手術時期の異なる増殖糖尿病網膜症に対する硝子体手術成績の検討

Outcome of vitreous surgery for proliferative diabetic retinopathy during two periods

要約　目的：増殖糖尿病網膜症に対して行った硝子体手術の成績を，前半と後半の各3年間について評価した報告。対象と方法：2010年までの6年間に硝子体手術が行われた増殖糖尿病網膜症124例141眼を対象とした。2006年までの3年間には55例64眼，以後の3年間には69例77眼に手術が行われた。全6年間を通じ，3ポートによる硝子体手術が行われた。前期3年間には20ゲージ（G）を用い，後期3年間には20Gを56眼，小切開による23または25Gを21眼に用いた。術後6か月後の視力を評価した。結果：20Gを用いた症例では，前期群と後期群とに術前視力の差はなく，小切開手術群では術前と術後視力がともに20G群よりも有意に良好であった（それぞれp＝0.03，p＝0.014）。結論：増殖糖尿病網膜症に対する硝子体手術では，術前視力が良好な症例群で良好な術後視力が得られた。

Abstract.　Purpose：To report the outcome of vitreous surgery for proliferative diabetic retinopathy（PDR）over a 6-year period comparing cases during the first and second 3 years. Cases and Method：This prospective study was made on 141 eyes of 124 cases who received vitreous surgery for PDR over 6 years through 2010. A total of 64 eyes were operated during the first 3 years and 77 eyes during the second 3 years. Three-port vitrectomy was used throughout. During the first 3 years, a 20-gauge（G）probe was used. During the second 3 years, 56 eyes were operated with 20 G and 21 eyes with 23 G or 25 G probe using microincision method. Results：No significant differences were present in eyes who received 20 G surgery regarding visual acuity before and after surgery. Eyes that received 23 G or 25 G surgery had significantly better visual acuity before and after surgery compared with those that received 20 G surgery（p＝0.03, p＝0.014 respectively）. Conclusion：These cases illustrate that better visual acuity may result after vitreous surgery when operated while visual acuity is not too impaired.