硝子体手術に関する臨床的研究（その7）—重症糖尿病性網膜症に対する硝子体手術成績の変遷

Clinical studies on vitreous surgery. Part 7.:Changing of results of pars plana vitrectomy on severe diabetic intraocular complications

　駿河台日大病院眼科で硝子体手術を行った重症糖尿病性網膜症196例224眼につき下記の検討を行った．

（1）視力向上を得たものは224眼中118眼（53％）であった．

（2）網膜剥離を伴う群と網膜剥離を伴わない群の視力向上率はそれぞれ43％，70％であり，前者において明らかに不良であった．

（3）手術術式の改良に伴う手術成績の変遷をみると，three port system，持続空気灌流による網膜復位術，および積極的なsilicone oil注入を導入した1983年以降，手術成績は大幅に向上した．

（4）術後合併症の処理方法の解決と，手術適応の再検討が今後の大きな課題である．

We evaluated the longterm results in 224 eyes with severe diabetic intraocular complications treated bypars plana vitrectomy during 10-year-period.

Lasting improvement in visual acuity was obtained in 118 out of the 224 eyes (53%). Prior to surgery, retinal detachment was absent in 82 eyes and present in 142. Restoration of visual acuity was obtained in 57 eyes (70%) in the series without prior retinal detachment and in 61 eyes (43%) in those with retinal detachment.

The final visual acuity in the 224 eyes was 0.1 or better in 70 eyes (31%), 0.09 to 0.05 in 31 eyes (14%) and less in the other 123 eyes (55%).

There was a significant improvement in the surgical outcome over the 10-year-period, particularly from 1983 on. The improved results were due to introduction of 3-port surgical system, continuous air insufflation and intravitreal silicone oil.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40(6) : 593-596, 1986