網膜剥離手術後の再剥離症例の検討

Recurrence of rhegmatogenous retinal detachment after initial surgery

　いったん完全に復位した後，再剥離した裂孔原性網膜剥離100眼につき，その原因，手術法，予後について検討した。再剥離眼の屈折状態は，73％が3Dを超える近視47％が8Dを超える強度近視であった。再剥離の原因は，硝子体の牽引の継続増強による原裂孔の再開（24％），増殖性硝子体網膜症（48％）が主であった。再剥離の時期は約50％が手術後2か月以内であり，その間の経過観察が重要であると考えられた。再剥離を生じても，術式を的確に選択すれば網膜の復位は可能であり，視力予後も良好な場合が多い。

We reviewed a consecutive series of 100 eyes of retinal detachment which recurred after initially successful surgery. This series was a part of 1,576 eyes of rhegmatogenous retinal detachment which were surgically treated by us during the foregoing 6-year period. Among the 100 eyes, 73 had myopia of -3 diopters or more and 47 had myopia of -8diopters or more. We could identify two major factors for the recurrence: proliferative vitreo-retinopathy 48% and reactivation of the former retinal break due to vitreous traction 24%. Recur-rence developed within 2 months after the initial surgery in 50% in the series. Reattachment of the retina resulted in 96% of the cases after the final surgery, of which 45% were transscleral and 52% were transvitreal.