眼内レンズ交換手術例の検討

Cases treated by intraocular lens exchange

（P−1-61）　最近3年間に眼内レンズ交換手術を施行した6例6眼について検討した。初回手術後再手術までの期間は5日から4年，平均307日であった。原因は，眼軸長の測定誤差，角膜曲率半径の測定誤差，眼内レンズの用意のミス，眼内レンズ光学部の傷患者の裸眼での遠見視力への不満，患者の裸眼での近見視力への不満がそれぞれ1例ずつであった。眼内レンズ挿入術中に後嚢破損のあった2例では，眼内レンズ交換時に硝子体脱出があり，前部硝子体切除術を必要とした。手術は再手術までの期間が短いほど容易であった。眼内レンズ交換を回避するためには，眼軸長，角膜曲率半径計測の精度を高めるとともに，患者の術後裸眼視力の希望を初回手術前によく聞くことが重要である。

We reviewed 6 eyes of 6 cases which underwent intraocular lens (IOL) exchange during the past 3 years. The interval after the initial surgery ranged from 5 days to 4 years, average 307 days. IOL had to be exchanged in one eye each due to incorrect axial length measurement, incorrect corneal curvature measurement, improper preparation of IOL, cracked IOL, dissatisfaction with the naked distant or near vision. During IOL exchange procedure, anterior vitrectomy had to be performed due to vitreous loss in 2 eyes due to ruptured posterior capsule at the initial surgery. Early IOL exchange surgery was generally easier than a late one. The findings show the importance of accurate measurement of axial length and corneal curvature during the initial cataract surgery. It is also advocated to give due attention to the requests of patients regarding the postoperative naked vision.