasses.
Patients with age-related macular degeneration are treated using the anti-vascular-endothelial-growth-factor antibody and photodynamic therapy, which was approved in 2004. The latter minimizes disturbance of the normal retina at the periphery, and reduces choroidal neovascularization. One of these therapies or their combination may prevent disease progression and improve vision in many patients.

Primary examinations and explanations

Optical coherence tomography (OCT)

This instrument facilitates the noninvasive measurement of cross-sections of the retina in a short period. It is useful for understanding the pathogeneses of all retinal diseases, especially macular diseases, represented by macular edema, epiretinal membrane, macular hole, and age-related macular degeneration, and quantitatively analyzing data. It is also useful for explaining individual conditions to patients.

SPECTRALIS? HRA + OCT (OCT)

A three-dimensional, image-analyzing system was introduced, in which a spectral domain OCT, with the highest resolution, was interfaced with a confocal laser scan-type funduscopy apparatus (HRA) as a first in the world. It facilitates simultaneous, accurate evaluation of fluorescence imaging and tomographic findings of the retina, making it possible to comprehensively evaluate the condition.

Anterior ocular OCT

It facilitates the analysis and quantification of the retina and anterior ocular (corneal/angle) shape. It is useful for diagnosing glaucoma/corneal lesions and evaluating the treatment response.