臨床眼科71巻13号

2017年12月発行

特集 網膜硝子体手術の新しいスタイル

補助剤（アジュバント）の進化

著者： 江内田寛¹

所属機関： ¹佐賀大学医学部眼科学講座

ページ範囲：P.1840 - P.1848

はじめに

　硝子体手術の発展に伴い，手術をより安全かつ快適に行うためのさまざまなツールが開発されてきた。手術に用いる補助剤（アジュバント）の進化もその1つである。

　現在の硝子体手術に用いられるアジュバントはいくつかあり，術中に組織の可視化のために用いるアジュバントは，より安全かつ確実な手術の実施を可能にした。また，手術操作時に有用なアジュバントやタンポナーデに使用するもの，その薬理作用に期待し術前，術中に使用するものなど，現在われわれが使用している広義のアジュバントは数多く存在する。これらのアジュバントは非常に有用である反面，安全性に問題があるものの報告もある。

　現在，硝子体手術関連で使用されているアジュバントで，国内においてきちんと承認を受け使用できるものは一部である。いまだアジュバントの多くはオフラベルや未認可で，現在臨床研究の一環として実際の治療に用いられているという現状があり，臨床研究に伴う厳格化された倫理審査など手続き的に煩雑な問題点も存在する。本稿ではその代表例について，それらの進化をその変遷を交え解説する。

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