糖尿病黄斑浮腫に対するトリプル手術後の屈折変化

Refractive changes after triple procedure for diabetic macular edema

（18-D501-16）　糖尿病黄斑浮腫29眼に対して，硝子体手術，水晶体除去，眼内レンズ挿入の同時手術（トリプル手術）を行い，予測屈折値と術後屈折値を検索した。結果は，白内障摘出と眼内レンズ挿入のみを行った70眼（単独手術）と比較した。両群とも，手術の1か月後には近視化した。以後，単独手術群では遠視化の傾向を示したが，トリプル手術群では屈折値にほとんど変化がなかった。手術後の角膜屈折力は両群間に有意な差はなかった。トリプル手術では，浮腫の軽減に伴って眼軸長が復元することが遠視化が起こらない理由であると推定された。

We evaluated the predicted and actual refraction in 29 eyes of diabetic macular edema treated by triple procedure with vitrectomy, phacoemulsification and intraocular lens implantation. The findings were compared with those in 70 eyes treated by the simple procedure with phacoemulsification and intraocular lens implantation. Both groups became more myopic after one month of surgery than the predicted value. Thereafter, the refraction remained stable in eyes treated by the triple procedure. Eyes in the simple procedure group showed a tendency towards hyperopia. There was no difference in the corneal refractive power between both groups. The absence of postoperative hyperopia in the triple procedure group was interpreted as the result of elongation of the axial length following reduction in macular edema.