増殖糖尿病網膜症における硝子体手術術後硝子体出血因子の検討

Risk factors for postoperative vitreous hemorrhage in proliferative diabetic retinopathy

　増殖糖尿病網膜症に硝子体手術を行い，術後早期に硝子体出血をきたした25例28眼から再出血の危険因子を追求するために全身的因子と眼局所危険因子を分析した。対照は硝子体出血のない35例38眼とした。全身的因子は年齢，性別，罹病期間，血糖コントロール法，HbA_1c，血圧，出血時間，血小板数，赤血球数，血漿クレアチニン，血漿アルブミンを，眼局所因子は増殖膜処理，網膜減張切開，術前網膜剥離，タンポナーデ，術前光凝固，術中光凝固，術前硝子体出血，術後眼圧上昇，虹彩新生血管，水晶体，の有無について検討した。危険因子は若年，男性，術前光凝固未施行，術後眼圧上昇であった。これらの因子を伴う症例では眼底の厳重な観察が必要と考えた。

We evaluated the systemic and local risk factors for vireous hemorrhage after vitreous surgery for proliferative diabetic retinopathy in 28 eyes, 25 patients. The findings were compared with 38 eyes, 35 patients, without postoperative vitreous homorrhage. Evaluated systemic factors included: age, sex, dura-tion of the disease, methods for controlling blood sugar levels, HbA_1c, blood pressure, bleeding time, platelet and red blood cell counts, plasma creatinine and plasma albumin. Evaluated local factors included: methods of treating the proliferative membrane, relief incision of the retina, preoperative retinal detachment, vitreous tamponade, photocoagulation before or after surgery, state of preoperative vitreous hemorrhage, postoper-ative intraocular pressure, rubeosis iridis and the state of the lens. We could identify the following items as risk factors for postoperative vitreous homorrhage: young males, lack of preoperative photocoagulation and postoperative ocular hypertension. Patients with these risk factors would need particular postoperative follow-up.