後部硝子体の癒着の特性と完全な人工的後部硝子体剝離の作製

Creation of posterior vitreous detachment as related to characteristics of posterior vitreous adhesion

要約　特発性黄斑円孔7眼に硝子体手術を行った。硝子体をトリアムシノロンアセトニドで可視化したのち，後部硝子体剝離を4眼では乳頭部から開始し，3眼では黄斑耳側から開始した。操作が終了した直後の検索で，人工的な後部硝子体剝離は剝離を乳頭部から開始した4眼では完全であったが，黄斑耳側から開始した3眼では不完全で，硝子体線維が黄斑鼻側の網膜上に残っていた。以上の所見は，網膜と硝子体の癒着が黄斑の耳側よりも鼻側で強い可能性を示している。後部硝子体剝離を人工的に作製する際には，黄斑耳側からではなく乳頭部から開始するとよい。

Abstract.　We performed vitreous surgery on 7 eyes of idiopathic macular hole. After the vitreous was stained by triamcinolone acetonide,posterior vitreous detachment was started at the optic disc in 4 eyes and temporal to the macula in 3 eyes. After completion of the procedure,artificial vitreous detachment was found to be complete in 4 eyes in which the procedure was started at the disc. It was incomplete in 3 eyes in which the procedure was started temporal to the macula. Vitreous fibers were adherent to the retina nasal to the macula in these 3 eyes. These findings suggest that the vitreoretinal adhesion is stronger in the area nasal than temporal to the macula. In creating artificial detachment of posterior vitreous,we advocate starting the procedure at the disc and not nasal to the macula to achieve complete detachment.