増殖硝子体網膜症（新分類Grade C, Type 2,3,4,5）の術後視機能

Visual function after surgery for proliferative vitreoretinopathy grade C type 2,3,4,5

要約　目的：硝子体手術を行った重症増殖硝子体網膜症での術後視機能の報告。対象と方法：過去1年9か月間に硝子体手術を行ったGrade Cで2,3,4,5型の増殖硝子体網膜症5例5眼を対象とした。年齢は28～60歳（平均39歳）で，原因疾患は遺伝性硝子体網膜症2眼，外傷性硝子体基底部裂孔2眼，特発巨大網膜裂孔1眼であった。いずれも陳旧性で，視力は手動弁～0.04であった。網膜前の増殖組織を処理し，全周網膜切開を行い，網膜下増殖組織を除去し，シリコーンオイルを充填し，レーザー光凝固と輪状締結を実施した。結果：全例でシリコーンオイルを抜去し，術後3.5～18か月の時点で，網膜復位が全例で得られた。矯正視力は0.03～0.3，眼圧は10～18mmHgで，Goldmann視野計のV-4視標で固視点周囲の10～50度の視野が残存していた。結論：長期間放置された重症硝子体網膜症5眼で，硝子体手術により網膜が復位し，ある程度の視機能が保存できた。

Abstract.　Purpose：To report the visual function after vitreous surgery for severe proliferative vitreoretinopathy（PVR）. Cases and Method：This study was made on 5 eyes of 5 patients who received vitreous surgery for PVR of grade C, type 2,3,4,5. The age ranged from 28 to 60 years, average 39 years. As causative lesion, 2 eyes had hereditary vitreoretinopathy, 2 had traumatic break at vitreous base borders and 1 had idiopathic giant retinal tear. PVR had persisted for 6 months or longer. Visual acuity ranged from hand motion to 0.04. All eyes received pars plana vitrectomy followed by removal of preretinal membrane, 360-degree retinotomy, removal of subretinal proliferative tissue, filling the vitreous cavity with silicone oil, laser photocoagulation, and scleral encircling. Results：After removal of silicone oil, the retina was reattached in all the eyes when evaluated 3.5 to 18 months after surgery. Visual acuity ranged from 0.03 to 0.3, and intraocular pressure from 10 to 18mmHg. Visual field was maintained within 10 to 50 degrees from the point of fixation when measured by isopter for V-4 of Goldmann perimeter. Conclusion：Vitreous surgery was effective for preservation of visual function in 5 eyes with prolonged and severe PVR.