網膜剝離を伴う未熟児網膜症に対する硝子体手術

Outcome of vitreous surgery for prematurity of retinopathy with retinal detachment

目的：重症未熟児網膜症に対する硝子体手術の評価。症例：過去3年間に硝子体手術を行った未熟児網膜症9例14眼を対象とした。在胎期間は23～27週，出生時体重は466～1,055g（平均657g）であり，初回手術時の月齢は3～12か月（平均5.3か月）であった。網膜症は2眼が4B期，12眼が5期であった。13眼にはclosed vitrectomy，角膜混濁がある1眼にはopen-sky vitrectomyを行った。結果：網膜の復位は7眼（50％）で得られ，すべて初回手術後であった。7眼では復位しなかった。結論：重症未熟児網膜症への硝子体手術で50％の復位率が得られた。さらに改善の必要があるが，硝子体手術は網膜剝離を伴う未熟児網膜症に有用である。

Purpose：To report the outcome of vitreous surgery for retinopathy of prematurity with retinal detachment. Cases：This study involved 14 eyes of 9 premature infants. They received vitreous surgery for retinal detachment during the past 3 years. They were born after gestation of 23 to 27 weeks. The birthweight ranged from 466 to 1,055 g,average 657 g. Surgery was performed at the age from 3 to 12 months,average 5.3 months. Stage of retinopathy was 4B in 2 eyes and 5 in 12 eyes. Closed vitrectomy was performed on 13 eyes and 1 eye received open-sky vitrectomy because of opaque cornea. Results：The retina became reattached in 7 eyes（50％）after first surgery. Retinal detachment persisted in the other 7 eyes after multiple surgeries. Conclusion：Vitreous surgery may be beneficial for stage 4B and 5 retinopathy of prematurity to save the eye from blindness or phthisis bulbi.