先天性眼瞼下垂眼における術後の屈折変化

Changes in refraction following surgery for congenital blepharoptosis

　眼瞼下垂の手術が眼球に与える影響，とくに乱視の変化を研究するため，下垂手術を行った先天性眼瞼下垂14例16眼について術後の屈折の変化をオートレフラクトメーターおよびケラトメーターで測定・検討し以下の知見を得た．

（1） spherical equivalentの近視化，乱視の直乱視化の傾向を認めた．

（2）7歳未満では7歳以上に比べ，また挙筋短縮術施行群は吊り上げ術施行群に比べ，術後変化の術前値への回復が悪い傾向があった．

（3）上記の変化は上眼瞼の角膜に対する圧迫によると思われるが，挙筋短縮術では吊り上げ術に比べて眼球圧迫方向のベクトルが大きいと考えられる．

（4）若年者に眼瞼下垂の手術を行う場合は術後の屈折の変化，視力に十分に注意することが必要であると思われた．

We evaluated changes in refraction in 16 eyes after surgery for congenital blepharoptosis. The cases were aged between 3 and 14 years at the time of surgery. Blepharoptosis was bilateral in 2 eyes and unilateral in 12 eyes.

As a general rule, the operated eyes showed progres-sion in myopia and development of astigmatism with the rule. These changes were transient so that the state of refraction returned to the presurgical level in sub-jects over 7 years of age. Recovery to the presurgical level was less apparent in younger age group and in cases treated by frontal sling method. These refractive changes were apparently induced by increased pressure exerted by the eyelid upon the cornea. It appeared that there was a difference in the intensity of the pressure between the group treated by levator resection and by frontal sling method.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(1) : 87-90, 1987