硝子体手術中に生じた駆逐性出血の2例

Two cases of expulsive hemorrhage during pars plana vitrectomy

　裂孔原性網膜剥離に対する硝子体手術中に高度の駆逐性出血が2眼に生じた。第1例は30歳男性で−10Dの近視があり，第2例は41歳男性で−11Dの近視があった。駆逐性出血は，第1例では初回と3回目の硝子体手術中に，第2例では2回目の硝子体手術中に起こった。駆逐性出血は，両症例とも，手術操作が終了し強膜創を縫合ずる時に生じた。発症要因として，高度近視，脈絡膜剥離，複数回の長時間手術が推定された。これらの要因がある症例には，手術時間の短縮，術中に高い灌流圧を設定すること，再手術時の強膜創の位置の変更，強固な縫合が必要であると考えた。

Expulsive hemorrhage developed in two eyes during pars plana vitrectomy for rhegmatogenous retinal detachment. Both were males aged 30 and 41 years each. One had myopia of-10D and the other-11 D. Expulsive hemorrhage occurred, in both cases, just before sutures of sclerotomy sites were completed. High myopia, preoperative choroidal detachment, repeated and prolonged surgery appeared to have been the risk factors of expulsive hemorrhage in these cases. We advocate to shorten the operation time, maintenance of high intraocular pressure during surgery, avoiding the former site of sclerotomy and tight suture of the scleral wound during vitrectomy for retinal detachment in eyes with these risk factors.