低加入度数分節眼内レンズ・レンティス®コンフォートの視力経過と眼鏡必要度からみた手術適応の検討

Predication of indication for surgery based on postoperative course of visual acuity and necessity of eyeglasses in eyes inserted with LENTIS® Comfort as low-power segmental intraocular lens

要約　目的：低加入度数分節眼内レンズであるレンティス^®コンフォート（LC）の視力経過と術後の眼鏡必要度を検討し，LCの手術適応を考察した。

対象と方法：LC両眼挿入例（38例76眼）と，LC片眼挿入例で僚眼が単焦点眼内レンズ（Mono）挿入群（Mono群）（23例23眼）・有水晶体群（17例17眼）の視力経過・焦点深度曲線を比較検討し，これら3群における遠用から近用の眼鏡の必要度を検討した。

結果：LC両眼挿入とLC片眼挿入群の遠方視力に差はなかった。中間視力は，LC両眼挿入がLC片眼挿入より良好な結果が得られ，さらにLC両眼挿入はLC＋僚眼Mono，LC＋僚眼有水晶体よりも良好な結果が得られ，焦点深度曲線からみた明視域の広さも同様の結果が得られた。LCのほぼ全症例で遠方と中間距離での眼鏡は不要であった。LC両眼挿入例の79％で近用眼鏡は不要であり，LC片眼挿入例では近用眼鏡不要例は40％であった。

結論：LCは遠方から中間距離で良好な裸眼視力が獲得可能で近用眼鏡が不要となるものがあり，白内障術後の視覚改善の有効な手段である。また，僚眼がMonoあるいは有水晶体であってもLCの片眼挿入により良好な両眼視機能が獲得可能である。

Abstract　Purpose：To discuss the indication of LENTIS^® Comfort（LC）as low-power segmental intraocular lens（IOL）.

Case：Visual function in 116 eyes was evaluated regarding visual acuity and depth of focus after insertion of IOL. LC was inserted in both eyes in 38 cases. LC was inserted in one eye and monofocal IOL in the fellow eye in 23 cases. LC was inserted in one eye while the fellow eye remained phakic in 17 cases. These three groups were evaluated regarding necessity of multifocal IOL for far and near.

Findings：There was no difference in far visual acuity between eyes inserted with bilateral and unilateral LC. Visual acuity in medium distance was better in eyes inserted with bilateral LC than unilateral LC. Eyes with bilaterally inserted LC showed better visual function for medium distance than the other two groups. Similar results were obtained regarding focal depth curve. No reading glasses were necessary in 79％ of cases inserted with bilateral LC and in 40％ of eyes with unilateral LC.

Conclusion：Cases with bilaterally inserted LC often showed excellent visual function in medium distance and required no reading glasses. Excellent binocular vision was acquired in eyes with unilaterally inserted LC with the fellow eye remaining phakic or inserted with conventional IOL.