白内障術後のインドメサシン点眼が角膜上皮に及ぼす影響

Influence of indomethacin eyedrops on corneal epithelium after cataract surgery

　白内障手術患者を対象とし，0.5％インドメサシン油性点眼液を術前術後に用いた10例（インドメサシン群）とインドメサシン点眼を用いない10例（コントロール群），インドメサシン点眼液の基剤を点眼した5例（基剤群）を対象とし，術前，術後1週，1か月，3か月に角膜中央部の上皮スペキュラーマイクロスコープ撮影を行い，平均露出細胞面積と角膜上皮スコアを用いた形態解析を行った。平均露出細胞面積はコントロール群，基剤群では術前術後に有意の変化を認めなかったが，インドメサシン群では術前は630.3±45.8μm²，術後1週は772.0±113.1μm²，1か月では818.4±106.3μm²，3か月では703.7±78.4μm²と術後1週，1か月で有意に増大し，コントロール群との間にも有意差を認めた。インドメサシン群のスコアはコントロール群に比べ術後1週，1か月で有意に増加していたが，基剤群とコントロール群との間には有意差を認めなかった。インドメサシン点眼は白内障術後の角膜上皮の形態に変化を与え，その作用は基剤ではなくインドメサシンによると考えられた。

We assessed the influence of indomethacin oily eyedrops on the corneal epithelium following cata-ract surgery. We used specular microscopy to observe the epithelium in the central cornea. The eyes were divided into 3 groups. In the indometh-acin group of 10 eyes, indomethacin eyedrops were instilled before and during 1 month after surgery. In the oil group of 5 eyes, castor oil eyedrops without indomethacin was instilled. The findings were compared with those in the control group of 10 eyes. The state of corneal epithelium wasdocumented with specular microscopic photogra-phy prior to surgery, and 1 week, 1 month and 3 months after surgery. The mean cell area in in-domethacin group was significantly larger than that in control group at 1 week and 1 month after surgery (p＜0.001). The corneal epithelial score in indomethacin group was also higher than that in control at 1 week and 1 month after surgery (p＜0. 05). There were no significant differences between the oil and control group. The findings indicate that indomethacin as oily eyedrops may induce damage in the corneal epithelium. This effect is ascribed to indomethacin and not to castor oil.