臨床眼科77巻13号

2023年12月発行

特集 知って得する白内障と屈折矯正の最新情報

老視矯正眼内レンズの現状と課題

著者： 佐々木洋¹

所属機関： ¹金沢医科大学眼科学講座

ページ範囲：P.1536 - P.1543

●3焦点IOLのPanOptix，連続焦点IOLのTECNIS Synergyは遠方から近方まで広い明視域が得られるためほとんどの患者で術後眼鏡は不要になるが，コントラスト感度の低下，不快光視現象，軽度の屈折ずれ・残余乱視に対する許容性が低いなどのデメリットもある。

●EDOF-IOLにはTECNIS Symfony，Clareon Vivity，LENTIS Comfortがあり，中間距離から遠方まで良好な視力が得られる。いずれもコントラスト感度は良好だが，不快光視現象はIOL間で差がある。Micro-monovisionやmix & matchにより眼鏡依存度を低減することができる。

●視機能の質と明視域の広さはトレードオフの関係にあり，現状では回折型とEDOFの利点を備えた理想のIOLがないことが課題である。コントラスト感度を維持しつつ焦点深度をさらに拡大した理想のEDOF-IOLの登場が待たれる。

●老視矯正IOLの大きな課題は長期での屈折安定性で，角膜の倒乱視化，眼軸長の延長により裸眼視力の低下を生じる可能性が高い。今後は，入れ替え可能なmulticomponent IOLの国内での使用が待たれる。

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