巨大裂孔に対するガスタンポナーデ後の経強膜手術

Treatment of giant retinal tear with gas tamponade followed by transscleral surgery

　翻転網膜が可動性を有する巨大裂孔性網膜剥離7例7眼に対し，ガスタンポナーデ後経強膜手術を施行した。内6眼で，ガスの縮小とともに裂孔縁の挙上を認め，ガスの追加注入とレーザー光凝固術を要したが，全例で復位を得た。長期的成績では，7眼中3眼にPVRが発生したが，硝子体手術を行って2眼で復位を得，12ヵ月経過観察しての最終復位率は約86％（7眼中6眼）と良好であった。本法は手術侵襲，手技の簡便さ，復位率などを考慮すると，現在のところ最も優れた方法と考えられた。

We treated 7 eyes with retinal detachment with giant retinal tear and inverted posterior retinal flap. We applied intravitreal SF 6 injection foll-owed by conventional transscleral surgery. Initial reattachment resulted in all the 7 eyes. Additional laser photocoagulation and gas injection were per-formed in 6 eyes. Proliferative vitreoretinopathy (PVR) developed in 3 eyes and had to be treated by vitreous surgery,

At the final evaluation 12 months or later after surgery, the retina was in reattached state in 6 eyes (86%). The above approach appears to be currently the most appropriate one in treating retinal detach-ment with giant tear.