進行した緑内障眼の線維柱帯切除術の中心視野中心10度以内静的視野検査による追跡

Course of central visual field following trabeculectomy for advanced glaucoma

　10度以内の中心部視野に障害の及んだ原発開放隅角緑内障患者14名19眼を対象とし，静的視野検査（セントラル10-2プログラム，ハンフリー視野計）を施行し中心部視野に対する線維柱帯切除術の影響について検討した。

　その結果，術後の中心部視野の感度閾値（dB）の変化は，術前の中心部視野と有意に弱い負の相関を示した（P＜0.05t-test）。すなわち，術前中心部視野が比較的よい例では術後の感度閾値は悪化傾向を示したが，比較的悪い例では改善傾向がみられた。術前の眼圧，視力，屈折，中心30度以内視野とは有意な相関を認めなかった。

　中心部視野の急激な悪化を示した例はなく，視力は術前後で有意な変化を認めなかった。

We evaluated the course of central visual field in 19 glaucomatous eyes in 14 patients following trabeculectomy. Visual field defect was present in the area within 10 degrees from the fixating point. All the exes were diagnosed as primary open angle glaucoma. The ages ranged from 25 to 49 years, average 38.8 years. The cases were followed up for 6 months after surgery. We used automated perime-ter, Humphrey visual field analyzer, to evaluate the visual field.

The intraocular pressure averaged 25.4±8.2mmHg before and 9.1±3.3 mmHg 6 months after surgery. There were no significant changes in visual acuity, mean of deviation by Program 30-2, or mean of total deviation in the central visual field by Program 10-2. Postoperative course of central visual field was also independent of preoperative intraocular pressure, visual acuity, retraction or visual field within 30 degrees of fixating point. Only the threshold in the central visual field before surgery was negatively correlated with that after surgery (p ＜0.05). This threshold was expressed as mean of total deviation by Program 10-2.