Laser trabeculoplastyの臨床的および形態学的研究

Clinical and histopathological study of laser trabeculoplasty

　教室におけるlaser trabeculoplasty （LTP）の最近の成績とLTP後眼圧コントロール不良例および正常隅角眼のLTP施行1週後の形態学的観察を行った．薬物治療不能な緑内障18例23眼に対しLTPを施行し，11例14眼（60.9％）で眼圧のコントロールが得られた．

　LTP後眼圧コントロール不良例のトラベクレクトミー切除片では，線維柱帯間隙の狭細化とシュレム氏管の一部に閉塞がみられた．また，走査電顕的に線維柱表面に膜様物の形成が観察された．

　照射1週後の正常隅角眼では，線維柱帯に間隙の拡大と内皮網の菲薄化がみられた．

We treated 23 eyes of 18 patients with uncon-trolled glaucoma with argon laser trabeculoplasty (LTP). An adequate control of intraocular pressure below 20mmHg was achieved in 14 eyes (61%).

Biopsy specimens were obtained during surgery in 3 LTP-treated eyes with uncontrolled intraocular tension. A normal eye was also treated with LTP prior to enucleation due to malignancy. These sam-ples were studied by light and scanning electron microscopy.

In the chamber angle of uncontrolled glaucoma-tous eyes after LTP, there were narrowing of in-tratrabecular spaces, partial or total occlusion of Schlemm's canal and presence of membrane-like tissue which partially covered the trabecular meshwork. In the angle of LTP-treated normal eye, there were widening of intratrabecular spaces and thinning of the endothelial meshwork.