白内障・硝子体同時手術における手術侵襲の軽減のための新しい方法

A new approach to reduce the surgical insult during simultaneous cataract and vitreous surgery

（26M-16）　新手技により水晶体除去と硝子体手術を同時に行った112眼を評価した。耳側の3×3mmの曲面1面切開創で超音波水晶体乳化吸引術を行い，硝子体切除後にシリコーンレンズを嚢内に挿入した。術後に遷延性の角膜上皮障害はなく，上方の結膜が保存されているために，血管新生緑内障に対する濾過手術が容易にできた。曲面1面切開は作成が簡便で，無縫合でも強膜内陥凹時に前房が消失しなかった。シリコーンレンズは，虹彩癒着がなく，良好な瞳孔が確保でき，レンズ偏位はなかった。この手技は，手術侵襲の軽減に有効であった。

We reviewed 112 eyes treated by simultaneous lens extraction and vitreous surgery by a new approach. Phacoemulsification-aspiration was performed through a curved one-plane incision 3 mm x 3 mm in length along the temporal limbus. After vitreous surgery, a silicone lens was inserted into the capsule. Prolonged corneal epithelial damage was consistently absent. Filtering surgery for neovascular surgery was easy because of the preservation of the bulbar conjunctiva in the superior sector. Curved one-plane incision without suturing was easy to perform and facilitated preservation of the anterior chamber during sclera] indentation. The silicone lens did not cause synechia, kept the pupil intact, and remained in place. The present approach was useful in reducing surgical insult during simultaneous cataract and vitreous surgery.