前囊切開時の水晶体動揺を基にしたZinn小帯脆弱度分類および前囊皺襞と眼内レンズ挿入後の前囊切開窓変形の関係

The classification of zonular weakness based on lens movement during capsulorrhexis and anterior capsule striae and capsulorrhexis ovaling

要約　目的：連続円形切囊術（CCC）時の水晶体動揺，前囊皺襞と眼内レンズ（IOL）挿入後のCCC楕円形化の所見との関係を検討した。

対象と方法：対象は水晶体乳化吸引術（PEA）とIOL挿入を行った224眼である。Zonular weakness（ZW）分類は，CCC時の水晶体動揺を基にしており，normal，weak，very weak，extremely weakとした。各群での前囊皺襞とCCC楕円形化を有する割合を調べた。

結果：Normal群は158眼，weak群は44眼，very weak群は20眼，extremely weak群は2眼であった。分類のグレードに一致してCCC時の前囊皺襞，IOL挿入後のCCC楕円形化の割合は高くなった。

結論：ZW分類の水晶体動揺と前囊皺襞，CCC楕円形化はPEA時のZinn小帯脆弱の指標となる可能性が示唆される。

Abstract　Purpose: To report the correlation between lens movement during continuous curvilinear capsulorrhexis（CCC）and the findings of the anterior capsule striae during CCC and capsule ovaling after intraocular lens（IOL）implantation.

Material and methods: This study was made 224 eyes that underwent phacoemulsification（PEA）and IOL implantation. We classified the zonular weakness into 4 grade based on lens movement during CCC：grade normal（N）, weak（W）, very weak（VW）, and extremely weak（EW）. We examined the presence of anterior capsule striae and capsulprhexis ovaling in each grade.

Results: We classified 158 eyes as grade N, 44 eyes as grade W, 20 eyes as grade VW, and 2 eyes and grade EW. The finding of anterior capsule striae and capsulorhexis ovaling was more frequent as the zonular weakened.

Conclusion: There is a possibility that lens movement during CCC, anterior capsule striae and capsulprhexis ovaling may be useful signs of zonular weakness.