急性網膜壊死の硝子体手術時期に関する検討

Optimum timing of vitreous surgery in acute retinal necrosis

　片眼の急性網膜壊死の手術を2例経験した。第1例52歳女子は進行例で，高度なPVRによる網膜全剥離，硝子体出血のために硝子体手術などにても治癒しなかった。第2例17歳男子は多発性の網膜裂孔による網膜剥離が認められた直後に行った硝子体手術，輪状締結，液ガス交換，意図的裂孔からの下液の排除および十分な眼内光凝固で治癒できた。本症は網膜剥離，および網膜裂孔が生じた場合，早急に硝子体手術などを行うことが重要であると思われた。

We performed vitreous surgery in two eyes of acute retinal necrosis to relieve retinal detachment and vitreous opacity. In the first case, a 52-year-old female, vitreous surgery was performed when theocular manifestations were far advanced with total retinal detachment, proliferative vitreoretinopathy, vitreous hemorrhage and widespread retinal ne-crosis. The surgery was futile. In the second case, a 17-year-old male, vitreous surgery was performed with success during the early stage of the disease after multiple retinal breaks and retinal detach-ment became manifest. We performed vitrectomy combined with scleral encircling, vitreous gas tamponade, internal drainage of subretinal fluid and endolaser photocoagulation. It seems logical to assume that vitreous surgery be undertaken imme-diately after retinal breaks ae detected.