術後早期眼内レンズ表面に観察された霧状混濁“steam-like clouding”の8症例

Steam-like clouding on the intraocular lens surface appearing shortly after surgery in 8 eyes

要約　目的：眼内レンズ（IOL）（エタニティー^®，参天製薬）の挿入後早期に，光学部に発生する霧状の混濁（steam-like clouding）の臨床的特徴の報告。

症例：“Steam-like clouding”を生じた白内障単独手術例3眼，硝子体とのトリプル手術5眼の計8症例である。

所見と経過：術後数日以内に，光学部の房水と接する前房側表面にのみ“steam-like clouding”が観察された。発症時点で視力障害を認める。混濁は数週で自然吸収する症例が多いが，混濁が残存し視力障害の改善のために吸引除去が必要な症例もあった。発生率は白内障単独手術では0.09％であり，硝子体トリプル手術では0.64％と推定される。

結論：“Steam-like clouding”は，エタニティー^®に術後早期に発症する原因不明の特異な混濁現象であり，予後は良好である。

Abstract　Purpose：To report clinical characteristics of steam-like clouding observed on the surface of acrylic intraocular lens（IOL）（Eternity^®）shortly after surgery in 8 eyes.

Subjects：Three cases undergoing phacoemulsification and intraocular lens implantation and five cases triple procedure of vitrectomy, phacoemulsification, and intraocular lens implantation developed steam-like clouding on the anterior surface of the IOL.

Findings and Clinical Course：Steam-like clouding, developing on the anterior surface of the IOL only a few days after surgery, was localized to the area contacting the aqueous humor. At this time patients complained of blurred vision. In most eyes, the phenomenon improved and disappeared after several weeks, while in some eyes it required surgical intervention to use an irrigating and aspirating tip. The rate of incidence is estimated to be 0.09％ after cataract surgery and 0.64％ after triple procedure of vitrectomy and cataract surgery.

Conclusion：The deposits on the anterior surface of the optic were localized to the area contacting the intraocular irrigating solution or the aqueous humor. This may be related to the origin（development?）of this kind of steam-like clouding.