内因性ぶどう膜炎に対する内眼手術の検討

Intraocular surgery on eyes with endogenous uveitis

（B3-2-28）　内眼手術を受けた内因性ぶどう膜炎患者の臨床像，手術の種類と，その術後結果および合併症について検討した。対象は1993〜1998年の期間に内眼手術が行われた内因性ぶどう膜炎患者35名51眼である。後ろ向き研究で病因，手術の種類，術後経過と合併症について検討した。その結果，内眼手術の8割が白内障手術で，眼内レンズ挿入眼と非挿入眼では術後視力に差はなく，炎症がおさまってから2か月未満と2か月以上では術後視力は後者で有意に良好であった。しかし，前房の消炎が不十分な状態での手術や，炎症が再燃しやすいぶどう膜炎を基礎疾患にもつ眼では予後不良なものが多かった。

Purpose : To assess clinical features, type of surgery, outcome and complications of intraocular surgery on eyes with endogenous uveitis. Cases : The series comprised 51 eyes of 35 patients during a 6-year period through 1998. Ocular sarcoidosis was present in 6 eyes, Behget disease in 5, juvenile rheumatoid arthritis (JRA) in 2, and HTLV-1- associated uveitis (HAU) in one. The etiology was unknown in about one-half of the series. Cataract surgery had been performed on 42 eyes (83%), vitreoretinal surgery on 5 eyes and glaucoma surgery on 3 eyes. Findings : There were essentially no differences in postoperative visual acuity whether the eyes received intraocular lens implantation or not. Significant differences were present in visual acuity between eyes which had recurrent inflammation within 2 months before surgery and those which were free of active inflammation in the same period. Conclusion : Overwhelming majority of eyes had good vision after surgery. Visual acuity tended to be poor in eyes which had active inflammation at the time of surgery or which had recurrent uveitis as Behcet disease or ocular sarcoidosis.