50歳未満の増殖糖尿病網膜症に対する硝子体手術成績

Visual outcome following vitreous surgery for proliferative diabetic retinopathy in patients under 50 years of age

　過去5年4か月間に硝子体手術を行った増殖糖尿病網膜症のうち，発症年齢が40歳以下，手術時年齢が50歳未満である59例83眼の手術成績を検討した。内境界膜剥離を行った症例は除外した。術後最終視力は，46眼（55％）で改善，14眼（17％）で不変，23眼（28％）で悪化した。最終視力が0.1未満であった主原因は，術前の黄斑剥離や虹彩ルベオーシスの併発であった。失明の原因は，術後の血管新生緑内障6眼，増殖硝子体網膜症8眼，前部硝子体線維性血管増殖2眼であった。良好な最終視力を得るには，早期硝子体手術が必要であると考えられた。

We reviewed 83 eyes of 59 cases of proliferative diabetic retinopathy treated by vitreous surgery during the past 64 months. As inclusion criteria, diabetes mellitus had been diagnosed at the age of 40 years or earlier and the cases were below 50 years of age at the time of surgery. Excluded were eyes that received additional peeling of the internal limiting membrane. The final visual acuity improved in 46 eyes (55%) , remained unchanged in 14 eyes (17%) and deteriorated in 23 eyes (28%). Final visual acuity under 0.1 was mainly due to preoperative macular detachment and rubeosis iridis. Causes of visual loss included postoperative neovascular glaucoma 6 eyes, proliferative vitreoretinopathy 8 eyes and anterior vitreous fibrovascular proliferation 2 eyes. The findings show that early vitrectomy is essential to obtain good final visual acuity.