深部裂孔による網膜剥離に対する手術の検討

Surgical outcome in retinal detachment with deeply located breaks

（B2-2-27）　1993年1月から1997年12月までに福岡大学病院眼科で，黄斑円孔を除く深部裂孔網膜剥離に対し初回手術を行った45例45眼において，術式とその選択基準について検討した。初回手術の術式は経強膜手術38眼で，網膜復位24眼（63.2％），網膜非復位14眼（36.8％）であった。裂孔の角膜輪部からの位置では，復位群18〜24mmで平均19.8mm，非復位群17〜24mmで平均216mmであり，両群に平均18mmの差があった。非復位群の8眼中5眼は20mm以上であった。両群とも最終的には全例で復位が得られた。裂孔の後極端が角膜輪部より20mm以上を，初回から硝子体手術適応の基準としてよいと考えた。

We reviewed 45 eyes of retinal detachment with deeply located breaks during the foregoing 5 years. Eyes with macular hole were excluded. Transscleral surgery as the initial procedure was performed in 38 eyes resulting in retinal reattachment in 24 eyes (63%) and failure in 14 eyes (37%) . The retinal break was located 18 to 24 mm, average 19.8 mm, posterior to the sclera in the attached eyes and 17 to 24 mm, average 21.6 mm, in the nonattached eyes. Nonat-tachment in the 14 eyes was due to new tear formation 1 eye and retinal traction 3 eyes. In 5 of the remaining 8 eyes, the retinal break was located deeper than 20 mm from the limbus. Final reattachment was obtained in all the eyes. The findings show that vitreous surgery is to be preferred to transscleral surgery when the posterior edge of retinal break is located deeper than 20 mm from the limbus.