緑内障白内障同時手術後の屈折誤差

Error in refraction following simultaneous surgery for cataract and glaucoma

要約　目的：線維柱帯切除術と白内障同時手術後の屈折誤差の報告。症例と方法：過去43か月間に線維柱帯切除術と白内障手術を同時に行った14例18眼を対象とした。術前と術後に，眼圧，屈折，角膜曲率，眼軸長を測定した。結果：眼圧の平均値は，術前の14.6±5.2mmHgが術後の10.1±2.83mmHgに有意に下降した（p＜0.005）。屈折誤差に影響する術前因子は眼圧のみで，術前と術後眼圧，術前後の眼圧変化と屈折誤差，眼圧変化と角膜曲率変化，角膜曲率と屈折誤差には相関があった。術前眼圧が高いほど眼圧下降幅が大きく，遠視寄りの屈折誤差があった。結論：眼圧下降幅に伴う屈折誤差は，眼圧下降による角膜の平坦化によると推定される。

Abstract.　Purpose：To report changes in refraction following simultaneous surgery for cataract and glaucoma. Cases and Method：This study was made on 18 eyes of 14 cases that received cataract and trabeculectomy. The eyes were recorded for intraocular pressure（IOP）, refraction, corneal curvature, and axial length before and after surgery. Results：IOP averaged 14.6±5.2 mmHg before and 10.1±2.83 mmHg after surgery. The difference was significant（p＜0.005）. Level of IOP before surgery was the sole factor that was related to error in refraction. Significant correlations were present between IOP before and after surgery, changes in IOP and refractive error, changes in IOP and corneal curvature, and corneal curvature and refractive error. Eyes with higher IOP showed greater decrease in IOP with refractive error towards hyperopia. Conclusion：The observed refractive error as related to height of IOP decrease appears to be due to greater corneal flattening.