白内障術後早期の角膜内皮障害

Corneal endothelial damage during an early stage following cataract surgery

　白内障術後早期の角膜内皮への障害を角膜の厚さおよび角膜内皮細胞の平均面績を指標として，機能的・形態的に評価した．角膜の厚さは術後1週までに急速に回復し，対数時間軸に対して直線的に減少し，4〜6カ月で術前値にまで回復した．一部2週前後に一過性に再び増加した症例もあった．超音波乳化吸引術（KPE）のほぼ全例で，術後1日目に角膜裏面に乳白色の沈着物がびまん性に付着しているのが観察された．角膜内皮細胞面積の増大率の平均値は，計画的嚢外法（ECCE）の方がKPEよりも小さく，症例間のばらつきも小さい値を示し，手術による障害はより小さいと考えられる．

We evaluated the corneal endothelial damage in 38 eyes who underwent cataract surgery. Extracapsular cataract extraction (ECCE) was performed in 26 eyes and Kelman's phacoemulsification (KPE) was perform-ed in 12 eyes. Corneal thickness, as measured by Mi-shima's pachymeter, and the endothelial cell size, as photographed by specular microscope, served as para-meters for the endothelial damage.

The corneal thickness was repeatedly measured during the 28 postoperative days. It decreased rapidly during the initial one week and gradually tended to return to the preoperative value.