白内障硝子体手術でのトーリック眼内レンズの有効性について

Usefulness of toric intraocular lens in simultaneous vitreous and cataract surgery

要約　目的：角膜乱視のある白内障硝子体手術においてトーリック眼内レンズ（T-IOL）の有効性を検討する。対象と方法：当科で白内障硝子体手術を施行した，明瞭な不正乱視のない角膜乱視1.5D以上，術後最高矯正視力0.7以上，目標屈折正視〜−0.5Dの黄斑上膜症例15眼を対象とした。T-IOL使用7眼と乱視矯正機能のないIOL使用8眼の2群に分け，自覚および他覚乱視度数，矯正視力に対する裸眼視力の割合の3項目につき術前および術後2，4，8，12週間目において後ろ向きに検討した。結果：T-IOL群は術後全期間において自覚および他覚乱視度数が有意に小さかった。結論：角膜乱視のある白内障黄斑上膜症例ではT-IOL使用で，より良好な裸眼視力になると考えられる。

Abstract.　Purpose：To report the outcome of insertion of toric intraocular lens（IOL）in simultaneous vitreous and cataract surgery. Cases and Method：This retrospective study was made on 15 eyes of 15 patients who received cataract surgery by us in the past 80 months. As inclusion criteria, the eyes had epiretinal membrane, corneal astigmatism over 1.5 diopters, prospective astigmatism within±0.5 diopters after surgery, and had best-corrected visual acuity of 0.7 or over 3 months after surgery. Toric IOL was inserted in 7 eyes and conventional IOL in 8 eyes. Cases were followed up for 12 weeks after surgery. Results：Eyes inserted with conventional IOL showed no difference in astigmatism before and after surgery. Eyes inserted with toric IOL showed, subjectively and objectively, significantly lesser astigmatism（p＝0.01）. Conclusion：Insertion of toric IOL resulted in reduced astigmatism after cataract and vitreous surgery in eyes with corneal astigmatism and epiretinal membrane.