難治性網膜剝離を合併した眼球温存療法後の脈絡膜悪性黒色腫に対して腫瘍切除併用硝子体手術を行った3例

Vitrectomy and endoresection in three cases of choroidal melanoma with intractable retinal detachment after the eye-preservation therapy

要約　目的：3例の脈絡膜悪性黒色腫の眼球温存療法後の合併症に対し，腫瘍切除併用硝子体手術を施行した成功例の報告。症例：全例とも放射線治療後の脈絡膜悪性黒色腫で，眼底は透見できず，超音波検査により腫瘍陰影とそれに連続する網膜剝離を認め，腫瘍切除を併用した硝子体手術を施行した。結果：全例シリコーンオイル注入眼であるが，眼球は温存され 腫瘍再発や転移は認めていない。結論：腫瘍切除を併用した硝子体手術により眼球摘出を回避し眼球癆予防と視機能温存ができることが示唆された。

Abstract.　Purpose：To report the efficacy and safety of pars plana vitrectomy combined with endoresection in 3 cases of choroidal melanoma with intractable retinal detachment after the eye-preservation therapy. Cases and Methods：All patients underwent radiation therapy for the eye-preservation therapy before surgery. Their fundi were not detectable because of cataract or fibrovascular membrane on iris. Ultrasound examination disclosed retinal detachment connected with a tumor. They were treated by vitrectomy combined with endoresection of the tumor. Results：All eyeballs were successfully preserved with silicone oil. Neither metastasis nor recurrence of the tumor was found. Conclusion：Vitrectomy combined with endoresection of radiation treated choroidal melanoma may preserve the eyeballs and prevent them from phthisis bulbi.