アトピー性皮膚炎に伴う網膜剥離に対する硝子体手術成績

Vitrectomy for retinal detachment associated with atopic dermatitis

　アトピー性皮膚炎に伴う網膜剥離18例18眼に対して硝子体手術を行った。年齢は15〜35歳，平均24.4歳であった。12眼は有水晶体であり1うち4眼は白内障で眼底検索が困難であった。網膜剥離手術の既往が4眼にあった。有水晶体眼では前嚢を残して水晶体を切除した。外傷によると思われる網膜または毛様体への牽引を解除するため，基底部まで硝子体を切除した。毛様体ひだ部裂孔がある例ではその部の水晶体嚢を切除した。全例に輪状締結を行い，網膜裂孔がある例にはその部にバックルを追加した。初回手術で全例に復位が得られ，術後6〜48か月，平均25か月の観察で再剥離はなかった。このような症例に対して本術式が有効であったと結論される。

We performed vitreous surgery for retinal detachment in 18 eyes of 18 cases of atopic dermatitis. The ages ranged from 15 to 35 years, average 24.4 years. Twelve eyes were phakic, of which detailed fundus examination was not possible due to cataract in 4 eyes. Previous surgery for retinal detachment had been performed in 4 eyes. In phakic eyes, pars plana lensectomy was performed leaving the anterior capsule intact. The vitreous was removed including the vitreous base in order to release traction to the retina or the ciliary body due to rubbing of the eyeball. Eyes with breaks in the pars plicata received resection of the lens capsule adjacent to the break. All the eyes received scleral encircling. Scleral buckling was added in eyes with retinal break. Reattachment was obtained in all the eyes after initial surgery. There has been no recurrence during the follow-up for 6 to 48 months, average 25 months. These cases illustrate that the current procedure is effective for retinal detachment with atopic dermatitis.