同一術者による20，23，25ゲージ硝子体手術の比較

Comparison of 20-,23-and 25-gauge vitrectomy by the same surgeon

要約　目的：同じ術者による20，23，25ゲージ（G）硝子体手術の比較。対象と方法：過去58か月間に同一術者が行った硝子体手術のうち，増殖糖尿病網膜症など周辺部硝子体の郭清を必要としない66例66眼を診療録の記述に基づいて検索した。34眼には20G，15眼には23G，17眼には25Gを使用した。術後6か月以上の経過を追った。結果：手術時間は20G群で有意に長かった。術後の視力と眼圧には3群間に差がなかった。術中合併症として20G群中9眼に赤道部の医原性裂孔が生じ，25G群中2眼に後極部の裂孔が生じた。術中合併症は3群間に差がなく，術後合併症としての眼内出血が20G群に多かった。結論：23Gと25Gによる硝子体手術は，20Gよりも侵襲と合併症が少ない。

Abstract.　Purpose：To compare the outcome of vitrectomy using 20-,23-and 25-gauge（G）vitrectomy by the same surgeon. Cases and Method：This retrospective study was made on 66 eyes of 66 cases who received vitrectomy during a 58-month period. Cases were excluded who needed complete removal of peripheral vitreous including proliferative diabetic retinopathy. Vitrectomy was performed using 20G in 34 eyes,23G in 15 eyes,and 25G in 17 eyes. Cases were followed up for 6 months or longer. Results：Duration of surgery was significantly longer when 20G was used than 23G or 25G. There was no difference among the 3 groups regarding visual acuity or intraocular pressure after surgery. Iatrogenic retinal break occurred in 9 eyes after 20G surgery. Posterior retinal break occurred in 2 eyes after 25G. Postoperative intraocular hemorrhage was more frequent in 20G group. Conclusion：Vitrectomy using 23G or 25G is less invasive and has lesser complications than using 20G.