糖尿病網膜症に対する硝子体手術時のステロイド

Systemic corticosteroid during and after vitrectomy for diabetic retinopathy

　糖尿病網膜症46例69眼に硝子体手術を行い，フィブリン反応抑制を目的として術中・術後にプレドニゾロンを全身投与した。66眼に術中汎網膜眼内光凝固を行った。最終視力は0.7以上が24眼（35％），0.1以上が61眼（88％）であった。術後のフィブリン反応は15眼（22％）に起こり，視力転帰に影響を与えなかった。術前と退院時で血糖コントロール法に変化はなく，血清クレアチニン値がやや上昇したが透析導入には至らなかった。術中・術後のプレドニゾロン全身投与は術後のフィブリン反応を完全には防止しないが，短期間であるために全身状態に大きく影響しなかった。

We performed vitrectomy on 69 eyes of 46 patients with diabetic retinopathy. These patients received sys-temic prednisolone during and after surgery in order to prevent fibrinous reaction. Panretinal photocoagulation was performed in 66 eyes during surgery. Final visual acuity of 0.7 or over was obtained in 24 eyes (35%) and that of 0.1 or over in 61 eyes (88%). Postoperative fibrnous inflammation occurred in 15 eyes (22%), but did not affect the final visual outcome. There was no change in the regimen for diabetes mellitus throughout the course of prednisolone ther-apy. There was a slight increase in serum creatinine without necessitating hemodialysis. The findings show that sys-temic prednisolone during and after vitrectomy neither prevented intraocular fibrinous reaction completely nor seri-ously affected the systemic condition.