隅角癒着解離術の手術成績と生命表法による解析

Results of goniosynechiolysis and analysis by lifetable method

　閉塞隅角緑内障15例17眼に対して，隅角癒着解離術を施行した。術後経過観察期間は，6か月から23か月（平均13.4か月）であり，生命表法による検討では，最終的に68％の症例で良好な眼圧コントロール（術前と同等以下の薬物治療で，眼圧が20mmHg以下かつ術前より3mmHg以上低いもの）が得られた。術後眼圧降下は，7日目で最大となった後，7日目から3か月目の間でやや小さく，それ以後安定する傾向にあった。良好な眼圧コントロールの得られなかった症例は，全例，術後8か月以内に眼圧の再上昇をきたしていた。また，術前のPAS index （虹彩前癒着部分の隅角全周に対する比率）が術後の眼圧降下率に有意の関連があった。

We performed goniosynechiolysis in 17 eyes of 15 patients with primary angle-closure glaucoma. The intraocular pressure (IOP) in these eyes cound not be controlled by preceding surgeries and maximum medications. The postoperative follow-up ranged from 6 to 23 months, average 13.4 months. The average IOP level decreased by 8mmHg 7 days after surgery and by 3 to 6mmHg 1 to 18 months later. We applied the life-table method in the evalu-ation of surgical results. Eyes were considered assuccessfully treated when following criteria were satisfied: 1) the postoperative IOP decreased by more than 3mmHg and remained below 20mmHg, and 2) the postoperative medications were either equal to or less than the preoperative ones. Life -table analysis showed the probability of surgical success of 68 % at 8 months or later. In all the failure eyes, the IOP became uncontrollable within 8 months after surgery. The decrease in postopera-tive IOP was positively correlated with the periph-eral anterior synechia (PAS) index prior to sur-gery.