Deep sclerectomy併用非穿孔性線維柱帯切除術の短期予後

Short-term outcome of nonpenetrating trabeculectomy with deep sclerectomy for glaucoma

　Deep sclerectomyを併用した非穿孔性線維柱帯切除術を21眼に行った。対象は原発性開放隅角緑内障11眼，正常眼圧緑内障2眼，水晶体嚢性緑内障3眼，原発性閉塞隅角緑内障2眼，外傷性緑内障1眼，発達緑内障1眼であった。13眼は単独手術，8眼には白内障手術を併用した。術後の観察期間は平均3.7±1.5か月であった。全21眼の眼圧の平均は術前22.5±6.5mmHg，術後12.8±3.0mmHgであり，有意に低下した（p＜0.05）。抗緑内障薬数は術前2.5±1.3，術後0.7±1.1であり，有意に減少した。単独手術群と白内障手術併用群とで，眼圧と抗緑内障薬数に有意差はなかった。術後に視野が大きく悪化した症例はなかった。合併症として，前房への穿孔3眼，白内障手術の際の後嚢破損1眼，結膜創離開「眼があった。周辺部虹彩前癒着が10眼にあった。

We performed nonpenetrating trabeculectomy with deep sclerectomy in 21eyes. The series comprised primary open-angle glaucoma 11 eyes, normal-tension glaucoma 2 eyes, capsular glaucoma 3 eyes, primary closed-angle glaucoma 2 eyes, and one eye each of traumatic and developmental glaucoma. Eight eyes in the series received simultaneous cataract surgery. The follow-up period averaged 3.7±1.5 months. The pre-and postoperative intraocular pressure (IOP) averaged 22.5±6.5mmHg and 12.8±3.0mmHg respectively. The difference was significant (p＜0.05). The number of antiglaucomatous medication before and after surgery averaged 2.5±1.3 and 0.7±1.1 respectively. The difference was significant (p＜0.05). There was no difference regarding the IOP control and number of medication between 13 eyes which received glaucoma surgery only and 8 eyes which received additional cataract surgery. No eye developed deterioration in visual field after surgery. Major complications comprised perforation into the anterior chamber 3 eyes, wound opening 1 eye, and peripheral anterior synechia 10 eyes.