フタラール消毒薬（ディスオーパ(R)）による白内障手術後の水疱性角膜症

Bullous keratopathy after cataract surgery using orth-phthalaldehyde for disinfection

フタラール0.55％溶液で手術器具の消毒を行い，2日間に7例8眼に対し超音波乳化吸引術と眼内レンズ挿入術による白内障手術を行った。全例に角膜内皮障害が生じた。4眼では術翌日に著しい角膜浮腫があり，約3週後に角膜裏面の色素沈着，虹彩萎縮，ぶどう膜外反などの虹彩壊死が生じた。2眼は水疱性角膜症になり，6眼では最終的に角膜が透明化したが，角膜内皮細胞密度が術前よりも12～57％，平均35.3％減少した。これらの角膜障害は，白内障手術器具に残留したフタラールが眼内灌流液中に溶出した結果と考えられた。

We performed cataract surgery on 8 eyes of 7 patients by means of phacoemulsification-aspiration and intraocular lens implantation. Solution of 0.55％ orth-phthalaldehyde was used for disinfection of surgical instruments. All the 8 eyes showed severe corneal damage after surgery. Marked corneal edema developed on the day after surgery in 4 eyes. Signs of iris necrosis developed 3 weeks later,including pigment deposit posterior to the cornea,iris atrophy,and uveal ectropion. Bullous keratopathy developed in 2 eyes. The cornea finally became transparent in 6 eyes. Density of corneal endothelial cells in these 6 eyes decreased by 12％ to 57％,average 35.3％. The observed corneal lesions appeared to be due to orth-phthalaldehyde that dissolved into the solution for intraocular perfusion.