白内障手術の術式と糖尿病網膜症の進行

Progression of diabetic retinopathy following different procedures of cataract surgery

　白内障手術および眼内レンズ挿入術を施行した糖尿病患者で，術後1年以上経過観察可能であった69例129眼を対象として，術式と術後網膜症の進行との関連について調査し，計画的水晶体嚢外摘出術（ECCE）と超音波水晶体乳化吸引術（PEA）の優劣を比較検討した。術式別の術後網膜症悪化率は，ECCE群（56眼）は非手術眼群（30眼）に比べて有意に高かった（p＜0.05）。PEA群（43眼）は後嚢破損がなければ，非手術眼群との間には有意差がなく，ECCE群に比べて有意に低かった（p＜0.05）．後嚢破損例では，ECCE群との間に有意差がなかった．この傾向は術前の網膜症の病期にかかわらず，認められた。

We reviewed the course of retinopathy following cataract surgery with intraocular lens im-plantation in 129 eyes of 69 diabetic patients. Planned extracapsular cataract extraction (ECCE) was performed in 56 eyes and phacoemulsification-aspiration (PEA) in 43 eyes (30 unoperated eyes served as control). At 12 months after surgery, retinopathy showed significantly greater progression in ECCE group than in control (p＜0.05). In PEA group without rupture of the posterior capsule, the course of retinopathy was similar to control and was more benign than in ECCE group (p＜0.05). The course of retinopathy was similar between PEA group with rupture of posterior capsule and ECCE group. Above tendency was independent of the severity of diabetic retinopathy at the time of surgery.