黄斑剝離を伴う裂孔原性網膜剝離に対する硝子体手術と強膜内陥術の成績

Outcome of vitrectomy and scleral buckling for rhegmatogenous retinal detachment involving the macula

　黄斑剝離を伴う裂孔原性網膜剝離166眼について，硝子体手術と強膜内陥術の成績を比較した。72眼には初回手術として硝子体手術を行い，94眼には強膜内陥術を行った。初回手術で，硝子体手術群では58眼（81％），強膜内陥術群では86眼（91％）で復位が得られた。最終復位率は，それぞれ86％，94％であった。術後の最終視力は，硝子体手術群では改善74％，不変19％，悪化7％であり，強膜内陥術群では改善88％，不変9％，悪化3％であった。復位率と視力改善については両群ともほぼ同様であったが，術後の最高視力に達するまでの期間は，硝子体手術群では7.4±5.3か月，強膜内陥術群では4.2±2.6か月であり，有意差があった（p＝0.005）。

　Purpose：To review 166 eyes treated by vitrectomy or scleral buckling for rhegmatogenous retinal detachment involving the macula. Cases：Vitrectomy was performed on 72 eyes and scleral buckling on 94 eyes as the primary procedure. Results：The retina became reattached in 58 eyes（81％）following vitrectomy and in 86 eyes（91％）following scleral buckling. Ultimate reattachment was obtained in 86 and 94％of eyes respectively. After vitrectomy,visual acuity improved in 74％,remained unchanged in 19％,and deteriorated in 7％. After scleral buckling,it improved in 88％,remained unchanged in 9％,and deteriorated in 3％. Best visual acuity was attained 7.4±5.3months after vitrectomy and 4.2±2.6months after scleral buckling. The difference was significant（p＝0.005）. Conclusion：Vitrectomy and scleral buckling resulted in similar outcome regarding rate of reattachment and fate of visual acuity. Best visual acuity was attained earlier after scleral buckling than vitrectomy.