術前に裂孔不明であった裂孔原性網膜剥離に対する硝子体手術成績

Vitrectomy for rhegmatogenous retinal detachment in eyes with no detectable retinal break prior to surgery

　術前に裂孔が不明であった裂孔原性網膜剥離15眼に手術を行った。裂孔が不明であった原因は，重複を含め，脈絡膜剥離4眼，角膜混濁3眼，小瞳孔3眼，網膜皺襞3眼，白内障2眼，硝子体出血または混濁2眼である。全例に超音波水晶体乳化吸引術または眼内レンズ摘出ののち，硝子体切除，網膜裂孔の検索，液・空気置換，裂孔凝固，ガスタンポナーデを行った。9眼に輪状締結，2眼に眼内レンズ挿入を併用した。術後14眼（93％）が復位し、1眼は再剥離のため再手術を行った。裂孔が不明な網膜剥離では，水晶体摘出の上，周辺部硝子体切除と網膜裂孔を検索することが推奨される。

We reviewed the surgical outcome in 15 eyes of rhegmatogenous retinal detachment with no detectable retinal break prior to surgery. Retinal breaks could not be initially detected due to choroidal detachment 4 eyes, cor-neal opacity 3 eyes, small pupil 3 eyes, retinal folds 3 eyes, cataract 2 eyes, vitreal hemorrhage or opacity 2 eyes among others. All the eyes underwent phacoemulsification-aspiration or extraction of intraocular lens, vitrectomy, at-tempts to identify the retinal break, fluid-air exchange, coagulation of retinal break, and gas tamponade. Scleral encir-cling was added in 9 eyes and intraocular lens implantation in 2 eyes. Retinal reattachment was obtained in 14 eyes (93%). The other one eye needed another surgery. We advocate lens extraction, peripheral vitrectomy and identifica-tion of retinal break in the treatment of retinal detachment with no detectable retinal break prior to surgery.