ハイドロジェル眼内レンズ挿入眼の前房フレア値上昇

Elevation of aqueous flare following implantation of hydrogel intraocular lenses

　3か月間に白内障手術と眼内レンズ（intraocular lens：IOL）挿入術を59眼に行った。ハイロドジェルIOL （H60M, Storz社）を43眼，S140NB （Allergan社）を16眼に挿入した。年齢と性別について、両群間に有意差はなかった。術後3か月間の経過を追跡した。術後の矯正視力と角膜内皮細胞密度について，両群間に有意差はなかった。術翌日の前房フレア値の平均値は両群で上昇したが，H60M群でのそれはS140NB群よりも有意に高かった（t＜0.05）。前群43眼中11眼ではフレア値が50を超え，うち4眼では100以上であり，2眼でフィブリン反応が生じた。これら11眼では，特定の2つのロットのIOLが関与していた。術前のフレア値が高い症例で術後のフレア値上昇が強かった。術後1週以降では，両群間に前房フレア値には差がなかった。ハイロドジェルIOL挿入後には一過性の前房フレアの上昇がありうることと，術前のフレア値が高い症例では挿入を回避すべきであると結論される。

Cataract surgery with intraocular lens (IOL) implantation was performed in 59 eyes during a 3-month period. Hydrogel IOL (H60M, Storz) was used in 43 eyes and S140NB (Allergan) in 16 eyes. There was no difference between both groups regarding age or sex. The postoperative course was followed up for 3 months. There was no difference between both groups regarding corrected visual acuity or density of corneal endothelial cells. One day after surgery, the average value of aqueous flare increased in both groups. Eyes implanted with H60M showed significantly higher values than in eyes with S140NB (t＜0.05) . The flare value exceeded 50 in 11 eyes and 100 in 4 eyes in the former group. Severe fibrinous reaction developed in 2 eyes. These 11 eyes had received IOL with either of two lot numbers. Eyes with higher flare values before surgery tended to show higher flare values the next day after surgery. There was no difference between both groups regarding aqueous flare after 1 week of surgery. The findings show that hydrogel IOL may induce temporary rise in aqueous flare after surgery and that eyes with elevated aqueous flare before surgery need particular caution.