緑内障眼の人工水晶体移植術

Intraocular lens implantation in glaucomatous eyes

　1981年4月から1986年3月までに当院および昭和大学病院で緑内障と診断されかつ眼内レンズ（IOL）移植を受けた緑内障眼77症例，101眼につきこれをiridectomy群，filtration群，triple群，β-blocker群の4群に分けて，その術式，術後眼圧コントロール等について検討した．また非緑内障眼81症例121眼をコントロールとして，術後合併症，視力等について比較した．

　結論として，緑内障眼のIOL移植は96％で良好であった．したがってfiltering blebをもつ緑内障眼でも眼圧コントロールが良好ならば，IOL移植はほぼ安全に行えると思われる．更に術前眼圧が30mmHg以下のものならば，一度の手術侵襲ですむ，triple procedureを考慮しても良いと思われた．

We evaluated a consecutive series of 101 glaucomatous eyes treated by intraocular lens (IOL) implantation during the 5 years through 1986. Out of the series, 67 eyes had been treated by prior antiglaucoma surgery, 11 eyes were treated by simultaneous trabeculectomy during IOL implanta-tion, and the other 23 eyes were treated by topical medication before and after IOL implantation.

Adequate control of intraocular pressure, wasmaintained in 97 eyes (96%) either without medica-tion or with topical beta-blocker instillation, Out of the remaining 4 eyes, trabeculectomy had to be performed in 3 eyes and laier trabeculoplasty in 1 eye, all with favorable results.

Above findings indicate that adequate control of intraocular pressure can be expected if the glau-coma is in an already controlled state prior to IOL implantation either with surgery or medication.

Rinsho Ganka (Jan J Clin Ophthalmol) 41(4) : 313-314,1987