白内障手術後における抗炎症点眼薬使用の角膜厚および角膜体積への影響

Changes in corneal thickness and volume following instillation of anti-inflammatory drugs in eyes after cataract surgery

要約　目的：白内障手術後の抗炎症薬点眼が角膜の厚さと体積に及ぼす影響の報告である。対象と方法：白内障手術を行った32例32眼を対象とした。男性12例，女性20例で，年齢は68.7±8.9歳であった。症例を無作為に3群に分け，それぞれ0.1％ベタメタゾン，0.1％ジクロフェナクナトリウム，および両薬剤の併用を，白内障手術後の1か月間，1日4回点眼させた。角膜の厚さと体積は，角膜形状測定装置Pentacam^(R)で測定した。測定箇所は，角膜の中心と上下4方向とした。結果：ベタメタゾン群では，下方を除く4測定部位で角膜の厚さと体積が術前よりも有意に増加した（p＜0.05）。ジクロフェナク群と併用群では，角膜の厚さと体積に手術前後で変化がなかった。結論：白内障手術後にベタメタゾン単剤では角膜の厚さと体積の増加がみられたが，ジクロフェナク単剤もしくは併用では増加がみられなかった。

Abstract.　Purpose：To report changes in corneal thickness and volume following instillation of anti-inflammatory drugs after cataract surgery. Cases and Method：This study was made on 32 eyes of 32 patients who underwent cataract surgery. The series comprised 12 males and 20 females. The age averaged 68.7±8.9 years. The patients were randomly divided into 3 groups. One group received instillation of 0.1％ betamethasone 4 times daily, the second received instillation of 0.1％ diclofenac sodium 4 times daily, and the third received instillation of both drugs. Instillation was continued for one month after cataract surgery. Pentacam^(R) was used in measurement of thickness and volume at 5 locations of the cornea：the center and along vertical and horizontal lines. Results：Corneal thickness and volume increased significantly in 4 measured points except the lower vertical line after instillation of betamethasone（p＜0.05）. There were no changes before and after surgery in eyes instilled with diclofenac or combined solution. Conclusion：Instillation of betamethasone only results in increased corneal thickness and volume in eyes after cataract surgery. However, that of diclofenac sodium only or both drugs prevented the increase of corneal thickness and volume.