翼状片手術前後の前眼部OCTを用いた角膜変化の観察

Changes in morphology of the cornea after pterygium surgery

要約　目的：翼状片術後の屈折と角膜形状の変化の報告。対象と方法：翼状片手術を行った21例26眼を対象とした。術前と，術後3か月までの5回，自動屈折計で角膜2方向の屈折を測定した。術前と術翌日に光干渉断層計（OCT）で前眼部の形状を記録した。結果：術直後の角膜屈折は平均3.1Dの先鋭化があり（p＜0.001），それ以後は変化しなかった。角膜屈折の変化は，翼状片長と有意に相関した（p＜0.05）。角膜形状と前房深度には，術前と術翌日で有意差がなかった。結論：翼状片手術では，角膜実質の形状は変化しない。翼状片での角膜乱視は，角膜表面でなく，翼状片の表面が関係する人工産物（アーチファクト）である。

Abstract.　Purpose：To report changes in refraction and shape of the cornea after pterygium surgery. Cases and Method：This study was made on 26 eyes of 21 cases that received resection of pterygium. Refraction along two axes was measured by autorefractometer before and up to 3 months of surgery. Morphology of the anterior ocular segment was recorded using an optical coherent tomograph（OCT）for anterior segment. Results：On the day after surgery, refraction along the horizontal axis shifted significantly towards myopia by an average of 3.1 diopters（p＜0.001）to remain constant thereafter. Changes in corneal refraction was positively correlated with the length of pterygium（p＜0.05）. There was no change in the depth of anterior chamber before and after surgery. Conclusion：There was not change in the shape of cornea after pterygium surgery. The apparent corneal astigmatism in eyes with pterygium may be an artifact inherent to autorefractometer.