トラベクレクトミーを併用した眼内レンズ手術の術後屈折誤差

Refractive error induced by trabeculectomy with intraocular lens implantation

要約　線維柱帯切除術，超音波乳化吸引術，眼内レンズ（IOL）挿入術の同時手術を13眼に行い，予想屈折値と術後の実測屈折値との差を検討した。年齢，性別，IOL度数をマッチさせた白内障手術単独例13例を対照とした。IOLは，すべてマルチピース型アクリルレンズを使用し，囊内に固定した。IOL度数の計算にはSRK-T式を用い，術後屈折値は自動屈折計による等価球面度数で表示した。術後屈折値と予想屈折値との差は，同時手術群で-0.54±0.73D，単独手術群で0.55±1.00Dであり，両群間に有意差があった（p＜0.05）。同時手術では平均1.1D近視側にずれるため，SRK-T式が修正される必要がある。

Abstract.　We performed combined surgery with trabeculectomy,phacoemulsification-aspiration（PEA）and intraocular lens（IOL）implantation in 13 eyes. We then calculated the difference between predicted and actual refraction. Another series of 13 eyes served as control. Both groups were matched regarding gender,age and IOL power. All the eyes received multipiece acrylic IOL fixed in the capsular bag. The IOL power and predicted refraction were calculated by SRK-T formula. Postoperative refraction was represented by the spherical equivalent with automated refractometer. The difference between predicted and actual refraction averaged-0.54±0.73D in the triple sugery group and 0.55±1.00D in the control. The values were significant between two groups（p＜0.05）. The findings show that due precaution is necessary in triple surgery since the postoperative refraction is shifted by 1.1D towards myopia.