硝子体手術時の散瞳不良例に対するpupillary stretchingの有用性

Value of pupillary stretching for small fixed pupil in vitreoretinal surgery

　Pupillary stretchingは硝子体手術時の散瞳不良例に対して十分な瞳孔領が確保でき，裂孔検出率を高めるだけでなく，前部増殖性病変の処理に非常に有用な手術手技である。本法を施行することで，前部増殖性硝子体網膜症や前部硝子体線維血管性増殖などの治療成績が向上するものと思われる。

Pupillary stretching technique facilitates vitreous surgery for anterior proliferative lesions and will contribute to detection of retinal breaks. This method consists of passig two sutures posterior to the iris through four points at the limbus. Stretch-ing of the sutures will dilate the pupil to form a quadrangle. We performed vitreous surgery in 20 eyes: rhegmatogenous retinal detachment 5,proliferative vitreoretinopathy 6 and proliferative diabetic retinopathy 9. The eyes were phakic in 13,pseudophakic in 2 and aphakic in 5. Fibrinous exudation developed postoperatively in 7 eyes but disappeared after subconjunctival corticosteroid after 3 to 7 days, average 4.3 days.