5 Fu，Nd：YAGレーザーを併用したSinuso-Sclerectomyの再評価

Reappraisal of sinuso-sclerectomy with additional fluorouracil injection and Nd: YAG laser trabeculopuncture

　Sinuso-Sclerectomyを開放隅角緑内障12眼に，濾過瘢痕形成を抑制する5Fuを併用して行った。うち4眼には眼圧上昇や濾胞縮小時にNd：YAGレーザーで線維柱帯穿孔を行った。術後観察期間は9か月〜3年5か月であった。大きい濾胞が全例にでき，眼圧は10眼は無治療，2眼は点眼使用で全例20mmHg以下，平均12.7±4．0mmHgとなった。有効率は手術のみ行った過去の成績に比して有意（P＜0.01）に高かった。重篤な合併症はなかった。手術で眼球外壁の流出抵抗を除き，さらに前房側からの穿孔で眼圧が下がれば，合併症を最小にして強膜全層炉過手術の効果があがったと言える。興味ある手術法であり，特に末期症例には有用と考える。

Our surgical results for glaucoma with sinuso-scler-ectomy (4×1.7mm) during the foregoing 14 years have been less gratifying than with other surgical modalities because of no perforation to the anterior chamber. In an attempt to improve the resuls, we performed sinuso-sclerectomy in 12 eyes of open angle glaucoma with the additional subconjunctival fluorouracil injections. The 4 out of 12 eyes were treated by Nd: YAG laser trabeculopuncture ab interno, when the intraocular pressure elevated or bleb diminished in size. During the follow up (varying for cases from 9 to 41 months), control of intraocular pressure (20mmHg or less) was attained in 10 eyes without medication and 2 eyes with eye drops. At the final examination, the mean intraocular pressure was 12.7±4.0mmHg, The good blebs have developed postoperatively in all cases. By this method, a good effect, as well as that of full-thickness filtration procedure, was achieved without any serious complications under the condi-tion of closed eye surgery.