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白内障手術を行った157例212眼につき,細隙灯顕微鏡と内視鏡により落屑症候群の有無を検索した。男性73眼,女性139眼であり,全体の平均年齢は72.6歳であった。内視鏡は眼内レンズを挿入する直前に12時の強角膜創より挿入し,6時付近の毛様体とチン小帯を約90°の範囲で観察した。落屑症候群は,細隙灯顕微鏡検査で4例5眼(2.4%),内視鏡で44例66眼(21.6%)に発見された。内視鏡による落屑症候群の頻度は60歳未満では少なく,以後加齢とともに増加した。片眼性16例での眼圧は,患側が14.9±0.5mmHg,他眼が14.2±0.4mmHgであり,罹患側が有意に高かった(p<0.02)。内視鏡観察による落屑症候群では,その頻度が細隙灯顕微鏡によるときの約9倍であり,緑内障の可能性があると結論される。
We evaluated 212 eyes of 157 cases,who underwent cataract surgery,regarding the presence of pseudoexfoliation syndrome(PXE). These eyes were examined by slitlamp biomicroscope and endoscopy. The series comprised 73 eyes of 56males and 139 eyes of 101 females. Their ages averaged 72.6 years. Endoscopic probe was inserted through the corneoscleral wound at the 12 o'clock position just before implantation of intraocular lens,followed by observation of the ciliary body and zonules in the inferior quadrant. PXE was present in 5 eyes of 4 cases(2.4%)by slitlamp and in 66 eyes of 44 cases(21.6%)by endoscopy. The incidence of PXE was low under 60 years of age and increased thereafter. In 16 unilateral cases of PXE,the intraocular pressure averaged 14.9±0.5mmHg in the affected eyes and 14.2±0.4mmHg in the fellow eyes. The difference was significant(p<0.02). The findings show that the incidence of PXE by endoscopy is about 9 times as that by slitlamp. Eyes with endoscopically detected PXE may have a risk for glaucoma.
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