角膜異常を有する眼における白内障手術の安全性と有効性

Safety and effect of cataract surgery on eyes with abnormal cornea

要約　目的：角膜異常眼における白内障手術の安全性と有効性の検討。

対象と方法：同一術者が白内障手術を施行した角膜異常眼79例100眼を対象に，合併症，矯正視力，術後屈折誤差を後方視的に検討した。

結果：術中の後囊破損を1眼認めた。術後，視認性不良部での核片残存の処理と眼内レンズハプティクス整復を各1眼に行った。矯正視力は白内障手術で有意に改善した（p＝0.0001）。屈折誤差は0.87±0.91Dであった。

結論：角膜異常眼における白内障手術はおおむね安全かつ有効であったが，視認性不良部での核片残存と術後屈折誤差に注意が必要である。

Abstract　Purpose: To report safety and effect of cataract surgery on eyes with abnormal cornea.

Cases and Method: This retrospective study was made on a consecutive series of 100 eyes of 79 patients who received cataract surgery by one surgeon. All the eyes had abnormal cornea including keratoconus, pathological stroma, history of corneal transplantation, phototherapeutic keratectomy, and LASIK among others. Outcome of cataract surgery was evaluated regarding complications, visual acuity and refraction.

Results: The posterior capsule ruptured in one eye. One eye needed repositioning of intraocular lens. One eye needed anterior chamber irrigation to remove fractured lens nucleus. Four eyes received endothelial keratoplasty for aggravation of bullous keratopathy. Visual acuity improved significantly after surgery（p＝0.0001）. Postoperative refractive error averaged 0.87±0.91 diopter.

Conclusion: Cataract surgery on eyes with abnormal cornea was safe and effective in general. Attention is needed regarding postoperative error and fractured lens nuleus in the anterior chamber due to poor visibility.