白内障手術における縫合糸の評価 ポリグリコール酸糸8-0,9-0，およびシルク糸9-0について

Evaluation of suture materials for cataract surgery

　比較的初心者の執刀による計画的水晶体嚢外摘出術（ECCE）26例31眼を対象として9-0silk糸，8-0 polyglycolic acid （PGA）糸および9-0PGA糸の評価を行った．強角膜はそれぞれの縫合糸を用いて5針の単結紮縫合を行い，術後3カ月間縫合糸周囲の刺激症状および角膜乱視の経時的変化について検討を加えた．各縫合糸を使用した群で，術後1週間目に4から6ディオプターの直乱視が認められたが，この乱視は漸次軽減して3カ月目にはほぼ消失した．乱視の変遷に関しては3種の縫合糸とも同様の傾向を認めたが，術後3カ月目の検査結果，2種のPGA糸に比較し，9-0 silk糸に乱視のばらつきが認められた．また，縫合糸周囲の刺激症状に関しては9-0 silk糸，9-0 PGA糸がほぼ同等の刺激症状を示したのに対し，8-0 PGA糸は術後早期に強い炎症所見が認められた．

We evaluated the role of different suture mate-rials in the amount of corneal astigmatism after conventional extracapsular cataract extraction (ECCE), when performed by relatively inexperi-enced surgeons.

Either of the three ophthalmology residents per-formed ECCE in 31 eyes following a set protocol : four-plane, 120°-incision, manual nucleus extrac-tion and cortex aspiration, and 5 interrupted sutures. The suture material was randomly selected from a choice of : 8-0 polyglycolic acid (PGA), 9-0PGA and 9-0 silk. The postoperative corneal astig-matism and conjunctival irritation around the sutures were evaluated over a follow-up period of 3 months.

The postoperative course and final amount of corneal astigmatism was independent of which suture material was used for surgery. As a minor difference, 8-0 PGA was slightly more irritating than the other two.

The findings show that the surgical procedure for ECCE as described above is a suitable one for relatively inexperienced surgeons. The choice of suture material does not significantly affect the postoperative corneal astigmatism.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(5) : 503-505, 1988