斜視手術が角膜形状に及ぼす影響

Morphology of the cornea before and after strabismus surgery

要約　目的：斜視手術前後での角膜形状の変化の報告。対象と方法：斜視手術を行った27例49眼を対象とした。年齢は5～81歳（平均26歳）であった。原則として，外斜視38眼には外直筋の後転，内斜視6眼には内直筋の後転，上下斜視5眼には下斜筋の後転を行った。角膜形状は術前と手術1か月後に，Pentacam，OrbscanⅡ，TMS-4で計測した。手術は500眼以上の斜視手術の経験がある医師と，50眼以下の医師の2名で行った。結果：PentacamとOrbscanⅡでは，角膜の前面と後面の形状に有意差はなかった。TMS-4では，surface asymmetry index，simulated keratometric cylinder change，coefficient of variation of corneal powerに有意差があった。術者間に有意差はなかった。結論：斜視手術の前後で角膜の前面と後面の形状に著しい変化は生じない。

Abstract.　Purpose：To report changes in the shape of the cornea after strabismus surgery. Cases and Method：This study was made on 49 eyes of 27 patients who received surgery for strabismus. The age ranged from 5 to 80 years,average 26 years. Recession of lateral rectus muscle was performed on 38 eyes of exotropia,recession of medial rectus on 6 eyes of esotropia,and recession of inferior oblique on 5 eyes of vertical strabismus. Corneal morphology was measured before and one month after surgery using Pentacam,Orbscan Ⅱ and TMS-4. Surgery was performed by two surgeons. One had experience of strabismus surgery on more than 500 eyes and the other on less than 50 eyes. Results：Pentacam and Orbscan Ⅱ showed no significant change in the shape of anterior or posterior surface of the cornea. TMS-4 showed changes in surface asymmetry index,simulated keratometric cylinder change,and coefficient of variation of corneal power. There were no interoperator differences. Conclusion：Strabismus surgery does not induce major changes in the shape of anterior or posterior surface of the cornea.