低加入度数分節型眼内レンズ5症例と単焦点眼内レンズ5症例の満足度比較

Comparison of satisfaction between five cases of diffractive intra-ocular lenses and five cases of monofocal intra-ocular lenses

要約　目的：低加入度数分節型眼内レンズ（LC群）もしくは単焦点眼内レンズ（単焦点群）を移植された患者の裸眼での距離別満足度を比較する。

対象と方法：対象は術後等価球面度数−0.50Dを想定し，両眼白内障に対し両眼に同じ種類の眼内レンズ移植を行い，両眼ともに術後遠方裸眼視力0.7以上となった症例（平均年齢77.2±7.6歳），LC群5例10眼，単焦点群5例10眼である。白内障手術は2週間の間隔で行い，2眼目の治療1週間後時点の距離別満足度および総合満足度を，非常に満足，満足，普通，不満，非常に不満のなかから回答してもらうアンケート形式で調査した。

結果：術後裸眼遠方視力（logMAR）の平均はLC群0.07±0.07，単焦点群0.04±0.12であり，両群間に差はなかった（p＝0.85）。術後等価球面度数の分布は，−1.00D以下がLC群9眼，単焦点群3眼，−1.00D超え−0.50D以下がLC群0眼，単焦点群4眼，−0.50D超え0D以下がLC群1眼，単焦点群3眼であった。「非常に満足」と「満足」の合計は，遠方においてLC群と単焦点群ともに5/5（100％），中間距離においてLC群5/5（100％），単焦点群3/5（60％），近方においてLC群4/5（80％），単焦点群1/5（20％）であった。

結論：両眼同一の度数設定で同種の眼内レンズを移植する場合は，低加入度数分節型眼内レンズを選択すると遠方から近方まで術後満足度が高くなる可能性がある。

Abstract　Purpose：To compare satisfaction with uncorrected visual acuity at different distances in patients implanted with low-power segmental intraocular lenses（LC group）and monofocal intraocular lenses（monofocal group）.

Subjects and methods：We included patients（mean age 77.2±7.6 years）who underwent the same type of intraocular lens implantation for cataract treatment with the expected postoperative refraction of −0.50D in both eyes and uncorrected distance logMAR visual acuity of 0.15 or better after surgery. There were five cases（10 eyes）in the LC group and five（10 eyes）in the monofocal group. Cataract surgeries in both eyes were performed 2 weeks apart, and the degree of satisfaction at each distance and overall satisfaction at 1 week after treatment of the second eye were surveyed using questionnaire with the options “very satisfied”, “satisfied”, “not bad”, “unsatisfied”, and “very unsatisfied”.

Results：The mean postoperative uncorrected distance visual acuity（logMAR）was 0.07±0.07 in the LC group and 0.04±0.12 in the monofocal group, with no significant difference between the two groups（p＝0.85）. The distribution of equivalent spherical refraction postoperative objective refraction findings was as follows：≤−1.00D in nine eyes in the LC group and three eyes of the monofocal group, −1.00D＜ and ≤−0.50D in none of the eyes in the LC group and four eyes in the monofocal group and −0.50D＜ and ≤0D in one eye in the LC group and three eyes of the monofocal group. Patients responding with “very satisfied” or “satisfied” included all patients（100％）in both the LC and monofocal groups at distance, five patients（100％）in the LC group and three（60％）in the monofocal group at intermediate distance, and four patients in（80％）for the LC group and one（20％）in the monofocal group at near distance.

Conclusion：Implantation of low-power segmental intraocular lenses in both eyes with the same expected postoperative refraction can increase satisfaction from distance to near vison after cataract surgery.