当科における無硝子体白内障手術の工夫と成績

Improved method and results of cataract surgery in vitrectomized eyes

　硝子体手術後に生じた白内障に対しては超音波乳化吸引術が勧められるが，チン小帯の断裂や脆弱化などのために前房深度が保たれにくい。灌流圧を3通りに設定して，無硝子体の28眼に対して白内障手術を行った。通常の75cmよりも20,25,30cm下げて比較した結果，25cm下げることで望ましい成績を得た。また，envelope法で前嚢切開したあと，十分なhydrodissectionを行えば，対面圧出法で安全確実に核を娩出できた。

Phacoemulsification and absorption are recommended for cataract after prior vitrectomy. Difficulties may arise in maintaining the anterior chamber due partly to weak or ruptured Zinn's zonule. We treated 28 such cataract eyes by reducing the height of perfusion flask by 20, 25 and 30cm from the standard 75cm. Stable depth of the anterior chamber was best achieved by 25cm reduction. Also, the envelope method for extracapsular cataract extraction proved safe and reliable is sufficient hydrodissection was achieved after incising the anterior capsule.