ヒアルロン酸ナトリウム溶解ICGとBSS溶解ICGでの黄斑円孔手術成績

Macular hole surgery using hyluronic acid or balanced salt solution as vehicle for indocyanine green

特発性黄斑円孔33眼に硝子体手術と内境界膜剝離を行った。16眼にはインドシアニングリーン（ICG）をヒアルロン酸ナトリウム0.06％に溶解し，17眼にはbalanced salt solution（BSS）0.125％に溶解して内境界膜を染色した。走査型レーザー検眼鏡（SLO）で，術後に残存するICGを観察した。全例に円孔の閉鎖が得られ，視力の改善率に両群間に差はなかった。蛍光の残留期間は，ヒアルロン酸ナトリウムでは平均3.6か月，BSS群では7.6か月であり，蛍光の分布は前者よりも後者で広範囲であった。内境界膜染色にヒアルロン酸ナトリウムに溶解したICGを用いることで，その残留を軽減できる可能性がある。

We performed vitreous surgery with peeling of for idiopathic macular hole in 33 eyes. Internal limiting membrane was stained by indocyanine green（ICG）dissolved in 0.06％ hyluronic acid in 16 eyes. It was stained by ICG dissolved in 0.125％ balanced salt solution in 17 eyes. A scanning laser ophthalmoscope was used to observe ICG in the fundus after surgery. Closure of macular hole was obtained in all the eyes. There was no difference in the improvement of visual acuity between two groups. ICG persisted for an average of 3.6 months in eyes receiving hyluronic acid and for 7.6 months in eyes receiving balanced salt solution. ICG was present in a wider area in eyes receiving balanced salt solution than hyluronic acid. There is a posslbllity to reduce persistent ICG by using hyluronic acid as its vehicle in macular hole surgery.