経毛様体扁平部水晶体切除を併用し硝子体手術を施行した若年者増殖糖尿病網膜症の手術成績

Outcome of vitreous surgery with pars plana lensectomy for juvenile proliferative diabetic retinopathy

要約　目的：若年者の増殖糖尿病網膜症に対する経毛様体扁平部水晶体切除を併用した硝子体手術の結果の報告。対象と方法：過去6年間に増殖糖尿病網膜症に対して経毛様体扁平部水晶体切除併用の硝子体手術を行った24例38眼を対象とした。年齢は18～38歳（平均31歳）であり，術後6か月以上の経過が観察できた症例に限った。黄斑浮腫のみ，または血管新生緑内障がある症例は除外した。手術の成績は術後の最終視力で評価した。結果：最終視力は，0.1以上が28眼（74％），0.5以上が21眼（55％）であった。最終視力が0.1未満の10眼では，30歳未満，網膜剝離，網膜下増殖の3項目が有意な術前因子であった（p＜0.05）。結論：経毛様体扁平部水晶体切除を併用した硝子体手術は，若年者の増殖糖尿病網膜症に対する選択肢の1つである。

Abstract.　Purpose：To report the outcome of vitreous surgery with pars plana lensectomy for juvenile proliferative diabetic retinopathy. Cases and Method：This retrospective study was made on 38 eyes of 24 patients who received vitreous surgery with pars plana lensectomy for proliferative diabetic retinopathy during the past 6 years. Their age ranged from 18 to 38 years, average 31 years. Cases were excluded who had macular edema only or neovascular glaucoma. All were followed up for 6 months or longer. Outcome of surgery was evaluated by visual acuity at the last follow-up. Results：Final visual acuity was 0.1 or better in 28 eyes（74％）and 0.5 or bettr in 21 eyes（55％）. Ten eyes with final visual acuity of less than 0.1 had, as significant risk factors, 30 years of age or less, retinal detachment, or subretinal proliferation（p＜0.05）. Conclusion：Vitreous surgery with pars plana lensectomy is one of therapeutic choices for proliferative diabetic retinopathy in patients under 40 years of age.