水晶体温存硝子体手術における周辺硝子体切除  [in Japanese] PERIPHERAL VITREOUS EXCISION IN CRYSTALLINE LENS PRESERVATION VITRECTOMY.  [in Japanese]

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Abstract

重症な網膜硝子体疾患に対する硝子体手術では完全な眼内郭清を行うことが前部増殖硝子体網膜症に対する予防になるため,水晶体切除を行うことが多い.しかし,50歳以下では白内障が見られないことも多く水晶体温存で行う場合もある.今回我々は硝子体手術時における眼内灌流のポート位置やポート数を変えることで水晶体を温存したまま,より確実な周辺硝子体の処理ができるかを検討した.対象は核白内障がEmery-Little分類のGrade1以下の網膜硝子体疾患18例18眼で,通常の3ポート硝子体切除術で行った群をA群,術中灌流ポート位置を変えた群をB群,4ポートで行った群をC群とした.3群について周辺硝子体切除後に硝子体可視化のためにトリアムシノロンを噴霧し残存硝子体を観察した.また,術後に水晶体の混濁を観察した.残存硝子体はA群では下方に多く見られたが,B,C群ではA群に比べ少なかった.水晶体混濁はA群では水晶体後極に2例,B群では水晶体赤道部付近に1例見られたがC群では見られなかった.これらより,水晶体温存硝子体手術では4ポートを用いることで水晶体に影響が少なくより確実な周辺硝子体の処理が可能であると考えられる.

Crystalline lens excision is performed in many cases of surgery for serious vitreoretinopathy, since the purpose is the prevention of anterior proliferative vitreoretinopathy by perfect intraocular excision. However, crystalline lens preservation may be done at the age of 50 or less when cataract is not present. We studied whether processing of the peripheral vitreous body could be performed while preserving the crystalline lens by changing the port position and the number of ports of infusion in vitreous surgery. 18 vitreoretinopathy eyes that had core cataracts of one or less Grade of an Emery-Little classification were divided into 3 groups: in group A the usual 3-port vitreous surgery was performed; in group B the port position was changed during the operation; and in group C4 ports were used. For the vitreous body visualization in the three groups after peripheral vitreous body excision, triamcinolone acetonide was injected and the residual vitreous body was observed. Cloudiness of the crystalline lens was also observed after the operation. Crystalline lens clouding on the posterior pole was seen in two examples of group A. In group B, one example was seen near the crystalline lens equatorial part. Cloudiness was not seen in group C. Therefore, the crystalline lens in not affected if 4 ports are used in crystalline lens preservation vitreous surgery.

Journal

  • Yokohama medical journal

    Yokohama medical journal 56(3), 157-160, 2005-05

    横浜市立大学医学会

Codes

  • NII Article ID (NAID)
    110004634190
  • NII NACSIS-CAT ID (NCID)
    AN00246369
  • Text Lang
    JPN
  • Article Type
    departmental bulletin paper
  • Journal Type
    大学紀要
  • ISSN
    03727726
  • NDL Article ID
    7715479
  • NDL Source Classification
    ZS7(科学技術--医学)
  • NDL Call No.
    Z19-520
  • Data Source
    NDL  NII-ELS  IR 
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