裂孔原性網膜剥離に対する白内障硝子体同時手術の成績

Outcome of simultaneous cataract and vitreous surgery for rhegmatogenous retinal detachment

　過去5年間に初回手術として白内障・硝子体手術を同時に行った裂孔原性網膜剥離73眼の成績を評価した。増殖硝子体網膜症と黄斑円孔網膜剥離は除外した。術式は，超音波水晶体手術の後，硝子体手術を行い，周辺硝子体を十分に切除し，液空気置換，眼内光凝固，眼内レンズ挿入，ガス置換の順とした。強膜輪状締結を16眼に併用した。術後観察期間は6〜48か月，平均23か月であった。初回復位が69眼（95％）で得られ，4眼（5％）で再手術を行った。最終的復位は71眼（97％）で得られた。周辺部の硝子体牽引が確実に行える本術式は，裂孔原性網膜剥離の初回手術として価値があると判断された。

We reviewed the outcome of simultaneous cataract and vitreous surgery which was performed as the primary procedure for rhegmatogenous retinal detachment in 73 eyes during the past 5 years. We excluded cases of proliferative vitreoretinopathy and macular hole retinal detachment. The surgical procedure comprised : phacoemulsification-aspiration, vitrectomy, subtotal removal of peripheral vitreous, fluid-air exchange, endophotocoagulation, intraocular lens implantation and air-gas exchange in the given order. Additional scleral buckling was performed in 16 eyes. The postoperative observation period ranged from 6 to 48 months, average 23 months. Initial retinal reattachment was obtained in 69 eyes (95%). Additional surgery was required for retinal redetachment in 4 eyes (5%). Final retinal attachment was obtained in 71 eyes (97%) . The present procedure, which releases the vitreous traction to the peripheral retina, promises to be of value as the primary surgery for rhegmatogenous retinal detachment.