原発閉塞隅角緑内障に対する隅角癒着解離術・線維柱帯切開術併用の有無による手術成績の比較

Comparison of outcome after goniosynechialysis with or without trabeculotomy for primary angle-closure glaucoma

要約　目的：原発閉塞隅角緑内障（PACG）に対して隅角癒着解離術を施行した群（GSL群）とそれに線維柱帯切除術を併用した群（LOT併用群）の短期成績を比較検討する。

方法と対象：PACGで初回手術を行ったGSL群6例6眼，LOT併用群8例10眼の眼圧と投薬スコアを，術前と術後で比較検討した。術前の眼圧，隅角閉塞の範囲，薬剤スコアに差はないが，診断からの手術までの期間がGSL群で1.0〜24.3か月（平均6.1か月），LOT併用群で5〜146か月（平均64.8か月）と有意差があった。

結果：両群とも眼圧と投薬スコアは，術後有意に下降し，両群間で有意差はなかった。

結論：診断から早期のPACGでは，隅角閉塞の範囲にかかわらず，GSL単独とLOT併用で同等の眼圧下降効果が得られた。

Abstract　Purpose：To report and compare the outcome of goniosynechialysis with or without trabeculotomy for primary angle-closure glaucoma（PACG）.

Case and Method：This retrospective study was made on 14 eyes that received goniosynechialysis for PACG in the past 64 months. Ten eyes received additional trabeculotomy in the same session. The outcome was evaluated regarding intraocular pressure（IOP）and medication score. Cases were followed up for 1 to 24 months, average 6 months, following goniosynechialysis alone. and for 5 to 146 months. average 65 months, following additional trabeculotomy.

Results：Both groups showed significant reduction in IOP and medication score after surgery（p＜0.05）. There was no difference between the two groups regarding the outcome of IOP medication score.

Conclusion：Goniosynechialysis was effective for PACG regarding IOP and medication score and was independent on simultaneously performed trabeculotomy.