眼内レンズoptic capture固定法の術後長期の屈折度数変動について

Long-term changes in refraction after intraocular lens optic capture

要約　背景：眼内レンズを固定する方法として，その支持部を前囊の前に乗せ，光学部のみを囊内に固定するout-in-out法と，囊外固定法などがある。後者よりも前者で，術後の屈折がより安定するという見解がある。目的：眼内レンズ固定法の術後長期の屈折変動の報告。対象と方法：過去58か月間に白内障手術を行った症例のうち，眼内レンズをout-in-out法で固定した25眼と，囊外で固定した23眼を対象とした。それぞれ6～225週（中央値54週）と，8～212週（中央値94週）の経過を追った。術後早期の屈折を基準値とし，それから±0.50Dまたは±1.00Dを超えた時点を脱落とし，生存率曲線を比較した。同様な26眼と27眼で，SRK/T式による目標屈折度数を基準値とし，それから±0.50Dまたは±1.00Dを超えた時点を脱落とし，生存率曲線を比較した。結果：いずれの基準値に対しても，両群の生存率曲線の間に有意差はなかった。結論：眼内レンズをout-in-outまたは囊外で固定した群とで，術後の屈折に差がなかった。

Abstract.　Background：Fixation of intraocular lens（IOL）by out-in-out method is claimed to be superior to out of the bag method regarding postoperative stability of refraction. Purpose：To report changes in refraction after IOL fixation by out-in-out method or out of the bag method. Cases and Method：This retrospective study was made on 48 eyes that received cataract surgery in the past 58 months. IOL was fixated in 25 eyes by out-in-out method and in 23 eyes by out of the bag method. The 25 eyes were followed up for 6 to 225 weeks with 54 weeks as the median. The other 23 eyes were followed up for 8 to 212 weeks with 94 weeks as the median. Refraction immediately after surgery was set as the norm. Later deviation by 0.50 or 1.00 diopter was regarded as dropout that served as data for survival curve. A similar of 53 eyes, comprising 26 and 27 eyes respectively, was evaluated regarding refraction after surgery. Refraction after SRK/T formula was set as the norm. Deviation by 0.50 or 1.00 diopter from the norm was regarded as dropout that served as data for survival curves. Results：There was no significant difference in refraction after surgery between eyes that received out-in-out or out-of-bag fixation. Conclusion：There was no difference in refraction following out-in-out or out-of-bag IOL fixation.