屈折手術施行眼における眼圧の過小評価

Underestimation of intraocular pressure in eyes after refractive surgery

（18-P3-6）　Minimally invasive radial keratotomy（mini-RK）施行後，ステロイドが点眼投与された176名310眼でのステロイド反応性眼圧上昇の頻度および時期を検討した。結果はステロイド反応強陽性23眼7.4％，中等度陽性52眼16.8％で，約85％の症例で術後2週目から1か月の間に眼圧上昇をみた。したがってmini-RK術後にステロイド点眼を併用した場合，早期からの眼圧測定が必須と考えられた。さらに，今回の結果を近視眼でのステロイドによる眼圧上昇についての報告と比較したところ，有意に低かった。このことからmini-RK術後眼では眼圧が過小評価される可能性があり，他の屈折矯正手術と同様，眼圧評価は慎重に行う必要があると考えられた。

We reviewed a series of 310 eyes in 176 myopic persons which underwent minimally invasive radial keratotomy regarding corticosteroid responsiveness. All the eyes were routinely treated by topical 0.1% betamethasone 4 times a day after surgery. The intraocular pressure (IOP) was measured by a noncontact pneumatic tonometer. As a result, 23 eyes (7.4%) were identified as high responders and 52 eyes (16.8%) as intermediate responders. These incidences were significantly low compared to the previous reports in myopic eyes (p＜0.01). It appears that postoperative IOP is underestimated due to decreased corneal curvature and corneal fragility after surgery. Due attention is advocated to this feature regarding IOP after refractive surgery.