ベーチェット病の併発白内障に対する手術成績

Outcome of surgery for complicated cataract in Behçet disease

　北海道大学病院眼科で白内障手術を行ったベーチェット病患者の手術成績について検討した。対象は35例56眼で，平均経過観察期間は6年3か月，手術時の平均年齢は49.6歳であった。手術後，56眼中29眼に眼発作が生じ，最終眼発作から3か月以内に手術を行った症例では全例で術後眼発作がみられた。最終眼発作から6か月以内に手術した症例と7か月以上たって手術した症例では，術後眼発作の出現に有意差がみられた。視力予後は，術後3か月では88％の眼で2段階以上視力が上昇していたが，最終受診時に2段階以上視力が上昇していたのは68％であった。視力予後不良例において，手術の術式，眼内レンズ挿入の有無，術前後の投薬に差はなかった。

We reviewed the outcome of surgery for complicated cataract in 56 eyes of 35 patients with Behçet disease. The age at surgery averagd 49.6 years. Cases were followed up for an average of 59 months postoperatively. Acute ocular attacks developed in 29 eyes (52%) after surgry. All the eyes which were operated within 3 months after the last attack developed attacks postoperatively. Eyes which were operated within 6 months after the last attack developed significantly more postoperative attacks than those which were operated later. Improvement in visual acuity by 2 lines or more was obtained on 88% of eyes at 3 months after surgery and in 68% of eyes at the final evaluation. Final visual outcome was independent of surgical modality, implantation of intraocular lens, or medication before and after surgery.