網膜剝離に対する硝子体手術後の眼圧変化

Changes in intraocular pressure after vitrectomy and gas tamponade for retinal detachment

要約　硝子体手術とSF₆によるガスタンポナーデで術翌日に復位した裂孔原性網膜剝離50眼の眼圧変化を検索した。男性33人，女性17人で，年齢は35～84歳，平均55.9歳である。手術では，まず水晶体を乳化吸引し，硝子体を切除し，網膜下液を排除して裂孔を閉鎖したのち，20％SF₆で硝子体腔を満たし，眼圧を15mmHgになるようにした。術後の眼圧測定には圧平眼圧計を用いた。術前眼圧は11.1±2.5mmHgであり，術後1日の眼圧は20.0±6.9mmHgで有意に上昇した（p＜0.0001）。以後4週後まで眼圧は徐々に下降した。多変量解析で，術後の眼圧上昇は，剝離の範囲の広さ，眼軸長の長さ，術前眼圧の低さそれぞれと有意な相関があった（各p＜0.05）。

Abstract.　We examined the changes in intraocular pressure（IOP）in 50 eyes of rhegmatogenous retinal detachment treated by vitrectomy and gas tamponade. The series comprised 33 males and 17 females. The ages ranged from 35 to 84 years,average 56 years. Vitrectomy was performed after phacoemulsification-aspiration. Following drainage of subretinal fluid and closure of retinal break,the vitreous was filled by 20％sulfur fluoride. The IOP was set at 15mmHg at the end of surgery. The retina became reattached in all the eyes on the next day of surgery. A Goldmann applanation tonometer was used in measuring the IOP after surgery. Before surgery,the IOP averaged 11.1±2.5 mmHg. It rose significantly to 20.0±6.9 mmHg on the next day of surgery（p＜0.0001）. It gradually decreased until 4 weeks after surgery. By multivariant analysis,the early postoperative IOP was significantly elevated in eyes with greater extent of retinal detachment,longer axial length,and lower preoperative IOP（p＜0.05 each）.