白内障の術式による線維柱帯切除術への影響の違い

Outcome of trabeculectomy in eyes with various types of cataract surgery

要約　目的：線維柱帯切除術（TLE）の予後因子の検討。対象と方法：初回TLEを施行した症例214例244眼を対象とした。眼圧コントロール率はKaplan-Meier法で検討した。白内障手術併用の有無と過去の白内障手術の術式別に比較検討した。結果：有水晶体眼への単独手術群（42眼）は，上方強角膜切開白内障手術既往群（33眼）に比べて有意に予後良好であった（p＝0.0129）。白内障手術併用群（137眼），耳側強角膜切開白内障手術既往群（7眼），角膜切開白内障手術既往群（25眼）の間には有意差がなかった。結論：上方強角膜切開白内障手術既往群では予後不良であった。

Abstract.　Purpose：To evaluate associated risk factors of trabeculectomy for failure. Case and Method：We reviewed 244 eyes of 214 patients who received initial trabeculectomy. Successful intraocular pressure control rate was evaluated with Kaplan-Meier survival curves. Phakic patients who underwent trabeculectomy only and combined with cataract surgery and pseudophakic patients who have histories of various types of small incision cataract surgery were evaluated. Result：Phakic patients who underwent trabeculectomy only（42 eyes）had significantly better prognosis than pseudophakic patients who had histories of superior scleral corneal incision cataract surgery（33 eyes）（p＝0.0129）. There was no significant difference between phakic patients who underwent trabeculectomy only and phakic patients who underwent combined surgery（137 eyes）and pseudophakic patients who have histories of temporal scleral corneal（7 eyes）and corneal incision cataract surgery（25 eyes）. Conclusion：Pseudophakic patients who had histories of superior scleral corneal incision cataract surgery had poor prognosis.