羞明感と眼精疲労により多焦点眼内レンズを交換した2例

Replacement of multifocal by monofocal intraocular lens in two cases for asthenopia and photophobia

要約　目的：術後の不満から，多焦点眼内レンズを単焦点眼内レンズに交換した2症例の報告。症例：75歳男性の両眼に白内障手術を行い，回折型多焦点眼内レンズを挿入した。術前からの眼精疲労と羞明感が悪化し，本人の希望で4か月後に単焦点眼内レンズに交換した。症状は持続したが，本態性眼瞼けいれんの治療で症状が改善した。52歳女性の両眼に白内障手術を行い，屈折型多焦点眼内レンズを挿入した。術後に羞明感があり，4か月後に単焦点眼内レンズに交換した。症状は改善しなかった。結論：多焦点眼内レンズを挿入したのち，本人の不満による単焦点眼内レンズへの交換は慎重に判断する必要がある。

Abstract.　Purpose：To report two cases who received replacement of multifocal intraocular lens（IOL）by monofocal IOL due to postoperative dissatisfaction. Cases：A 75-year-old male received bilateral cataract surgery with implantation of diffractive multifocal IOL. Asthenopia and photophobia became worse after surgery. In accordance to his wish,the multifocal IOL was replaced by monofocal IOL 4 months later. His subjective complaints persisted but improved after treatment for essential blepharospasm. Another 52-year-old female received similar bilateral cataract surgery with implantation of refractive multifocal IOL. The lens was replaced by monofocal one due to photophobia 4 months later. Her subjective complaints persisted. Conclusion：These cases illustrate that replacement of multifocal by monofocal IOL due to dissatisfaction of patients need careful considerations.