前房混濁測定装置による白内障術後炎症の定量的検討

Quantitation of inflammation in the anterior chamber after cataract surgery

　He-Neレーザー光を用いた新しい前房混濁測定装置が開発されたが，その臨床応用への報告は少ない．我々は水晶体嚢外摘出術（ECCE）の患者を対象に房水混濁度・前房内細胞数を本装置で測定し，その経時的変化を明らかとした．また後房人工水晶体（IOL）挿入の影響や，消炎剤であるアゼラスチン内服の薬効判定の検討も試みた．結果は，術直後が混濁度・細胞数ともに最も高く，以後経時的に低下するのが示された．ECCE＋IOL群はECCE群よりも混濁度では術後3〜20日，細胞数では1〜3日目まで有意に計測値が高く，以後は差を認めなかった．アゼラスチン投与群は非投与群よりも房水混濁度が低く，ECCE＋IOL群内では2〜4日，ECCE群内では1・2日目に有意差が認められ，本剤の有効性が示された．本装置で白内障手術後の炎症が客観的・定量的に測定でき，安全に繰り返し測定することで詳細な経時変化も得られ，術式改善の判定や或いは薬効判定の検討に利用できた．

We quantitated the inflammation in the anterior chamber using our newly developed flare and cell counting apparatus. State of aqueous flare was measured in 15 eyes after extracapsular cataract extraction (ECCE) and in 32 eyes with additional intraocular lens implantation (ECCE+IOL). Cells in the aqueous were measured in 8 eyes after ECCE and in 12 after ECCE+IOL. We also evaluated the influence of anti-inflammatory agent by prescrib-ing azelastine, 3 mg daily, to be continued for 6days from the day of surgery.

Inflammation was most pronounced the next day after surgery, to gradually subside later. Inflamma-tion was severer in the group with additional IOL implantation than without (p<0.05), during the 3rd to 20th postoperative day regarding the flare and during the 1st to 3rd postoperative day regarding cells. Systemic azelastine was effective in suppress-ing the flare during 2nd to 4th postoperative day in eyes with IOL implantation and during 1st to 3rd day in eyes without.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(7) : 781-784, 1988