先天性緑内障の視機能予後

Visual function in surgically treated congenital glaucoma

　先天性緑内障52例81眼について，術前眼圧，角膜径，視神経乳頭陥凹と術後視力，視野の関係について検討した．術式はすべてtrabeculotomy ab externoを用い，術後眼圧は全例の77.8％で20mmHg以下にコントロールされたが，0.4以上の良好な視力を得た症例は39.4％であった．

　術前眼圧が35mmHg以上の症例で術後の視機能障害が高度になる傾向があり，C／D比が0.7以下の症例では視機能障害が軽く，C／D比0.8以上になると視機能障害が高度となる傾向があった．しかし角膜径の大小とは，一定の相関はなかった．

We treated 81 eyes of 52 cases with congenital glaucoma by means of trabeculotomy. The series included 65 early-onset eyes occurring before 3 years of age, 13 late-onset eyes, 2 eyes with Sturge -Weber syndrome and one eye with Rieger syn-drome. The postoperative period ranged from 6 months to 13 years, average 6 years 2 months.

Control of intraocular pressure (IOP) below 20mmHg was attained in 63 of the 81 eyes (78%).Visual acuity of 0.4 or greater was attained in 40% of the cases.

Postoperative IOP, corneal diameter and optic cup/disc ratio were documented in all the cases. Visual field could be measured in 38 eyes. Eyes with preoperative IOP levels of 35mmHg or more and those with c/d ratio greater than 0.7 thended to be associated with poor visual function in spite of good TOP control.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(4) : 309-312, 1987