長期コンタクトレンズ装用の角膜内皮に及ぼす影響—1．その発生について

Corneal endothelium after long-term contact lens wear. Report 1. Incidence of endothelial disorders

　長期間（平均14.6年）コンタクトレンズ（CL）を装用した39症例74眼の角膜内皮細胞をspecular microscopeで観察し，次の結果を得た。

　（1）変動係数（SD／mean）は15年以上の装用，年齢30歳以上の症例に，平均細胞面積は20年以上の装用，年齢35歳以上の症例に。日本人正常者平均値から離れて，大きな値を示す症例をみた。

　（2） CL非装用者で，明らかに異常な内皮細胞をみたものはなかった。

　（3）装用状態と内皮細胞異常出現の関係を調べたところ，自覚的訴えの有無・検査時の角膜びらんの有無・CLの装着状態の各々と，内皮細胞異常出現との間には関係はみられなかった。しかし，photokeratographで歪みをみたものは，明らかに内皮細胞異常の出現頻度が高く，長期の　steepな装用は，内皮に悪影響を及ぼす可能性が示唆された。

We evaluated the corneal endothelium in 74 eyes in 39 subjects who had worn contact lens for an average of 14.6 years. Specular microscopy was used in the evaluation. We observed significant polymegathism in subjects who were more than 30 years of age and who had worn contact lens for more than 15 years. Pleomorphism was present in subjects who were over 35 years of age and whohad worn contact lens for more than 20 years. Polymegathism or pleomorphism was consistently absent in a control series of 18 eyes of 11 contact lens no-wearers.

The observed abnormalities in corneal endoth-elium was not associated with conditions of contact lens wear including subjective feeling, corneal ero-sion or fitting pattern. More than 50% of eyes with abnormal corneal endothelium manifested abnor-mal photokeratographic findings due, presumably, to long-term wear of steep contact lens.