眼内レンズ移植後早期の眼圧上昇とその対策

Prevalence and management of early intraocular pressure elevation following intraocular lens implantation

　眼内レンズ（IOL）移植6〜12時間後の眼圧は，術前に比べて有意に上昇し，21眼中10眼が21mmHg以上であった。高滲透圧剤を術前に投与すると，非投与に比べて眼圧上昇が有意に抑えられた。

　術翌日の眼圧は，ECCE,IOL移植例ともに，術前に比べて有意に上昇し，21mmHg以上は40％に見られた。術前の高滲透圧剤による眼圧への影響は認められなかった。45mmHg以上の上昇はIOL移植眼にのみみられ，最高は72mmHgであった。

　高眼圧に伴う自覚症状は4例にのみみられた。術後処置として，炭酸脱水酵素阻害剤，高滲透圧剤およびベータ遮断剤などを使用した。高眼圧は術後2日目までには大部分が正常化した。

We monitored the intraocular pressure (IOP) after cataract surgery with or without posterior chamber lens (PCL) implantation in 183 eyes. Patients were randomly assigned to either of the 3 groups: extracapsular cataract extraction (ECCE) group of 22 eyes, PCL group with intravenous hyperosmotic agent prior to surgery (treated PCL group) of 84 eyes, and PCL group without hyperos-motic agent (non-treated PCL group) of 56 eyes. We used 0.2 ml of sodium hylurinate in both PCLgroups. Surgery was uneventful throughout the cases.

We observed elevation of IOP over 21 mmHg 6 to 12 hours after surgery in 40% of eyes in both PCL groups. The IOP values were significantly higher than the preoperative level. The elevation of IOP was significantly greater in non-treated than in treated PCL group. On the next day after surgery, elevation of IOP over 21 mmHg was seen in 50% of eyes in both PCL groups. There was no significant defference between treated and non-treated PCL group.