裂孔原性網膜剝離に対する小切開硝子体手術における強膜縫合と術後眼圧

Scleral suture and postoperative intraocular pressure in microincision vitreous surgery for rhegmatogenous retinal detachment

要約　目的：裂孔原性網膜剝離に対する小切開硝子体手術で，徹底的な硝子体切除と積極的な強膜縫合を行ったときの術後眼圧と手術成績の報告。対象と方法：過去25か月間に初回手術として23ゲージ小切開硝子体手術を行った網膜剝離の連続症例70例71眼を対象とした。年齢は20～79歳（平均54歳）であった。術中に硝子体を可能な限り切除し，強膜創を積極的に縫合した。結果：網膜の初回復位は70眼（99％），強膜縫合は174か所（82％）に行った。術後の低眼圧は発症しなかった。結論：裂孔原性網膜剝離に対する小切開硝子体手術での積極的な強膜縫合は，初回復位率を向上させ，術後の低眼圧防止に有効であった。

Abstract.　Purpose：To report the outcome of microincision vitreous surgery for rhegmatogenous retinal detachment with aggressive removal of formed vitreous and placement of scleral suture. Cases and Method：This retrospective study was made on consecutive 71 eyes of 70 cases who received 23G microincision vitreous surgery for rhegmatogenous retinal detachment during the past 25 months. The age ranged from 20 to 79 years,average 54 years. All the eyes received dissection of vitreous base and scleral suture to prevent postoperative complications. Results：The retina became reattached after primary surgery in 70 eyes（99％）. Intraoperative leakage through the site of sclerotomy was prevented by scleral suture in 174 sclerotomy sites（82％）. No case developed hypotony after surgery. Conclusion：Placement of scleral suture resulted in high rate of retinal reattachment with no hypotony after microincision vitreous surgery for rhegmatogenous retinal detachment.