増殖性硝子体網膜症に対する硝子体手術シリコンオイルタンポナーデの成績

Results of vitreous surgery with temporary silicone oil tamponade for selected cases of proliferative vitreoretinopathy

　増殖性硝子体網膜症21例21眼の網膜復位手術として，硝子体切除，増殖組織除去，気圧伸展網膜復位，輪状締結，シリコンオイルタンポナーデ，網膜裂孔のキセノン眼内光凝固および汎網膜光凝固を施行し，シリコンオイルは平均18日で除去した．気圧伸展による網膜復位が遅滞するが完全に復位するもの，あるいは完全には復位しなくとも網膜下に空気が侵入しないものをシリコンオイルタンポナーデの適応とした．いずれも前部網膜の短縮肥厚が明らかに認められた．術後12カ月以上の経過観察で17眼，81％が復位を維持し，うち13眼が0.1以上の視力を得た．

Vitreous surgery with temporary silicone oil tamponade was performed on 21 eyes, 21 cases, of rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy. After meticu-lous removal of epiretinal and subretinal prolifer-ative tissue if necessary, silicone oil was injected into the vitreous when the detached retina failed to completely resettle under pneumatic pressure through fluid-air exchange technique. These casesinvariably manifested thickened and shortened anterior retina.

Cases with subretinal air entering during fluid-air exchange had to be treated by additional retinectomy and were excluded from this study. panretinal xenon endophotocoagulation was performed in all the cases. Silicone oil was removed 2 to 3 weeks later.. At the final evaluation 12 months or more after surgery, the retina was in attached state in 17 out of 21 eyes (81%) and the visual acuity was 0.1 or above in 13 (62%).

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(12) : 1355-1357, 1987