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増殖糖尿病網膜症(PDR)に対して行った早期硝子体手術16例17眼の視力予後および術中・術後合併症について検討した。早期硝子体手術としたのは,A.頑固な新生血管例,B.切迫牽引性網膜剥離例,C.硝子体出血による光凝固不足例である。手術による視力改善率はA.B群が75%,C群が100%であり,0.4以上の術後視力保持例はA.B群は50%,C群は78%であった。術中合併症は3眼に医原性裂孔を生じたが,網膜剥離を生じることなく対処可能であった。術後合併症として術後硝子体出血を3眼に生じたが,2眼は簡便な硝子体洗浄で対処でき,1眼のみ手術による硝子体洗浄を必要とした。今後は,良好な視機能の保持を目的として,早期硝子体手術を考慮すべきであると考えられた。
We performed vitrectomy in 105 eyes with proliferative diabetic retinopathy (PDR) during the past 2 years. We reviewed 17 eyes in the series which were operated at an earlier stage before development of unresolved vitreous hemorrhage or tractional macular detachment. These 17 eyes were operated because of progressive neovasculariza-tion, impending tractional retinal detachment, orvitreous hemorrhage preventing photocoagulation. At 6 months after surgery, visual acuity in 75% in the former two categories and in all in the last category. There were 3 instances of iatrogenic tear formation and 3 of recurrence of vitreous hemor-rhage. These complications did not contribute to the final visual outcome. The findings seemed to advocate early vitrectomy for PDR before develop-ment of major clinical manifestations.
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