桐沢型ぶどう膜炎に対する眼内液体シリコン充填術

Pars plana vitrectomy and silicone tamponade for Kirisawa's uveitis

　桐沢型ぶどう膜炎は急性の滲出性病変と網膜動脈炎にはじまり，網膜の壊死性変化および網膜剥離を続発し予後不良の疾患である．この網膜剥離に対して多くの報告者は輪状締結術等を試みているが，一般に良好な成績をあげていない．我々は従来の手術法では網膜復位が困難であった全網膜剥離を来した桐沢型ぶどう膜炎の2例に対して，硝子体切除術と眼内液体シリコン充填術を施行し，1例で網膜を完全に復位させた．この症例は術後1年8カ月を経ても，白内障の手術を施行後は，矯正視力0.15の視力を維持しており再剥離を来していない．他の例は完全な網膜の復位が得られなかった．

Two cases of unilateral acute retinal necrosis (Kirisawa's uveitis) developed retinal detachment with multiple holes. Both cases were treated by pars plana vitrectomy with silicone oil tamponade. The surgery was a success in the first case, a 3-1-year-old female, with visual acuity maintained at 0.15 for 18 months postoperatively. In the second case, a 10-year-old male child, the retina could not be reattached due to proliferative changes.

It is concluded that vitrectomy with silicone oil tamponade may be effective for retinal detachment in acute retinal necrosis, particularly in its early stage.