線維柱帯切除術後裂孔原性網膜剝離に対してpneumatic retinopexyを施行した1例

Pneumatic retinopexy in an eye with rhegmatogenous retinal detachment following trabeculectomy

　77歳女性が右眼の眼圧上昇で紹介され受診した。2年前に両眼に白内障手術を受けている。矯正視力は右1.2，左1.0で，眼圧は右30mmHg，左20mmHgであった。薬物で眼圧コントロールが得られないので，マイトマイシンC併用線維柱帯切除術を行った。術後7日目に上方網膜に弁状裂孔を伴う網膜剝離が発見された。SF₆によるpneumatic retinopexyを行い，網膜の復位と濾過胞の維持が得られた。Pneumatic retinopexyは，合併症と復位率について異論があるが，適応を選べば有効な治療法の1つになる。

　A 77-year-old female was referred to us for elevated intraocular pressure. She had received cataract surgery in both eyes 2 years before. Her corrected visual acuity was 1.2 right and 1.0 left. The intraocular pressure（IOP）was 30mmHg right and 20mmHg left. Medication failed to control the IOP. We performed trabeculectomy with adjunct use of mitomycin C on the right eye. Retinal detachment with horseshoe tear was detected in the superior quadrant 7 days after surgery. Pneumatic retinopexy using sulfur fluoride resulted in retinal reattachment and preserved filtering bleb. This case illustrates that pneumatic retinopexy may be effective in certain situations in spite of controversy over complications and rate of success.