上方弁状裂孔による裂孔原性網膜剝離に対する術後長期滞留性ガスタンポナーデを用いない硝子体手術の成績

Vitreous surgery with air tamponade for retinal detachment with superiorly located retinal break

　眼底上方に弁状裂孔がある網膜剝離に対する硝子体手術と液空気置換の成績を評価した。男性16例，女性9例の合計25例25眼に手術を行った。年齢は46～85歳（平均62歳）である。24眼が有水晶体眼，1眼が偽水晶体眼であった。外傷，黄斑円孔，増殖性硝子体網膜症などを伴う症例は除外した。通常の方法で硝子体手術と液空気置換を行い，眼内光凝固で裂孔を閉鎖した。その結果，初回手術で24眼（96％），複数回手術で25眼（100％）で復位が得られた。術後120～773日（平均295日）の観察期間内に，黄斑前膜1眼，遷延性虹彩炎1眼，裂孔周囲の増殖膜形成1眼以外には格別の合併症はなかった。眼底上方の弁状裂孔を原因とする網膜剝離に対する硝子体手術では，単純な液空気置換が有効であり，必ずしも長期滞留性ガスを必要としない。

　Purpose：To evaluate vitrectomy with air-fluid exchange for retinal detachment secondary to superiorly located retinal break. Cases and Method：Above surgery was performed on 25 eyes of 25 patients. The series comprised 16males and 9 females. Their ages ranged from 46 to 85 years,average 62 years. One eye was pseudophakic and 24 eys were phakic. Excluded were cases with trauma,macular hole,or proliferative vitreoretinopathy. After vitrectomy and air-fluid exchange,the retinal break was closed by intraocular photocoagulation. Results：Retinal reattachment was obtained in 24 eyes（96％）after initial surgery and in 25 eyes（100％）eventually. During the follow-up period from 120 to 773 days,average 295 days,no serious complications developed except proliferative membrane formation around the retinal break in one eye. Conclusion：Vitrectomy with air-fluid exchange is effective for retinal detachment secondary to superiorly located retinal break. Long-acting gas tamponade is not necessary for this type of retinal detachment.