Trabeculotomy retrospective study—（第4報）術後の視野変化について

Course of visual field after trabeculotomy for glaucoma

　各種緑内障に対し第1回目の手術としてトラベクロトミーを施行した387眼について平均3年3か月の期間視野の変化を調査した。視野狭窄の進行に影響する要因について考察した。眼底コントロールが良好であっても24.5％に視野狭窄の進行が認められた。視野障害は，高齢者，高血圧，肥満者に視野狭窄の進行しやすい傾向が認められた。術前視野が湖崎分類Ⅰ期の症例はそれ以後の時期の症例より術後視野は進行しにくかった。視野狭窄の進行と術後眼圧の相関はなかった。

We performed trabeculotomy as the first surgery in 387 eyes with various types of glaucoma during a 13-year period through 1987. We evaluated the fate of visual field in 249 eyes with well-controlled intraocular pressure below 20 mmHg. We used the Goldmann perimetry. The follow-up period aver-aged 39 months. Further constriction in the visual field was observed in 24.5 % in the series. Deteriora-tion in the visual field occurred in 19.6 % of eyes when surgery was performed while the visual field defect was in its early stage. Further deterioration in the visual field occurred in 30 % to 40 % of eyes when surgery was performed after the visual field defect was in an advanced stage. Presence of sys-temic hypertension, obesity score of 120 % or more, or age of more than 60 years contributed to further progression of visual field defect.