ベバシズマブ硝子体注入を併用した23ゲージ硝子体手術の検討

Review of intravitreal bevacizumab before vitreous surgery with 23-gauge microincision for diabetic retinopathy

要約　目的：増殖糖尿病網膜症に対する23G硝子体手術でベバシズマブを併用した結果の報告。対象と方法：40か月間に23G硝子体手術を行った増殖糖尿病網膜症69例84眼を診療録に基づいて検索した。22眼には手術の2～5日前にベバシズマブ1.25mgの硝子体注射を行った。術後3か月以上の経過を追跡した。結果：ベバシズマブ投与群と非投与群との間に，手術時間，術後の視力改善率，術後の合併症について有意差がなかった。術後の硝子体出血はベバシズマブ投与群では27％，非投与群では52％で生じ，有意差があった（p＜0.03）。ベバシズマブの硝子体注射による合併症は皆無であった。結論：増殖糖尿病網膜症に対する23G硝子体手術で，術前のベバシズマブの硝子体注射をした症例では，術後の硝子体出血の頻度が小さかった。

Abstract.　Purpose：To report the outcome of intravitreal injection of bevacizumab prior to 23-gauge vitreous surgery for proliferative diabetic retinopathy（PDR）. Cases and Method：This retrospective study was made on 84 eyes of 69 patients who received vitreous surgery for PDR during a 40-month period. Twenty-two eyes received intravitreal injection of 1.25 mg bevacizumab 2 to 5 days before surgery. Cases were followed up for 3 months or longer after surgery. Results：There was no significant difference in postoperative visual acuity,duration of surgery,or postoperative complications between eyes treated with or without bevacizumab. Incidence of postoperative vitreous hemorrhage was 27％ in eyes treated with bevacizumab and 52％ in those without. The difference was significant（p＜0.03）. Conclusion：Incidence of vitreous hemorrhage was smaller in eyes treated with intravitreal bavacizumab than those without after 23G vitreous surgery for PDR.