Suture trabeculotomy眼内法の手術成績

Surgical outcome of suture trabeculotomy ab interno

要約　目的：Suture trabeculotomy眼内法（s-lot）の成績について報告する。

対象と方法：s-lotを施行し，3か月以上経過観察が可能であった165例242眼を対象とした。症例の内訳は，狭義原発開放隅角緑内障122眼，落屑緑内障50眼，原発閉塞隅角緑内障37眼であった。眼圧，累積生存率，薬剤スコア（点眼1点，アセタゾラミド内服1錠1点），術後合併症，視力について後ろ向きに検討した。累積成功率は眼圧が5mmHg以上21，18，15mmHg以下を成功基準と定義した。

結果：平均切開範囲は335.6±46.7°，176眼（72.7％）で360°切開することができた。平均眼圧は術前21.9±8.0mmHg，術後12か月12.0±4.8mmHgと有意に下降した。術後12か月での累積生存率は基準眼圧が21，18，15mmHgで，それぞれ93.7％，88.8％，85.9％であった。平均点眼スコアは4.3±1.2，術後12か月2.3±0.9と有意に減少した。術後に前房出血が153眼（63.2％），30mmHg以上の眼圧上昇が69眼（28.5％）にみられ，2眼で前房洗浄を行った。

結論：Suture trabeculotomy眼内法は有用な術式と考えられる。

Abstract　Purpose：To report surgical result of suture trabeculotomy ab interno（s-lot）.

Method：This retrospective study was made on 242 eyes of 165 cases that underwent the procedure of s-lot. There were 122 cases of primary open-angle glaucoma, 50 eyes with exfoliation glaucoma, and 37 eyes with primary angle-closure glaucoma. The intraocular pressure（IOP）, the cumulative survival rate, the number of glaucoma medications and complication were examined. Surgery was judged as success when IOP was kept between 5 and 21, 18, 15 mmHg.

Result：Mean incision range was 335.6±46.7 degrees, and 176 eyes（72.7％）were able to perform 360 degrees incision. The mean IOP significantly decreased from 21.9±8.0 mmHg before surgery to 12.0±4.8 mmHg 12 months after surgery. The mean number of glaucoma medications was significantly reduced from 4.3±1.2 before surgery to 2.3±0.9 12 months after surgery. The cumulative survival rates was 93.7, 88.8 and 85.9％ at IOP of 21, 18, 15 mmHg or less, respectively 12 months after surgery. Hyphema was seen in 153 eyes and IOP elevation of 30 mmHg or more was seen in 69 eyes.

Conclusion：S-lot was regarded as an effective procedure.