白内障手術による交感性反応の検討

Consensual reflex by unilateral cataract surgery

　一眼の白内障手術が他眼に及ぼす交感性反応について検討した。嚢外摘出術を行った9例と嚢外摘出術および眼内レンズ挿入術を行った21例の計30例を対象として術前および術後1，3日，1，2週，1，2，3，6か月目に非手術眼の対光反応諸因子ならびにフレア値を測定し，統計学的に検定した。一定数の症例において瞳孔面積の縮小（縮瞳）およびフレア値の上昇が術後早期から現れ前者は後者よりも高頻度かつ長期間にわたって認められた。この縮瞳は嚢外摘出術群で術後3日，眼内レンズ挿入群で術後1か月まで有意に認められた。両眼の白内障手術を行う際には，この交感性反応の存在を念頭において手術間隔を設定することが望ましいと思われた。

We tried to estimate the optimum minimal inter-val between cataract surgeries in both eyes. We evaluated the direct pupillary light reflex and quantitated the protein and cells in the anterior chamber in the fellow eye after cataract surgery in 30 patients. Extracapsular cataract extraction was performed in 9 eyes. Additional intraocular lens implantation was perfomed in 21 eyes. When stud-ied by computerized videopupillogram, significant miosis developed in the contralateral eye from the day after surgery to last for one month. The proteincontent in the aqueous in the contralateral eye rose significantly from the first to 14th postoperative day. There was no change in aqueous cells through-out the duration of observation for 6 months. The findings seemed to show that miosis is a sensitive indicator reflecting postoperative consensual inflammation in the fellow eye after cataract sur-gery in the other. We recommend to take note on the consensual miosis to determine the timing of cataract surgery in the second eye.