脈絡膜出血への手術治療

Surgical treatment of choroidal hemorrhage

要約　目的：術中または術後に発症した脈絡膜出血への手術成績の検討。対象と方法：過去2年間に脈絡膜出血に対して手術を行った7例7眼につき，発症の危険因子，術後の網膜復位率，術後視力を検討した。年齢は49～89（平均70）歳であった。結果：脈絡膜出血の発症時期は，硝子体手術中2眼，硝子体手術後3眼，白内障手術中1眼，白内障手術後1眼であった。危険因子は，65歳以上の高齢6例，高血圧6例，糖尿病3眼，26mm以上の眼軸長1例，術中低眼圧2例であった。脈絡膜出血の除去は5眼で硝子体手術の強膜創を通じてのみ行い，2眼ではさらに強膜切開を加えた。7眼中6眼で網膜復位が得られた。最終視力は，術前に比べて5眼で維持または改善した。結論：術中生じた脈絡膜出血には積極的に手術を行うべきである。

Abstract.　Purpose：To review the outcome of surgery for intra-or postoperative choroidal hemorrhage. Cases and Methods：Seven eyes of 7 cases received surgery for choroidal hemorrhage during a two-year period. Their ages ranged from 49 to 89 years,average 70 years. They were evaluated regarding risk factors,retinal reattachment,and visual outcome. Results：Choroidal hemorrhage developed during vitrectomy 2 eyes,after vitrectomy 3 eyes,and during or after cataract surgery 1 eye respectively. Following features appeared to be risk factors：age over 65 years 6 cases,systemic hypertension 6 cases,diabetes mellitus 3 cases,axial length over 26mm one case,and intraoperative ocular hypotony 2 cases. Choroidal hemorrhage was drained through the scleral port in 5 eyes. Additional sclerotomy had to be performed in the other 2 eyes. The retinal became reattached in 6 out of 7 eyes. Final visual acuity was the same or better than the preoperative value in 5 eyes. Conclusion：Surgical intervention is indicated for surgery-related choroidal hemorrhage.