シリコン眼内レンズ移植術についての検討

Clinical results after implantation of silicone intraocular lens

　眼内で非活性といわれるシリコンを材料とした後房レンズを49症例に移植し，その術後経過を観察した．従来のpolymethylmethacrylate（PMMA）を光学部とした後房レンズ移植例と比較検討し以下の結果を得た．①術後の視力経過，角膜内皮細胞減少率は差がなかった．②血液房水柵への影響は術後1カ月において，毛様溝固定のPMMAレンズに比べシリコンレンズの方が侵襲は少なかった．③瞳孔運動への影響はシリコンレンズの方が良好であった．④後発白内障の発生はシリコンレンズに高かったがNd：YAGレーザーによるレンズ損傷は少なかった．⑤支持部のbulgingを1例に経験し，手術的に整復が可能であった．⑥レンズ表面の付着物はシリコンレンズに少なかった．⑦眼圧およびC値に異常はなかったが，隅角部に虹彩色素沈着を認めた症例があった．

　短い観察期間ではあるが，新しい眼内レンズの材質として有用性があると思われた．

We treated 49 eyes with cataract by implantation of posterior chamber intraocular lens (IOL) made of silicone and supplied by Staar Surgical Co. The postsurgical period of observation ranged from 5 to 10 months, with the mean at 8.4 months.

The course of postoperative visual recovery in the series was essentially similar to eyes treated by conventional IOL implantation. The corneal endoth-elial loss at 3 months after surgery averaged 12.2% in the series: a value similar to eyes after conven-tional IOL surgery. Fluorophotometric findings one month after surgery showed that the effect on blood-aqueous barrier was less in the silicone group thanin control eyes receiving conventional IOL fixated at the ciliary sulcus.

We found fewer deposits on the silicone IOL surface than the PMMA IOL when seen by specular microscopy. After-cataract developed in 13 out of the 49 eyes at 3 months postoperatively. The incidence was higher than in PMMA - IOL -treated eyes. One eye developed bulging of silicone IOL haptic, necessitating later repositioning. The procedure of repositioning was easy due to absence of adhesion between the silicone IOL and the ocular tissue.

Silicone IOL is lightweight, autoclavable, holda-ble and excerts minimum activity when implanted in the eye. The present clinical findings further show the usefulness of silicone IOL.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(4) : 319-323, 1987