トラベクロトミー術後眼に対するラタノプロストの影響

Effect of topical latanoprost in eyes after trabeculotomy

　手術既往のない発達緑内障を含む原発開放隅角緑内障に対して，トラベクロトミーを1回施行して経過観察中の症例に，ラタノプロストを12か月投与してその眼圧経過を検討した。症例数は34例50眼で，男性18例25眼，女性16例25眼であった。投与後1・3・6・12か月の平均眼圧は15.1±2.4,153±2.3,15.2±2.2,15.2±1.8mmHgであり，投与前の平均眼圧18.0±2.2mmHgよりも有意に低下した（Wilco×on検定，p＜0.001）。視野進行別の目標眼圧の達成率は，I期（n＝36）では66.7％から100％に増加し，II期（n＝14）では21.4％から92.9％へと増加した。III期の症例は含まれなかった。これらの結果から，ラタノプロストはトラベクロトミー術後の症例に対しても，非手術例と同様に効果があると考えられた。

We treated 50 eyes of 34 patients by instillation of latanoprost. All the eyes had received a single session of trabeculotomy for primary open-angle glaucoma before. The intraocular pressure (IOP) averaged 18.0±2.2mmHg before start of latanoprost and 15.2±1.8mmHg after 12 months of treatment. The differ-ence was significant (p＜0.001, Wilcoxon test). The treatment was evaluated as success when IOP was re-duced to 19mmHg or less in early-stage glaucoma, 16mmHg in middle stage and 14mmHg in advanced stage. The treatment was successful in 36 of 36 eyes (100%) of early-stage glaucoma, in 13 of 14 eyes (92.9%) of middle-stage glaucoma. The present series did not include eyes with advanced-stage glaucoma. The rate of success before latanoprost was 66.7% in early-stage glaucoma and 21.4% in middle-stage one. The find-ings show that latanoprost is effective for glaucoma following a single session of trabeculotomy as well as for non-operated glaucoma.