発育異常緑内障の手術成績

Surgical outcome of developmental glaucoma

（24-A12）　発育異常緑内障の術後成績に影響すると思われる高眼圧持続期間，手術方法，発見年齢について検討した。対象は，最近の7年間に発育異常緑内障と診断された9例16眼とした。手術方法は，主として二重強膜弁法によるトラベクロトミーを行い，必要に応じて深部強膜切除，あるいはトラベクロトミーを併用した。晩発型の1例2眼は，再手術を要したが全ての症例で術後眼圧コントロールが良好であった。

　高眼圧持続期間が短く，他覚症状が出現しやすい早発型のほうが、視機能予後が良好であった。

We reviewed 16 eyes of 9 patients with developmental glaucoma during the past 7-year period. We tried to identify prognostic factors including age of diagnosis, duration of elevated intraocular pressure (TOP) and surgical modalities. We performed trabeculectomy with double-scleral flapped approach as first choice. Advanced or severely impaired cases were treated by deep sclerectomy (sinusotomy) and/or trabeculectomy with sclera] tunnel. All the eyes achieved good TOP control after the first surgery except one late-onset eye which required another surgery. As a general trend, early-onset cases showed better clinical courses than late-onset ones, partly because early-onset glaucoma showed more pronounced clinical signs leading to early surgical intervention.