後房レンズ移植時使用粘稠液の比較検討

Evaluation of viscoelastic materials in posterior chamber lens implantation

　後房レンズ移植時使用粘稠液としてヒアルロン酸を主成分とするHealon®，DE O50®，コンドロイチン硫酸を主成分とするCDS II,CDSを使用する機会を得たので，使用粘稠液群別に術時の有用性，安全性および術後の経過等を比較検討した．Healon®とDE 050®は粘性が高く，とくにHealon®の粘性は著明に高く，前後房の形成，維持が確実であった．一方，CDS II,CDSは粘性が低く，前後房の形成が不完全で，また術野の赤血球の凝集が認められた．術後炎症はHealon®，DE 050®は軽度で早期に消退したが，CDS ll,CDSは遷延化した．

　今回の検討では，粘稠液として，術操作，安全性の点で，Healon®，ついでDE050®が最も有用であると考えられた．

We evaluated the clinical value of 4 viscoelastic materials used to protect the corneal endotheliumduring posterior chamber lens implantation surgery. In a series of 14 surgeries, we used sodium hya-luronate preparation (Healon or DE050) or chon-droitin sulfate (CDS or CDS II). Among the four materials, Healon proved to be most viscous and to far surpass other materials in maintening the anterior and posterior chamber depths. CDS and CDS II, on the other hand, were less viscous and elastic, poorly contributing to the maintenance of anterior and posterior chamber depths during sur-gery.

During the postoperative course,eyes treated with Healon or DE050 manifested minimal corneal edema and slight or moderate signs of anterior uveitis. Eyes treated with CDS or CDS II mani-fested corneal edema and medium to severe signs of anterior uveitis, frequently resulting in synechia formation between the iris and the intraocular lens. The present findings indicate that sodium hya-luronate preparations are safer and more beneficial viscoelastic materials to be used in posterior cham-ber lens implantation.