白内障術後眼に対するエキシマレーザー乱視矯正手術の臨床成績

Outcome of excimer laser photoastigmatic refractive keratectomy in pseudophakic eyes

（R1-8PM−21）　白内障術後の乱視20例25眼に対してVISX社STARエキシマレーザーシステムを用いた乱視矯正術（photoastigmatic refractive keratectomy：PARK）を行い，術後6か月の経過観察を行った。自覚円柱度数は術前平均3.64±1.23ジオプター（D）から術後6か月で1.08±0.64Dと減少し，戻りもなく安定していた。等価球面度数で平均2D弱の遠視化が生じた。裸眼視力は有意に改善し，矯正視力は術直後に一時的に低下したものの，速やかに回復した。目標度数の±1.0D以内に矯正できたのは術後6か月の時点で64％であった。強い上皮下混濁，遷延性上皮欠損などの重篤な合併症はなかった。PARKは白内障術後の乱視矯正術として安全かつ有効であると考えられた。

We performed photoastigmatic refractive keratectomy (PARK) on 25 astigmatic eyes of 20 patients after cataract surgery with intraocular lens implantation. The astigmatism averaged 3.64± 1.23 diopters (D) before and 1.08± 0.64D 6 months after PARK. The difference was significant (p ＜ 0.0001) . The time course of changes in postoperative astigmatism was stable during the 6 months of follow up. PARK induced a hyperoptic shift by approximately 2 D. Uncor-rected visual acuity also improved significantly. Best corrected visual acuity showed transient deterioration during the immediate postsurgical period to promptly recover to the preoperative levlel. The achieved astigmatic correction was within 1.0 D of the target value in 64% of eyes. Major complications were consistently absent including severe haze or persistent corneal epithelial defect. The findings show the safety and effectiveness of PARK for astigmatism in pseudophakic eyes.