初回バックリング手術非復位例の検討

Review of cases of non-attached retina after primary scleral buckling

要約　目的：強膜バックリングを初回手術として受け，復位が得られず再手術を必要とした症例の検討。対象と方法：裂孔原性網膜剝離に対し，過去5年間に強膜バックリング手術が335例344眼に行われた。うち初回手術で復位が得られなかった59例60眼を検討の対象とした。内訳は男性41眼，女性19眼で，年齢は13～84歳（平均43歳）である。結果：円孔例よりも裂隙例で再手術が多かった（p＜0.01）。網膜下液の排液を行わなかった例よりも行った例で再手術が多かった（p＜0.05）。最終的に344眼中340眼（99％）で復位が得られた。復位しなかった4眼中1眼では裂孔が上方にあり，3眼では下方にあった。結論：網膜下液の排液が必要な裂孔原性網膜剝離に対する強膜バックリングでは，手技の改善と，下方裂孔または円孔に対する適切な処理が望ましい。

Abstract.　Purpose：To review cases of retinal detachment that needed multiple surgeries after scleral buckling as initial procedure. Cases and Method：This retrospective study was made on 344 eyes of 335 cases that received scleral buckling for rhegmatogenous retinal detachment during the past 5 years. The retina failed to reattach after initial surgery in 60 eyes of 59 patients. The latter series comprised 41 males and 19 females. The age ranged from 13 to 84 years,average 43 years. Results：Additional surgical intervention was needed more in eyes with retinal tear than eyes with retinal hole（p＜0.01）,and more in eyes that received drainage of subretinal fluid（p＜0.05）. Final reattachment was obtained in 340 out of 344 eyes（99％）. In the other 4 eyes,the retinal break was located in the superior sector in one eye and in the inferior in 3 eyes. Conclusion：In scleral buckling procedure for rhegmatogenous retinal detachment,there is need for further improvement in drainage of subretinal fluid and in treatment of inferiorly located retinal break or breaks.