沖縄の白内障手術症例の特徴

Characteristics of operated cases of cataract in Okinawa

　沖縄本島の2施設で手術が行われた白内障722眼の診療録を検索した。施設Aでは425眼，施設Bでは297眼である。Shaffer分類2度以下の狭隅角は，施設Aで106眼（24.9％），施設Bで130眼（43.8％）にあった。施設Aでの前房深度は2.30±0.60mm，眼軸長は22.7±1.2mmであり，施設Bと過去の久米島検診でのそれと差がなかった。施設AとBで同一術者が耳側透明角膜切開で行った手術の合併症は，虹彩脱出2眼，チン小帯断裂2眼，一過性眼圧上昇21眼であった。最終眼圧は平均3.4mmHg下降し，5眼に濾過手術を追加した。沖縄の白内障症例では狭隅角の頻度が高いことと，このような症例に耳側透明角膜切開が有用であることが結論される。

We reviewed 722 eyes operated for cataract in two major clinics in Mainland Okinawa. The series com-prised 425 eyes treated in clinic A and 297 eyes in clinic B. Narrow angle of grade 2 or less after Shaffer was present in 106 eyes (24.9%) in clinic A and in 130 eyes (43.8%) in clinic B. The anterior chamber depth averaged 2.30± 0.60 mm and the axial length averaged 22.7±1.2 mm in eyes in clinic A. These values were similar to those in clinic B and in Kumejima in Okinawa archipelago. All the cases in both clinics were operated by one surgeon by transcorneal incision. The complications comprised iris prolapse 2 eyes, disrupted zonules 2 eyes, and transient rise of intraocular pressure (IOP) 21 eyes. The final IOP averaged 3.4mmHg below the preoperative level. Five eyes needed additional filtrating surgery. The findings show a high incidence of narrow angle in operated cases of cataract in Okinawa. Trans-corneal approach is advocated for narrow angle eyes.