輪部減張切開術の手術成績

Outcome of limbal-relaxing incision in pseudophakic eyes

目的：白内障手術後に残存する角膜乱視に対する輪部減張切開術の成績の評価。対象と方法：過去4年間の白内障手術と眼内レンズ挿入後に1.5D以上の倒乱視がある27眼に対し，耳側と鼻側に輪部減張切開術を行った。視力はlogMARで評価した。結果：裸眼視力は，術前が平均0.66，術後が0.33であり，矯正視力は術前が平均0.11，術後が0.03であり，裸眼と矯正視力はともに有意に改善した（p＜0.01）。手術の1か月後で，角膜乱視は平均2.12D変化し（Jaffe法），1.88D直乱視化した（Cravy法）。術後2年間の経過観察ができた10眼では，輪部減張切開術の効果が持続していた。結論：白内障手術後に残存する強い倒乱視に対し，輪部減張切開術は乱視軽減効果があった。

Purpose：To evaluate limbal-relaxing incision for corneal astigmatism after cataract surgery. Cases and Methods：This retrospective study involved 27 eyes that received cataract surgery with intraocular lens implantation during the past 4 years. All the eyes had inverse astigmatism of 1.5 diopters or greater. Limbal-relaxing incision was performed in the nasal and temporal sector. Visual acuity was evaluated as logMAR unit. Results：Uncorrected visual acuity averaged 0.66 before and 0.33 after limbal-relaxing incision. Best corrected visual acuity averaged 0.11 before and 0.03 after incision. The difference was significant for both visual acuity values（p＜0.01）. One month after surgery,corneal astigmatism had changed by an average of 2.12 diopters（Jaffe's method）and by 1.88 diopters towards with-the-rule direction（Cravy's method）. Ten eyes could be followed up for 2 years after limbal-relaxing incision. The effect was still maintained in the 10 eyes. Conclusion：Limbal-relaxing incision relieved inverse astigmatism in pseudophakic eyes.