眼内レンズ挿入術による糖尿病網膜症の進行

Progression of diabetic retinopathy after intraocular lens implantation

　糖尿病患者73例73眼に眼内レンズ挿入術を施行し，術6か月後の網膜症の進行について非術眼と比較して検討を行った。術眼は非術眼に比較して術6か月後に有意に網膜症が進行し，白内障手術そのものによる網膜症悪化は16例21.9％で，不変が57例78.1％であった。単純網膜症眼でもっとも悪化率が高率で，白内障術式，年齢，HbA_1C値は網膜症悪化に影響しなかったが，ダイエットのみでコントロールしている患者に比較して，インスリン使用者は有意に術眼の網膜症が悪化した。糖尿病患者の眼内レンズ挿入術後では，網膜症の経過観察が重要であることを再認識した。

We evaluated the course of diabetic retinopathy in 73 diabetic persons following unilateral intraocular lens implantation for cataract. The phakic fellow eyes served as control. At 6 months after surgery, diabetic retinopathy showed further progression in 16 operated eyes, 22%, than in the fellow eyes. The course of retinopathy remained similar in both eyes in the other 53 patients, 78%. Postoperative progression was more prevalent in eyes with simple retinopathy before surgery and in patients under insulin therapy. The initial state of retinopathy and the mode of medication were thus major risk factors for postoperative progression of retinopathy. Progression of retinopathy was independent of age, HbA_lc level or method of surgery. Patients with diabetic retinopathy need close observation after cataract surgery with intraocular lens implantation.