血管新生緑内障に対する眼内毛様体光凝固術

Pars plana cyclophotocoagulation for neovascular glaucoma

要約　目的：難治性血管新生緑内障に対する毛様体光凝固の報告。対象と方法：血管新生緑内障3例3眼を対象とした。年齢は54，57，88歳で，緑内障の原因はそれぞれ網膜中心動脈閉塞症，穿孔性外傷と糖尿病，白内障手術と糖尿病網膜症であった。罹患眼の視力は，それぞれ0，手動弁，0で，眼圧は64mmHg，51mmHg，40mmHgであった。毛様体扁平部経由での硝子体切除を行ったのち，緑色レーザーで240°の範囲で毛様体突起を凝固した。平均13か月の経過を追った。結果：最終眼圧は，それぞれ4mmHg，8mmHg，24mmHgであり，眼痛，角膜浮腫，虹彩新生血管は消失した。結論：難治性の血管新生緑内障3眼に，毛様体扁平部を経由する毛様体光凝固関連薬を行い，眼圧が下降し，角膜浮腫と虹彩新生血管が軽快した。

Abstract.　Purpose：To report the outcome of cyclophotocogulation for neovascular glaucoma. Cases and Method：This retrospective study was made on 3 eye of 3 patients of neovascular glaucoma. They were aged 54, 57 and 88 years respectively. Glaucoma was secondary to central retinal vein occlusion, diabetes mellitus with perforating injury, and cataract surgery following diabetes mellitus. Visual acuity of involved eye was zero, hand motion, and zero respectively. Intraocular pressure（IOP）was 64 mmHg, 51 mmHg and 40 mmHg respectively. Each eye received pars plana vitrectomy followed by green laser photocoagulation of ciliary processes ranging 240 degrees of the circumference. Cases were followed up for an average of 13 months. Results：Final IOP was 4 mmHg, 8 mmHg and 24 mmHg respectively without medication. Ocular pain, corneal edema and rubeosis iridis disappeared in all the eyes. Conclusion：Cyclophotocoagulation in 3 eyes of neovascular glaucoma resulted in IOP reduction with disappearance of corneal edema and rubeosis iridis.