網膜剥離手術後の角膜知覚の経時的観察

Follow-up of corneal sensitivity after retinal detachment surgery

　片眼の網膜剥離手術症例63例を対象に，両眼の角膜知覚を，術前，術後1週から18カ月までの所定時期で観察した．術後の知覚の変化は，同一症例の非手術眼と手術眼の角膜知覚閾値の差を術後の知覚低下値として求め，諸条件下での比較を行った．輪状締結術，部分的バックリングを施した両群とも術後18カ月まで有意に角膜知覚は障害されていた．両者を合わせた全症例群を統計的にみると，術後3カ月と6カ月との間で角膜知覚は有意に回復した．輪状締結術について，凝固を施さない部分での知覚をみたところ，シリコンの強膜への縫着単独では，通常の圧迫程度であれば，9カ月以降その影響はほとんどない結果をえた．ジアテルミー凝固と冷凍凝固を比較すると，角膜知覚に与える影響は，9カ月以降では，ジアテルミー凝固の方が，強い傾向を示した．

I measured the threshold of corneal sensitivity in 63 patients who underwent surgery for unilateral retinal detachment. Measurements were made prior to and after surgery for maximally 18 months. The value in the fellow eye served was taken into consideration in the evaluation.

The corneal sensitivity was decreased in all the cases during the postsurgical period of up to 18 months, whether treated by segmental scleral buck-ling procedure or by scleral encircling. A signifi-cant improvement in sensitivity took place between 3 and 6 months after surgery.

In eyes with scleral encircling with silicone rod, compression of the sclera alone did not affect corneal sensitivity 9 months after surgery. After 9 months or more after surgery, scleral diathermy exerted more pronounced influence on corneal sen-sitivity than cryoapplication.

Rinsho Ganka (Jpn J Olin Ophthalmol) 42(7) : 775-779, 1988