歯科医師における多焦点眼内レンズ挿入後の視機能

Visual function of multifocal intraocular lens in the dentist

要約　目的：多焦点眼内レンズ（IOL）が挿入された歯科医師の術後視機能，特に歯科診療時の見え方を，単焦点IOLが挿入された歯科医師の結果と比較する。

対象と方法：当院にて両眼に白内障手術が施行された歯科医師にアンケートを送付して本研究に同意と回答の得られた症例を対象とした。調査内容は，歯科診療において，歯冠や歯の欠損を修復する補綴，歯を保存し機能させることを目的とする保存，齲歯や歯周病の治療を除く顎口腔領域の外科系処置をする口腔外科の3分野に分け，それぞれの分野で代表的な3項目，計9項目における見え方と，日常生活における遠方・中間・近方の見え方とした。それぞれの状況で眼鏡使用頻度を使用なし1・ときどき使用2・常用3，見え方を全く問題なし1・ときどき問題あり2・問題あり3にスコア化して検討した。

結果：該当する44例に郵送し34例（回答率77.3％）（多焦点IOL：17例，単焦点IOL：17例）から同意および回答が得られた。両群の遠方矯正視力に有意差はなく（マン・ホイットニーのU検定p＝0.680），多焦点群の近方視力は裸眼0.96，遠方矯正下0.97で良好であった。診療の9項目中7項目で多焦点群の眼鏡依存度が低く有意に関連があり，見え方は有意差がなかった。日常生活は全距離で多焦点群の眼鏡依存度が低く有意に関連があり，近方視で単焦点群の見え方が良好で有意に関連があった（χ²検定p＜0.05）。

結論：多焦点IOL挿入は歯科診療に支障なく，眼鏡依存度を低下させることが示唆された。

Abstract　Purpose：To compare postoperative visual function, particularly during dental procedures, between dentists with multifocal intraocular lenses（IOLs）versus monofocal IOLs.

Methods：We sent questionnaires to dentists who had undergone cataract surgery on both eyes at our hospital, and obtained consent and responses for this study. The survey assessed visual function during various dental procedures, including prosthodontic procedures such as restoration device polishing and color shade assessment, color changes in teeth, and color shade selection during prosthesis fabrication；endodontic treatment such as differences in color shade between natural teeth and composite resin restorations；pigmentation changes with medication；and oral surgical conditions such as gingival swelling, redness, bleeding, suppuration, and oral mucosal lesions. The survey also evaluated distant, intermediate, and near vision in daily activities. The spectacle usage was scored as none（1）, occasional（2）, and always（3）, and the problem of photic phenomena were scored as none（1）, occasional（2）, and always（3）for each situation.

Results：Out of 44 participants contacted, consent and responses were obtained from 34（response rate 77.3％）（multifocal IOLs：17 patients, monofocal IOLs：17 patients）. There was no significant difference in distant corrected visual acuity（VA）between both groups（Mann-Whitney U test, p＝0.680）, and the near VA in the multifocal group was good, with 0.96 for uncorrected and 0.97 for distance corrected. The multifocal group showed significantly lower spectacle dependence in seven out of nine items, and there was no significant difference in photic phenomena between the multifocal and monofocal groups. In daily activities, the multifocal group showed significantly lower spectacle dependence of all distances, and better near vision. The monofocal group demonstrated significantly lower photic phenomena（χ² test, p＜0.05）.

Conclusion：For dentists, multifocal IOLs reduce spectacle dependence and provide good visual function.