器質的眼疾患のない視力良好な疎水性アクリル眼内レンズ表面散乱光増強患者に対してレンズ交換を行った1例

Replacement of hydrophobic acrylic intraocular lens in a case with pronounced surface light scattering

要約　目的：眼疾患がなく，視力良好な表面散乱光増強患者に眼内レンズ（IOL）を交換した報告。症例：82歳男性が右眼の霧視，光の散乱を主訴に受診した。所見：矯正視力は右1.2，左1.5で，眼疾患は認めなかった。右眼に挿入されたアクリルIOL（左眼はシリコーンIOL）のみ表面散乱光の増強を認めた。右眼のIOL交換を施行し，コントラスト感度は改善し，霧視，光の散乱は軽減したが，左眼と比較すると完全ではないと答えた。結論：眼疾患のない視力良好な表面散乱光増強患者に対するIOL交換により，コントラスト感度および自覚症状の一定の改善を得られた。しかし，眼疾患を伴う場合と比べ，改善度は軽度であり，対眼との比較も影響するため，摘出交換には慎重な対応が必要と考えられた。

Abstract.　Purpose：A case report that received replacement of intraocular lens（IOL）for pronounced surface light scattering without ocular disease. Case：A 82-year-old man presented with blurring and light scattering in the right eye. He had received cataract surgery with insertion of IOL 15 years before. Findings：Corrected visual acuity was 1.2 right and 1.5 left. Both eyes were free of organic disorders. Both eyes were pseudophakic, with acrylic IOL in the right eye and silicone IOL in the left eye. By slit-lamp microscopy, IOL in the right eye showed pronounced surface light scattering. The right eye was treated by removal of IOL and insertion of another acrylic IOL. The surgery was followed by improved contrast sensitivity and reduction of blurring and light scattering, although he reported a difference in whiteness between his right and left eye. Conclusion：Replacement of IOL resulted improved contrast sensitivity and subjective symptoms. However, the degree of improvement was milder than in ocular fundus disease patients that underwent lens exchange.