50歳以下の増殖糖尿病網膜症に対する硝子体手術成績

Outcome of vitrectomy for proliferative diabetic retinopathy in patients below fifty years of age

　50歳以下の増殖糖尿病網膜症15眼に対して硝子体手術を行った。7眼には硝子体手術のみを，8眼にはこれと同時に超音波水晶体摘出術と眼内レンズ挿入術を行った。術後視力は，硝子体手術単独群4眼（57％）と併用手術群6眼（75％）で2段階以上に改善し，両群各1眼で不変，単独群2眼と併用群1眼で悪化した。単独群3眼と併用群1眼が0.5以下の視力であり，術後の硝子体出血がその主な原因であった。血管新生緑内障が単独群1眼で発症した。以上の結果から，50歳以下の増殖糖尿病網膜症に対する硝子体手術では，増殖組織の確実な処理と水晶体摘出術を同時に行うことで，合併症が少なく比較的良好な結果が得られると結論される。

We performed primary vitrectomy for proliferative diabetic retinopathy in 15 eyes in patients below 50 years of age. Vitrectomy alone was performed in 7 eyes. The other 8 others received additional phacoemulsification-aspiration with intraocular lens implantation. Visual acuity improved by 2 lines or more in 4 eyes (57%) in the former group and in 6 eyes (75%) in the latter. It remained unchanged in one eye each in both groups. It deteriorated in 2 eyes in the former group and in 1 eye in the latter. Postoperative visual acuity was 0.5 or less in 3 eyes in the former group and in 1 eye in the latter, mainly due to vitreous hemorrhage. Neovascular glaucoma developed in one eye in the for-mer group. The findings show that proliferative diabetic retinopathy in patients below 50 years of age can be effectively managed by vitrectomy with simultaneous phacoemulsification.