眼瞼下垂術後の角膜形状変化と涙液量の検討

Changes in corneal morphology and lacrimal fluid after surgery for blepharoptosis

要約　目的：眼瞼下垂術後の角膜収差の変化を検討する。

対象と方法：対象は眼瞼下垂手術を施行した48名74眼（平均年齢74.5±9.23歳）。二次収差および角膜高次収差を術前，術後1週間，術後1か月で測定した。Schirmer I法，SPKスコアで他覚的ドライアイの評価を行った。

結果：角膜二次収差は術前後で有意な変化がなかったが，角膜高次収差は術後1週間で有意に増加した。Schirmer I法による涙液量は術後1週間で有意に増加し，SPKスコアの変化には有意差がなかった。

結論：眼瞼下垂手術は一時的な術後角膜高次収差の増加により視機能に影響を及ぼす可能性がある。

Abstract　Purpose: To report changes in corneal morphology and lacrimal fluid after surgery for blepharoptosis.

Cases and methods: This retrospective study was made on 74 eyes of 48 patients who received surgery for blepharoptosis in the past 7 months. The series comprised 16 male and 58 female eyes. The age averaged 75 years. Second and higher-order corneal aberrations wes recorded before, one week and one month after surgery. Lacrimal fluid was evaluated by fluorescein staining of the cornea and Schirmer I test.

Findings: No change was present in second-order corneal aberrations after surgery. Higher-order aberration increased at one week after surgery when compared with the findings before or one month after surgery（p＜0.05）. Schirmer I test score increased significantly one week after surgery when compared with the preoperative finding. Mean corneal staining score showed no difference after surgery.

Conclusion: Surgery for blepharoptosis may affect quality of vision by temporary increase in higher-order corneal aberration even in the absence of superficial punctate keratitis.