小児眼内レンズ挿入術後の後発白内障対策

Strategy for secondary cataract following intraocular lens implantation in children

（R1-8PM−11）　小児の白内障手術および眼内レンズ挿入術において，術中に施行した水晶体後嚢切開および前部硝子体切除の後発白内障予防への有効性について検討した。対象は，13例20眼（年齢は2歳から11歳）。水晶体後嚢を温存した11眼では，全例に瞳孔領にかかる後発白内障が発生した（平均発生期間は9か月）。白内障手術時に後嚢切開を施行した6眼では，5眼に後発白内障が発生した（平均期間は15か月）。後嚢切開に加え前部硝子体切除を施行した3眼中2眼では瞳孔領は透明に保たれていた。1眼は術後26か月目に後発白内障が発生した。単に水晶体後嚢を切開するだけでなく，前部硝子体切除も同時に行ったほうが，後発白内障予防に有効であると考えられた。

We reviewed 20 eyes of 13 children which received posterior chamber intraocular lens implantation for cataract. Their ages ranged from 2 to 11 years. There were 11 eyes in which the posterior capsule was left intact. All the 11 eyes developed secondary cataract in the pupillary area after an average of 9 months after surgery. There were 6 eyes which received posterior capsulotomy during cataract surgery. Secondary cataract developed in 5 of the 6 eyes after an average of 15 months after surgery. The remaining 3 eyes received posterior capsulotomy and anterior vitrectomy during cataract surgery. The pupil area remained clear in 2 eyes and secondary cataract developed in 1 eye after 26 months. The findings suggest that secondary cataract may be prevented or delayed by posterior capsulotomy and anterior vitrectomy during cataract surgery in children.