無硝子体眼白内障に対する眼内レンズ挿入手術

Cataract surgery with intraocular lens implantation after previous vitrectomy

　硝子体手術後の無硝子体眼白内障手術99例108眼に眼内レンズを挿入した。糖尿病網膜症53眼，糖尿病網膜症以外55眼。硝子体手術から白内障手術までの期間は21±14か月，術後経過観察期間は17±13か月。水晶体嚢外摘出術16眼水晶体超音波乳化吸引術92眼であった。術中併発症は，前房出血6眼，後嚢破損9眼，チン小帯離断3眼，核硝子体腔落下2眼，前房形成不良2眼術後併発症は，フィブリン反応24眼，虹彩後癒着15眼，一過性眼圧上昇8眼，網膜剥離1眼，後発白内障20眼，緑内障8眼，瞳孔偏位2眼，硝子体再手術を要した硝子体出血2眼を認めた。無硝子体眼白内障手術は，超音波乳化吸引術が術後併発症も少なく適していると考えられた。

We performed cataract surgery with posterior chamber lens implantation in 108 eyes after vitrectomy for diabetic retinopathy 53 eyes and others 55 eyes. The interval between vitrectomy and cataract surgery ranged 2 to 60 months, mean 21 months. The cases were followed up for 3 to 57 months, mean 17 months. Intraoperative complica-tions included hyphema 6 eyes, posterior capsulerupture 9 and nucleus loss into the vitreous cavity 2. Postoperative complications included fibrin reac-tion 24 eyes, posterior synechia 15, pupillary occlu-sion 2, ocular hypertension 8, retinal detachment 1, aftercataract 20, glaucoma 8 and vitreous hemor-rhage 2. Phacoemulsification-aspiration was foll-owed by least incidence of intra- and postoperative complications.