アトピー性皮膚炎に伴う網膜剝離に対する硝子体手術の手術成績

Outcome of vitreous surgery for retinal detachment associated with atopic dermatitis

アトピー性皮膚炎に伴う網膜剝離26例28眼に対して硝子体手術を行った。年齢は15～35歳，平均24.1歳であり，対象は顔面叩打との関連が疑われる毛様体上皮裂孔，高度白内障，裂孔不明眼などの症例に限定した。すべての裂孔を検出する目的で，水晶体は前囊を残して切除した。硝子体を基底部まで切除し，毛様体ひだ部裂孔例では，裂孔縁の水晶体囊を切除した。将来の顔面叩打の際の眼球変形を抑制する目的で，全例に輪状締結を，網膜裂孔例ではさらにバックルを置いた。27眼は初回手術で復位し，1眼は再手術で復位した。アトピー性皮膚炎に伴う網膜剝離に対し，この術式による硝子体手術は有効であった。

We performed vitreous surgery for retinal detachment in 28 eyes of 26 patients with atopic dermatitis. Their ages ranged from 15 to 35 years,average 24 years. By definition,we reviewed only cases suspected of traumatic origin,including advanced cataract,breaks in the ciliary epithelium,or undetectable retinal break. In order to visualize the whole fundus area,the lens was removed except the anterior capsule in all the eyes. We removed the vitreous up to its base. The lens capsule was also removed in eyes with breaks in the ciliary epithelium. All the eyes received scleral encircling to prevent deformation of eyeglobe by rubbing in future. Scleral buclking was placed at the site of retinal breaks. The retina became reattached in 27 eyes after initial surgery and in one eye after second surgery. The findings show that the current procedure is effective for retinal detachment associated with atopic dermatitis.