増殖糖尿病網膜症に対する20ゲージ硝子体手術と25ゲージ硝子体手術成績の比較検討

Comparison of outcome of vitrectomy with 25-guage and 20-guage system for proliferative diabetic retinopathy

要約　目的：増殖糖尿病網膜症に対する20ゲージと25ゲージ硝子体手術の成績の比較。対象と方法：過去64か月間に増殖糖尿病網膜症に対して硝子体手術を行った連続86症例を対象とし，術後1年までの成績を診療録に基づいて検索した。前半の24か月間は20ゲージで43眼，後半の40か月間は25ゲージで43眼に手術を行った。結果：術後の視力の経過には，両群間に有意差がなかった。術後の硝子体出血は20ゲージよりも25ゲージで有意に少なく（p＝0.016），術後の高眼圧も同様に少なかった（p＝0.029）。結論：増殖糖尿病網膜症に対する25ゲージ硝子体手術では，20ゲージと同様な視力転帰が得られ，術後の硝子体出血と高眼圧が有意に少なかった。

Abstract.　Purpose：To report and compare the outcome of 20G and 25G vitrectomy for proliferative diabetic retinopathy（PDR）. Cases and Method：This retrospective study was made on consecutive 86 eyes treated by vitrectomy for PDR in the past 64 months. A 20G system was used for the initial 43 eyes and 25G system for the other 43 eyes. Cases were followed up for 12 months or longer. Results：There was no significant difference in the postoperative course of visual acuity between the two groups. Incidence of vitreous hemorrhage was significantly less in eyes treated by 25G than 20G system（p＝0.016）. Postoperative ocular hypertension was significantly less frequent in eyes treated by 25G than 20G system（p＝0.029）. Conclusion：Visual outcome was the same between 20G and 25G vitrectomy for PDR. Incidence of vitreous hemorrhage and ocular hypertension was less frequent in eyes treated by 25G than 20G vitrectomy.