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Rinsho Ganka Volume 40, Issue 6 （June 1986）

臨床眼科 40巻6号（1986年6月発行）

Japanese English

特集第39回日本臨床眼科学会講演集　（5）

学会原著

増殖型糖尿病性網膜症の術後合併症としてのルベオージスの臨床的検討 Rubeosis iridis following intraocular surgery in eyes with proliferative diabetic retinopathy 三木正毅 ¹ , 斉藤伊三雄 ¹ , 塚原陽子 ¹ , 近藤武久 ¹ Masaki Miki ¹ , Isao Saito ¹ , Yoko Tsukahara ¹ , Takehisa Kondo ¹ ¹神戸市立中央病院眼科 ¹Dept. of Ophthalmol, Kobe Munic. Hosp pp.603-606

発行日 1986年6月15日 Published Date 1986/6/15

DOI https://doi.org/10.11477/mf.1410209741

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Abstract 文献概要
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　増殖型糖尿病性網膜症患者68例80眼の術後合併症を，術式により4群に分類してルベオージス，血管新生緑内障の発生頻度を検討した．第I群は白内障嚢内摘出術群17例22眼，第II群は白内障嚢外摘出術群17例20眼，第III群は有水晶体の硝子体手術群19例20眼，第IV群は無水晶体眼の硝子体手術群15例18眼である．ルベオージス／血管新生緑内障の発生はそれぞれ第I群は11／7眼，第II群は5／1眼，第III群は3／0眼，第IV群は11／7眼にみられ，発生率は第IV群，第I群，第II群，第III群の順に高く，ルベオージス発生には水晶体の有無が大きく関与しており，後嚢一層でも前部硝子体膜でも水晶体に準じたbarrierとしての役割を果たせることが推察された．視力予後は白内障手術間，硝子体手術間で術式による差は無く，網膜症の悪化は第I群が高率であった．以上の結果からルベオージスの発生機序を文献的に考察し，今後の望ましい手術方法に言及した．

We evaluated 80 eyes with proliferative diabetic retinopathy that underwent intraocular surgeries to determine the incidence of postoperative angle neovas-cularization and neovascular glaucoma. In the present series, 22 eyes were treated by intracapsular cataract extraction, 20 by extracapsular cataract extraction, 20 phakic eyes by vitreous surgery, and 18 aphakic eyes by vitreous surgery.

Postoperative angle neovascularization developed in 11 eyes following intracapsular cataract extraction, with neovascular glaucoma in 7. After extracapsular cataract extraction, angle neovascularization develoed in 5, with glaucoma in 1.

Six cases were tested with the New Aniseikonia Test (Awaya). In all the cases, aniseikonia was reduced after the surgery.

Radial keratotomy thus greatly increased the oppor-tunity for correction with spectacles in anisometropia patients who could not tolerate contact lenses. Following vitreous surgery inphakic eyes, rubeosis developed in 3, with no developed in 11, with glaucoma in 7.

The present findings suggest that the presence of intact lens-zonular diaphragm prevents angle rubeosis and neovascular glaucoma, even if only the posterior lens capsule and the zonule remain intact. The presence of anterior vitreous surface also seemed to supress angle neovascularization, although to a lesser degree. A less complicated surgical approach is advocated to eves with proliferative diabetic retinopathy.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40(6) : 603-606, 1986