硝子体手術後の眼内レンズ二次挿入

Secondary intraocular lens implantation in vitrectomized aphakic eyes

　硝子体手術後の無水晶体眼に対し眼内レンズ二次挿入術を行った，10例10眼の術中・術後合併症について検討した。原疾患は，増殖糖尿病網膜症5眼，増殖性硝子体網膜症1眼，裂孔原性網膜剥離3眼（穿孔性眼外傷後2眼，巨大裂孔網膜剥離1眼），黄斑円孔網膜剥離1眼であった。眼内レンズ二次挿入後，裂孔原性網膜剥離2眼，黄斑円孔網膜剥離1眼に網膜再剥離が生じた。このうち2眼は毛様溝縫着例であった。無硝子体眼では眼球の虚脱による変形を生じやすく，特に網膜剥離術後眼では，裂孔再開通による網膜再剥離の誘引となる可能性が示唆された。

We reviewed ten eyes which underwent secondary intraocular lens implantation. All the eyes were aphakic and had received vitrectomy. The original lesions were proliferative diabetic retinopathy 5 eyes, proliferative vitreoretinopathy 1 eye, rhegmatogenous retinal detachment (RRD) 3 eyes and macular hole retinal detachment (MHRD) 1 eye. Postoperatively, retinal detachment recurred in 3 eyes, including 2 eyes of RRD and 1 eye of MHRD. Sutured sulcus fixation had been performed in 2 of the 3 eyes. The findings illustrate that eyes with previous retinal breaks have a high risk of retinal redetachment probably due to collapse of the vitreous-free eyeglobe during secondary intraocular lens implantation.