フェムトセカンドレーザーによる角膜実質内乱視矯正切開術と多焦点眼内レンズ同時手術

Simultaneous intrastromal astigmatic keratotomy using femtosecond laser and multifocal intraocular lens implantation

要約　目的：フェムトセカンドレーザーを使用した角膜実質内乱視矯正切開術と多焦点眼内レンズ挿入術の同時手術成績の報告。対象と方法：対象は角膜乱視が両眼1.50D以上の白内障症例17例34眼で，年齢は47～68歳，平均55歳であった。術後1か月までの角膜乱視量，自覚的屈折度，裸眼および矯正視力を検討した。結果：角膜乱視量は術前の1.99Dから術後翌日には0.79Dまで有意に減少し，術後1か月は0.89Dで安定していた。術後1か月の等価球面屈折度は－0.19D，両眼遠方裸眼視力は1.42，両眼近方裸眼視力は0.50，矯正視力は1.46と良好であった。結論：今回施行した同時手術では，術後早期から乱視が安定して軽減し，良好な裸眼視力が得られた。

Abstract.　Purpose：To report the outcome of simultaneous intrastromal astigmatic keratotomy using femtosecond laser and multifocal intraocular lens implantation. Cases and Method：This prospective study was made on 34 eyes of 17 patients. The age ranged from 47 to 68 years, average 55 years. All the eyes had corneal astigmatism of 1.5 diopters or more. They were followed up for one month regarding corneal astigmatism, subjective refraction, and visual acuity with or without correction. Results：Corneal astigmatism averaged 1.99 diopter before and 0.79 the day after surgery. The difference was significant（p＜0.001）. It remained stable for one month and averaged 0.89 diopter. One month after surgery, spherical equivalent of refraction averaged －0.19 diopter. Binocular visual acuity without correction averaged 1.42 for distance and 0.50 for near. Corrected visual acuity averaged 1.46. Conclusion：Reduced astigmatism with good visual acuity followed simultaneous intrastromal astigmatic keratotomy and multifocal intraocular lens implantation.