増殖糖尿病網膜症に対する硝子体手術後の前房フレアー値

Aqueous flare values following vitreous surgery for proliferative diabetic retinopathy

　硝子体手術を施行した増殖糖尿病網膜症のうち術後3か月以上追跡できた27例を，術前の眼底状態により，1群；硝子体出血，2群；硝子体出血＋増殖組織，3群；網膜剥離を伴うものに分け，術後3日，1週間，1か月，3か月後に前房フレアー値を測定し，臨床経過とともに検討した。増殖膜や網膜剥離を伴う硝子体切除群のフレアー値は術後1週間と1か月後には単純硝子体切除群よりも有意に高値を示した。ガス注入眼のフレアー値は術後1週間後にはガス非注入眼に比較して有意に高値を示した。術後硝子体出血，網膜脈絡膜剥離や虹彩ルベオーシス発生眼でのフレアー値は高値を示した。前房フレアー値は各種の硝子体手術における手術侵襲や術後の臨床経過，予後の指標となり得ると考えられた。

We quantitated the aqueous flare in 28 eyes with proliferative diabetic retinopathy before and after vitreous surgery. The series included 13 eyes with vitreous hemorrhage, 4 with additional proliferation and 11 with retinal detachment. A flare cell meter was used in the quantitation. The aqueous flare was significantly higher at 1 week and 1 month in eyes with preoperative proliferation or retinal detachment than those with vitreous hemorrhage only. Eyes treated by intravitreous gas showed significantly higher values of aqueous flare at the 1 postoperative week. Eyes with postoperative vitreous hemorrhage, retinochoroidal detachment or rubeosis iridis showed elevated values of aqueous flare. Aqueous flare values thus seemed to serve as a parameter for surgical insult, clinical course and prognosis after vitreous surgery for diabetic retinopathy.