糖尿病黄斑浮腫に対する硝子体手術の術後成績

Outcome of vitreous surgery for diabetic macular edema

要約　目的：糖尿病黄斑浮腫に対する硝子体手術の成績の報告。対象と方法：9年7か月間に糖尿病黄斑浮腫に対して硝子体手術を行った93例123眼を対象とした。男性72眼，女性51眼で，年齢は39～78歳（平均61歳）である。硝子体手術は20ゲージ3ポートシステムで行い，後部硝子体膜を剝離し，黄斑周囲の網膜前透明膜を除去した。手術の補助薬剤は使用しなかった。術後の経過は6か月以上（平均31.8か月間）観察した。結果：3眼を除き黄斑浮腫は徐々に消退した。視力は改善54眼（44％），不変56眼（46％），悪化13眼（10％）で，最終観察時に31眼が0.6以上であった。結論：糖尿病黄斑浮腫に対する硝子体手術は，多数例で黄斑浮腫と視力を改善し，視力を長期間維持できた。

Abstract.　Purpose：To report the outcome of vitreous surgery for diabetic macular edema. Cases and Method：This retrospective study was made on 123 eyes of 93 cases who underwent vitreous surgery for diabetic macular edema during 9 years 7 months. The series comprised 72 male and 51 female eyes. The age ranged from 39 to 78 years, average 61 years. Vitreous surgery was performed with a 3-port system using 20-gauge to create posterior vitreous detachment and to remove posterior hyaloid membrane in the macular area. No adjunct medication was used during surgery. Cases were followed up for 6 months or longer, average 31.8 months. Results：Macular edema gradually regressed in all the eyes except 3. Visual acuity improved in 54 eyes（44％）, remained unchanged in 56（46％）, and deteriorated in 13（10％）. Thirty-one had visual acuity of 0.6 or more at the latest examination. Conclusion：Vitreous surgery for diabetic macular edema was effective in improving macular edema and in long-term preservation of visual acuity in the majority of cases.