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(P1-2-17) アトピー性網膜剥離に対する初回手術として,強膜バックリングに白内障手術を併用した14例15眼を対象とし,その手術成績について検討した。白内障の術式は経角膜輪部水晶体・前部硝子体切除術(LE)3眼,水晶体吸引術(ASP)6眼,水晶体吸引術+眼内レンズ挿入術(IOL)6眼であった。全体の初回復位率は80%作最終復位率は93%であった。初回手術後再剥離を生じたのは7眼で,白内障術式別ではLE群2眼(67%),ASP群3眼(50%),IOL群2眼(33%)であった。その原因は,新裂孔5眼(毛様体雛襲部1眼,毛様体扁平部3眼,赤道部1眼),PVR 2眼であった。なお,皺襞部裂孔による再剥離はASP群であった。手術成績に関して白内障術式による明らかな差はみられず,患者のQOLを考えれば,眼内レンズ挿入の同時施行も考慮してよいと思われた。
We reviewed 15 eyes of atopic retinal detachment treated by scleral buckling and cataract surgery as the initial procedure. Cases with breaks in the pars plicata, giant tear or proliferative vitreoretinopathy (PVR) were excluded. Cataract surgery was performed by translimbal lensectomy with anterior vitrectomy 3 eyes, lens aspiration 6 eyes and intraocular lens (IOL) implantation 6 eyes. The retina became reattached in 12 eyes (80%) after the initial procedure and in 14 eyes (93%) finally. Retinal detachment recurred after the initial surgery in 7 eyes, including lensectomy with anterior vitrectomy 2 eyes (67%) , lens aspiration 3 eyes (50%) and IOL implantation 2 eyes (33%) . Retinal redetachment was due to new breaks 5 eyes and PVR 2 eyes. New breaks were located in the pars plicata following lens aspiration 1 eye, pars plana 3 eyes and equatorial retina 1 eye. There was no difference in the surgical outcome regarding the type of cataract surgery. The findings show that IOL implantation is indicated as adjunct to surgery for atopic retinal detachment.
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