若年者増殖糖尿病網膜症の硝子体手術成績

Vitrectomy for proliferative diabetic retinopathy in patients under 40 years of age

　40歳未満の増殖糖尿病網膜症16例24眼に行った3ボート硝子体手術の成績を検索した。11眼に輪状締結，16眼に水晶体切除を併用した。初回手術成功例は20眼（83.3％）であった。不成功の原因は，光凝固の追加で消失しない虹彩ルベオーシス2眼，術後14日以上持続する硝子体出血1眼，網膜再剥離1眼であった。これら4眼は再手術で成功した。最終視力は，0.1未満が1眼（4％），0.1〜0.4が5眼（21％），0.5以上が18眼（75％）であった。術後の経過観察期間（6か月から54か月，平均18か月）中に視力が低下した症例はなく，若年者でも良好な手術結果が得られた。

We reviewed the outcome of pars plana vitrectomy for proliferative diabetic retinopathy in pa-tients under 40 years of age. Scleral encircling was additionally perfomed in 11 eyes and lensectomy in 16 eyes. Surgery was a success in 20 eyes (83.3%) after the initial procedure. The remaining 4 eyes had rubeosis iridis in spite of additional photocoagulation 2 eyes, persistent vitreous hemorrhage for 14 days or longer 1 eye, and retinal redetachment 1 eye. Cure was achieved in all these 4 eyes after another session of vitrec-tomy. The final visual acuity was less than 0.1 in 1 eye (4%), 0.1 to 0.5 in 5 eyes (21%), and over 0.5 in 18 eyes (75%). There was no instance of decreased visual acuity during the follow-up for 6 to 54 months, aver-age 18 months. Vitrectomy was thus beneficial for proliferative diabetic retinopathy in patients under 40 years of age.