トリパンブルー前囊染色施行，Torsional phaco®使用白内障手術による角膜内皮への影響

Changes in corneal endothelial cells following torsional phacoemulsification with adjunct use of trypan blue staining during capsulorhexis

要約　背景：白内障手術でのトリパンブルーによる前囊染色は，角膜内皮細胞への障害が少ないとする報告がある。目的：白内障手術でのトリパンブルー前囊染色の角膜内皮細胞への影響の報告。対象と方法：過去33月間に0.1％トリパンブルーによる前囊染色を施行してTorsional phaco^®使用白内障手術を行った74名98眼を対象とした。エメリーの核硬化度は，1度1眼，2度46眼，3度45眼，4度6眼であった。手術3か月後の角膜内皮細胞の減少率を調べた。トリパンブルー染色なしで白内障手術を行った300眼を対照とした。結果：術後の角膜内皮細胞減少率は，核硬化度2度では1.7％，3度では2.8％，4度では1.8％であった。対照群では，それぞれ2.0％。1.8％，3.3％であり，両群間に有意差はなかった。結論：白内障手術から3か月後の角膜内皮細胞の減少率は，トリパンブルーによる前囊染色を行った症例と行わなかった症例間で有意差はなかった。

Abstract.　Purpose：To report changes in corneal endothelial cells following torsional phacoemulsification with adjunct use of trypan blue staining during capsulorhexis. Cases and Method：This retrospective study was made on 98 eyes of 74 patients who received cataract surgery during the past 33 months. Trypan blue was used during surgery to stain the lens capsule. Sclerosis of the lens was grade 1 in one eye, grade 2 in 46, grade 3 in 45, and grade 4 in 6 after Emmery. Corneal endothelial cell population was measured before and 3 months after surgery. Another series of 300 eyes that received cataract surgery served as control. Results：Decrease in corneal endothelial cell population averaged by 1.7％ in eyes with grade 2 cataract, by 2.8％ in grade 3, and by 1.8％ in grade 4. The values in controls averaged by 2.0％, 1.8％ and 3.3％ respectively. There was no signficiant difference between the two groups. Conclusion：There was no difference in corneal endothelial cell population 3 months after cataract surgery whether trypan blue was used or not during capsulorhexis.