Sinusotomyの手術成績

Results of sinusotomy for glaucoma

　非穿孔性濾過手術としてのsinusotomyの眼圧下降効果および合併症について検討した。対象は緑内障患者58例71眼（男性47眼，女性24眼）で，平均年齢は64.3歳（29〜83歳），緑内障病型の内訳は原発開放隅角緑内障44眼，正常眼圧緑内障8眼，原発閉塞隅角緑内障10眼，続発開放隅角緑内障5眼，発育異常緑内障2眼，嚢性緑内障2眼であった。これらに対してsinusotomyを施行し，経過を観察した。観察期問は98〜1,223日（平均609.6日），術前眼圧は平均23.0mmHg，術後最終観察時における眼圧は平均15.1mmHgであった。術中合併症はボタンホール3眼，強膜フラップの損傷1眼，前房穿孔3眼で，術後合併症が浅前房4眼，結膜創からの房水漏出が5眼であった。本術式は長期間にわたる十分な眼圧下降効果を示し，重篤な合併症のない安全な術式と考える。

We reviewed the outcome of sinusotomy on 71 eyes in 58 cases of glaucoma. The series comprised 47 male and 24 female eyes. The ages ranged from 29 to 83 years, average 64.3 years. There were primary open-angle glaucoma 44 eyes, normal-tension glaucoma 8 eyes, primary closed-angle glaucoma 10 eyes, secondary open-angle glaucoma 5 eyes, developmental glaucoma 2 eyes and capsular glaucoma 2 eyes. The postoperative follow up ranged from 98 to 1,223 days, average 610 days. The intraocular pressure averaged 23.0mmHg before and 15.1mmHg after surgery. Intraoperative complications included formation of button hole 3 eyes, damaged scleral flap 1 eye, perforation into the anterior chamber 3 eyes. Postoperative complications included shallow anterior chamber 4 eyes and leakage of the aqueous through the conjunctival flap 5 eyes. The findings show that sinusotomy in an effective and safe procedure on a long-term basis.