特発性黄斑上膜手術に対する23ゲージシステムの使用成績

Evaluation of 23-guage system in vitreous surgery for idiopathic epiretinal membrane

要約　目的：20ゲージ（G）と23Gシステムによる特発性黄斑上膜に対する硝子体手術の比較。症例と方法：25か月間に手術を行った特発性黄斑上膜40例40眼を検索した。20眼には20G，20眼には23Gシステムを用い，白内障同時手術を20G群中18眼，23G群中13眼に行った。両群を手術時間，術後視力，改善度について比較した。結果：白内障同時手術を行ったときの手術時間は，20G群では44.7±14.6分，23G群では37.1±11.8分であり，有意差があった。術後最高視力と視力の改善については，両群間に差がなかった。合併症として，両群それぞれの約10％に，網膜剝離または硝子体出血などが生じた。結論：特発性黄斑上膜に対する硝子体手術では，20Gと23Gシステムの間に成績または合併症に有意差はない。23Gシステムでは手術時間が短縮され，術者と被術者の負担が軽減される。

Abstract.　Purpose：To compare 20 gauge（G）and 23 G system during vitreous surgery for idiopathic epiretinal membrane. Cases and Method：This study was made on 40 eyes of 40 patients who received vitreous surgery for epiretinal membrane during a 25-month period. 20 G system was used in 20 eyes and 23 G system was used in the other 20 eyes. Simultaneous cataract surgery was performed on 18 eyes in the former group and on 13 eyes in the latter. Both groups were compared regarding duration of surgery and postoperative visual acuity. Results：Duration of surgery averaged 44.7±14.6 min in 18 eyes in 20 G group and 37.1±11.8 min in 13 eyes in 23 G group. The difference was significant. There was no difference between the two groups regarding postoperative best visual acuity or improvement of visual acuity. Incidence of retinal detachment or vitreous hemorrhage was about the same in both groups. Conclusion：There was no difference between 20 G and 23 G system regarding the outcome of surgery. Use of 23 G resulted in shorter duration of surgery benefiting both the patient and the surgeon.