小切開による眼内レンズ縫着術後成績の検討

Outcome of small-incision cataract surgery with insertion and fixation of foldable intraocular lens

要約　目的：眼内レンズ（IOL）縫着術の切開幅別術後成績の検討。対象と方法：IOL縫着術を施行した47例49眼。創口2.4mmの極小切開群（18眼），4.0mmの小切開群（14眼），6.0〜7.0mmの中切開群（17眼）の3群に分け，矯正視力，角膜内皮減少率，屈折誤差，乱視絶対量を比較した。結果：矯正視力は極小切開群0.94，小切開群0.91，中切開群0.70で良好であった。角膜内皮減少率は極小切開群4.5％，小切開群5.3％，中切開群6.1％であった。屈折誤差は3群ともに近視化していた。術後乱視絶対量は極小切開群で1.12D，小切開群で1.44D，中切開群で2.59Dであり，極小切開群は中切開群と比較し有意に低かった（p＜0.01）。結論：IOL縫着術は良好な手術成績が得られ，切開幅が小さくなると術後乱視量が低下した。

Abstract.　Purpose：To report the outcome of small-incision cataract surgery with insertion and fixation of foldable intraocular lens（IOL）. Cases and Method：This study was made on 49 eyes that received surgery in the past 13 months. The age ranged from 39 to 96 years, average 72 years. The series included subluxation of luxated IOL 26 eyes and of crystalline lens 16 eyes. Cases were evaluated after subdivision into 3 groups：18 eyes of microincision group of 2.4 mm, 14 eyes of small-incision group of 4 mm, and 17 eyes of medium-incision group of 6 to 7 mm. Results：Corrected visual acuity averaged 0.94 in microincision group, 0.91 in small-incision group, and 0.70 in medium-incision group. Decrease in population of corneal endothelial cells averaged 4.5％, 5.3％ and 6.1％ respectively. Amount of astigmatism averaged 1.12D, 1.44D and 2.59D respectively. Astigmatism in the first group was significantly less than the third. All the 3 groups showed a tendency towards myopia. Conclusion：Good outcome was obtained following insertion and fixation of foldable IOL. Amount of astigmatism was smaller after small-incision cataract surgery.