網膜切開術を併用した硝子体手術で良好な結果を得たstageV未熟児網膜症の1例

Retinal reattachment was obtained in a case of stageVretinopathy of prematurity following vitrectomy and retinotomy

要約　生後5か月の女児が未熟児網膜症で受診した。在胎26週で生まれ，生下時体重は924gであった。生後2か月で未熟児網膜症が発見され，両眼にレーザー光凝固が行われたが，当科受診時には後水晶体線維症を伴う全網膜剝離があり，右眼は未熟児網膜症の第5期，左眼は第4期の状態にあった。ただちに硝子体手術を両眼に行ったが網膜は復位しなかった。左眼には以後5か月間に2度の硝子体手術を行ったが，そのまま全剝離に終わった。右眼には，初診から11か月間に2度の硝子体手術，輪状締結術，さらに全周の網膜切開術と一過性のシリコーンオイル注入を行った。生後5年の現在，右眼の網膜は復位し，0.1の矯正視力を保っている。進行した未熟児網膜症に対して網膜切開術が奏効した1例である。

Abstract.　A 5-month-old female infant presented with advanced retinopathy of prematurity（ROP）. She was born after 26 weeks of gestation with the birthweight of 924g. ROP was detected 2 months after birth,leading to panretinal photocoagulation in both eyes. When seen by us,both eyes had total retinal detachment with retrolental fibroplasia. The right eye was diagnosed with stage V ROP and the left eye with stageIVROP. The left eye received two sessions of vitrectomy during the ensuing 5 months but resulted in total retinal detachment. The right eye received two sessions of vitrectomy followed by retinotomy and temporary implantation of silicone oil during the 11 months after initially seen by us. This last procedure induced retinal reattachment. At the end of follow-up until 5 years of age,her corrected visual acuity is 0.1 right and hand motion left. This case illustrates that vitrectomy with retinotomy can be effective for advanced ROP after other surgical means have failed.