25ゲージ硝子体手術における強膜斜め刺入法による術後早期併発症の軽減効果

Reduction of early postoperative complications by oblique insertion technique in 25-guage vitreous surgery

要約　目的：硝子体手術でのトローカの斜め刺入法と垂直刺入法による術後早期合併症を比較した報告。対象と方法：25ゲージ硝子体手術を行った138眼を対象とした。内訳は黄斑上膜88眼，黄斑円孔23眼，網膜静脈閉塞症13眼，糖尿病黄斑浮腫6眼などである。71眼ではトローカを斜めに刺入し，68眼では垂直に刺入した。結果：斜め刺入眼では，一過性低眼圧と結膜浮腫が各2眼に生じた。垂直刺入眼では，一過性低眼圧と結膜浮腫が各15眼，結膜からの眼内液漏出が7眼，脈絡膜剝離が8眼に生じた。結論：25ゲージ硝子体手術ではトローカを斜めに刺入することにより，術後早期の合併症が減り，より安全な手術ができる。

Abstract.　Purpose：To compare oblique and vertical insertion technique of troca in 25-guage vitreous surgery regarding early postoperative complications. Cases and Method：This retrospective study was made on 138 eyes that received 25-gauge vitreous surgery. The series comprised epimacular membrane 88 eyes, macular hole 23 eyes, retinal vein occlusion 13 eyes, diabetic retinopathy 6 eyes and others. The troca was inserted obliquely in 68 eyes and vertically in 71 eyes. Results：Postoperatively, transient ocular hypotony and conjunctival edema occurred in 2 eyes each that received oblique insertion. Transient ocular hypotony and conjunctival edema occurred in 15 eyes each that received vertical insertion. Further, leakage of vitreous and choroidal detachment occurred in 7 and 8 eyes respectively. Conclusion：Early postoperative complication can be decreased by oblique insertion of troca in 25-guage vitreous surgery.