ソフトシェルテクニックとヒーロンVの角膜内皮細胞保護効果の比較

Comparison of protective effects for Healon(R) V and the soft shell technique on corneal endothelium during phacoemulsification and intraocular lens implantation

目的：ソフトシェルテクニック（soft shell technique：SST）とヒーロンV（Healon^(R)V：HV）の角膜内皮細胞保護効果の比較。対象と方法：熟練した1人の術者によって同一の術式と器械設定で施行された眼内レンズ挿入術を伴う超音波水晶体乳化吸引術症例121眼のSST群（ヒーロンとビスコート併用）と110眼のHV群（ヒーロンVのみ使用）を術前と術後1か月の角膜内皮細胞の細胞減少率とストレスインデックス（Stress Index：SI）で統計学的に比較した。結果：細胞減少率はSST群で平均2.4％，HV群で平均2.2％であった。SIはSST群で平均17.3μm²，HV群で平均9.2μm²であった。どちらの指標においても両群に統計学的有意差がなかった。結論：両者は同等の保護効果を有する。

Purpose：To compare protective effects of Healon^(R) V（HV）and the soft shell technique（SST）on corneal endothelium during cataract surgery. Patients and Methods：Two hundred and thirty-one eyes of cataract patients underwent uneventful phacoemulsification with posterior chamber intraocular lens implantation by one surgeon using the same procedures and machine settings except different viscoelastic agents. Patients were divided into 2 groups；the SST group with use of Healon^(R) and Viscoat^(R) for 121 eyes,and the HV group with use of only Healon^(R) V for 110 eyes. Corneal endothelium was examined 1 month after the surgery and was analyzed regarding the rate of cell loss and stress index（SI）. Results：The mean rate of cell loss was 2.4％ in the SST group and 2.2％ in the HV group. The SI averaged 17.3μm² in the SST group and 9.2μm² in the HV group. In both indicators,there were no statistically significant differences. Conclusion：Healon^(R) V and the soft shell technique are considered to be equivalent in regarding protection of corneal endothelium from damage during cataract surgery.