長崎大学における裂孔原性網膜剥離に対する復位術の検討

Outcome of surgery for rhegmatogenous retinal detachment in our institution

　過去27か月間に手術を行った裂孔原性網膜剥離114名118眼を遡及的に検討した。強膜内陥術が94眼，硝子体手術が24眼であった。初回復位は強膜内陥術群の82％，硝子体手術群の77％で得られ，最終復位は前群の98％，後群の89％で得られた。硝子体手術群では，術前に黄斑剥離があっても90％以上で視力が改善した。経強膜手術での非復位例は，違った象限にある複数の裂孔，巨大裂孔，深部裂孔，高度近視の症例であり，その程度により術式を検討する必要があると結論される。

We reviewd the outcome of surgery for rhegmatogenous retinal detachment in 118 eyes of 114 patients during the past 27 months. Scleral buckling procedure was performed on 94 eyes and vitrectomy was performed on 24 eyes. After initial surgery, retinal reattachment was obtained in 82% in the former group and in 77% in the latter. Final re-attachment was obtained in 98% in the former group and in 89% in the latter. Vitreous surgery induced improved visual acuity in 90% of eyes with macular detachment. Scleral buckling procedure induced low rates of retinal reattachment in cases with giant tear, deeply located tear, multiple tears located in different meridians, or in eyes with high myopia. These findings suggest that different surgical approaches have to be chosen dependent on the actual state of retinal detachment.