小瞳孔眼の眼内レンズ挿入術

Intraocular lens implantation in eyes with small pupil

　小瞳孔を伴う白内障眼61例75眼に対して，虹彩切開および虹彩縫合を併用して眼内レンズ挿入術を行った。術式の内訳は嚢外摘出術（extracapsular cataract extraction：ECCE）34例43眼，超音波乳化吸引術（phacoemulsification-aspiration：PEA）27例32眼であった。

　術中合併症の頻度にはECCE, PEAの両群間で有意差はなかった。術後合併症では、一過性眼圧上昇の頻度がECCE群で有意に高かった。散瞳良好眼の白内障手術例を対照群として比較すると，術中合併症には有意差はなかつたが，術後合併症ではECCE, PEA群ともフィブリン反応の発生率が小瞳孔眼で有意に高く，PEA群の後発白内障とECCE群の瞳孔捕獲の発生率が小瞳孔眼で有意に高かった。

We performed cataract surgery with intraocular lens implantation in 75 eyes with persistent small pupil. Extracapsular cataract extraction, ECCE, was performed in 43 eyes and phacoemulsification-aspiration, PEA, was performed in 32 eyes. Iridotomy with iris suture was necessary in all the eyes. The incidence of intraoperative complication was the same for ECCE and PEA groups. Postoperatively, the incidence of transient elevation of intraocular pressure was significantly higher in ECCE than in PEA group. Fibrous iridocyclitis was significantly more frequent in the present series than in eyes without small pupil. There was a higher incidence of aftercataract requiring YAG laser capsulotomy in PEA group than in controls. Iris capture was significantly more frequent in ECCE eyes than in controls.