糖尿病患者に対する白内障手術と眼内レンズ素材—左右眼の比較

Bilateral cataract surgery in diabetic persons using different intraocular lenses for either eye

　片眼にシリコーンレンズ，他眼にアクリルレンズを挿入された糖尿病患者33名66眼（以下，糖尿病群）と全身疾患を有さない患者45名90眼（以下，コントロール群）の白内障手術術後経過を観察した（観察期間は6か月）。前房フレア値は，糖尿病群の術後3か月，コントロール群の術後1日，1か月，3か月でシリコーンレンズがアクリルレンズに比べ有意に高値を示した。前房フレア比（シリコーン／アクリル）は，コントロール群の術後1日，1週，1か月，3か月で術前値に比べ有意に高値を示した。矯正視力，角膜内皮細胞密度減少率，Nd-YAGレーザー後嚢切開術頻度，糖尿病網膜症病期の推移は，レンズ素材間に有意差を認めなかった。

Purpose : To evaluate the clinical course of cataract surgery dependent on the type of foldable intraocular lens (IOL) in diabetic persons.

Cases : Bilateral cataract surgery was performed in 33 diabetic persons. Each case received silicone IOL in one eye and acrylic PMMA IOL in the other. Another series of similarly operated 45 cataract patients without diabetes served as control. They were followed up for 6 months after surgery.

Results : Postoperatively, eyes receiving silicone IOL showed significantly higher values of aqueous flare than those receiving acrylic IOL at 3 months in the diabetic group and at 1 day, 1 month and 3 months in the control group. There were no significant differences between the pairs of eyes regarding corrected visual acuity, rate of loss of corneal endothelial cells, incidence of Nd : YAG laser capsulotomy, or the fate of diabetic retinopathy.

Conclusion : The two types of IOL were similar regarding the postoperative course in diabetic persons. Silicone IOL induced higher aqueous flare than acrylic IOL in non-diabetic persons.