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糖尿病眼の白内障術前のレーザー干渉縞視力(laser interference fringe visual acuity:LVA)の信頼性について検討した。糖尿病患者107例130眼を対象とし,術前のLVAと術後最高視力を比較した。LVAの測定可能な120眼中,その差が1段階以内は58眼(48%),LVAが2段階以上良好は39眼(33%),逆に2段階以上不良は23眼(19%)であった。その原因は良好群では後嚢下白内障が,不良群では糖尿病黄斑症が最多であった。中間透光体に混濁のない糖尿病黄斑症例23例30眼に対して,LVAと矯正視力の比較を行った。全例でLVAが矯正視力より有意に良好であった(p<0.01)。以上のLVAの特徴を考慮し,糖尿病眼の白内障術前のインフォームドコンセントを得る必要性が示された。
We evaluated the prognostic value of laser interference fringe visual acuity (LVA) before surgery for cataract in 130 eyes of 107 diabetic patients. The findings were compared with the maximum visual acuity after phacoemulsification-aspiration or extracapsular cataract extraction with intraocular lens implantation. Actual determination of LVA was possible in 120 eyes. Its value was within one line of the postoperative visual acuity in 58 eyes, 48%, was better by 2 lines or more in 39 eyes, 33%, and was worse by 2 lines or more in 23 eyes, 19%. The LVA value tended to be better than the final visual acuity in posterior capsular cataract and to be worse in diabetic maculopathy. The LVA value was consistently better than the actual visual acuity in another series of 30 eyes of diabetic maculopathy with clear media (p < 0.01). These characteristics of LVA have to be borne in mind before obtaining an informed consent before cataract surgery in diabetic patients.
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