透析中の増殖性糖尿病性網膜症に対する硝子体手術

Vitrectomy for proliferative diabetic retinopathy in patients under hemodialysis therapy

　国立大阪病院眼科にて硝子体手術を施行した透析中の増殖性糖尿病性網膜症症例18例について検討した．透析患者では再出血や続発性緑内障等の術後合併症の頻度が高い傾向にあった．術後の伏臥位を避けるためにガスタンポナーデのかわりに意図的に液体シリコン注入を行ったが，結果的には無水晶体眼で液体シリコンによる瞳孔ブロックを生じた．透析患者でも術後の伏臥位は可能であるので，網膜の復位を得るためにはガスタンポナーデの方が液体シリコン注入より優れている．

We performed vitrectomy for proliferative dia-betic retinopathy in 18 cases who were under hemodialysis therapy. The series included 3 apha-kic eyes and another 5 eyes who underwent pars plana lensectomy adjunct to vitreous surgery. There was a high incidence of postoperative com-plications, including vitreous hemorrhage 10 eyes and secondary glaucoma 4 eyes. We employed sili-cone oil retinopiesis instead of gas tamponade for aphakic eyes in order to avoid postoperative prone positioning. Postoperative pupillay block glaucoma developed in 3 such eyes. Since postoperative prone positioning is technically feasible in patients under hemodialysis, gas tamponade is to be preferred to silicone oil retinopiesis.

Rinsho Ganka (Jon J Clin Ophthalmol) 42(9) : 1075-1077, 1988