黄斑疾患への23ゲージ硝子体手術時に内視鏡で周辺部処理をした場合の成績

Outcome of 23-gauge vitrectomy for macular diseases with endoscopic observation of peripheral fundus

要約　目的：内視鏡を併用した硝子体手術で，術中に発見した周辺部の眼底病変の報告。対象と方法：過去20か月間に黄斑円孔18眼と黄斑上膜38眼に対して23ゲージ硝子体手術を行った54例56眼を対象とした。男性26眼，女性30眼で，年齢は48～86歳（平均68歳）である。全症例につき，内視鏡で周辺部眼底を観察した。50眼（89％）で白内障手術を併用した。結果：術中の内視鏡による検索で，周辺部網膜の病変が9眼（16％）に発見された。その位置は7眼が5～7時方向にあった。術後に低眼圧が3眼，網膜剝離が1眼に生じた。結論：硝子体手術時の内視鏡による観察で，16％の症例に周辺部網膜病変を発見できた。

Abstract.　Purpose：To report the outcome of 23-gauge vitreous surgery with adjunct endoscopic observation of peripheral fundus. Cases and Method：This study was made on consecutive 56 eyes of 54 patients who received vitreous surgery in the past 20 months. The series comprised 18 eyes with idiopathic macular hole and 38 eyes with idiopathic epiretinal membrane. There were 26 male eyes and 30 female eyes. The age ranged from 48 to 86 years, average 68 years. All the eyes were examined for peripheral fundus lesion by endoscopy. Fifty eyes（89％）underwent simultaneous cataract surgery. Results：Lesions in the peripheral retina were detected in 9 eyes（16％）. The lesion was present between 5 and 7 o'clock position in 7 eyes（78％）. Ocular hypotony developed in 3 eyes and retinal detachment in one eye after surgery. Conclusion：Disorders in the peripheral retina were detected in 16％ of eyes during vitreous surgery with adjunctive use of endoscopy.