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原発開放隅角緑内障または嚢性緑内障患者22名29眼に対してアルゴンレーザー線維柱帯形成術(ALT)を施行し,術前および術後経時的にフルオロフォトメトリーを行いALTが血液房水柵透過性に及ぼす影響を検討した.そしてALTによる血液房水柵透過性の変化とプロスタグランディンズ(PGs)の関与を知るため,対象を術前および術後3日間のPGs生合成阻害剤であるFlurbiprofen (0.1%)点眼群(FP[+]群,12名12眼)と,非点眼群(FP[—]群,15名17眼)の2群に分けて検討した.FP (+)群,FP (—)群いずれも,ALT術後7ないし14日までは術前に比較して血液房水柵透過性が有意に上昇したが,両群間での比較では,術後14日目までの各時期ではFP (+)群ではFP (—)群に比較して血液房水柵透過性亢進が有意に抑制された.術後14日までのoutflow pressureの下降率はFP (—)群の方が有意に高かった.また,術後早期の一過性眼圧上昇(5mmHg以上)の頻度には両群間で有意の差を認めなかった.PGsは,ALTによる血液房水柵透過性の亢進および眼圧下降作用には密接な関与をしていることが判明したが,術後一過性の眼圧上昇に及ぼす影響については明らかではなかった.
We performed argon laser trabeculoplasty (ALT) in 29 eyes with open angle glaucoma. The cases were evaluated by means of fluoro-photometry as to the permeability of blood-aque-ous barrier after ALT. Topical 0.1 % flurbiprofen (FP) ophthalmic solution was instilled in 12 eyes, 12 subjects, 3 hours before and for 3 consecutive days after ALT. The remaining 17 eyes, 15 subjects, received a vehicle solution as control.
The permeability of blood-aqueous barrier was significantly increased after ALT for 1 to 2 weeks in both groups. The increased permeability was significantly less in FP-treated group than in con-trols during 14 days after ALT. The decrease in outflow pressure was significantly more in control eyes than FP-treated eyes. There was no difference in the rate of transient rise of intraocular pressure within 24 hours after ALT in the two groups. The findings suggest that prostaglandins play a key role in increasing the blood-aqueous barrier and in decreasing the intraocular pressure after ALT.
Rinsho Ganka (Jpn J Chn Ophthalmol) 42(10) : 1155-1159, 1988
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