特発性黄斑円孔手術における内境界膜剝離法と非剝離法の手術成績

Outcome of vitreous surgery for idiopathic macular hole with or without peeling of internal limiting membrane

　硝子体手術を行った特発性黄斑円孔78眼につき，内境界膜を剝離した45眼と剝離しなかった33眼に分けて術後成績を検索した。両群の間には，術前視力，円孔のstage分類，円孔径，眼軸長などの背景因子に差がなかった。初回手術で円孔閉鎖が内境界膜剝離群の100％，非剝離群の79％で得られた。視力はlogMARで評価した。0.2以上の最終視力の改善が，剝離群の64％，非剝離群の73％で得られた。以上，内境界膜剝離を併用することで黄斑円孔の閉鎖率が有意に向上し，術後視力については両群間に有意差がなかった。

　We reviewed the outcome of vitreous surgery for idiopathic macular hole in 78 eyes. The internal limiting membrane（ILM）was peeled in 45 eyes and was not peeled in 33 eyes. There were no differences between the two groups regarding preoperative visual acuity,stage of macular hole,hole size,or axial length. After initial surgery,the macular hole closed in 100％of ILM-peeled group and in 79％of non-peeled group. When the visual acuity was expressed as logMAR,it improved by 0.2 or more in 64％of ILM-peeled group and in 73％of non-peeled group. The findings show that ILM peeling significantly improves the rate of macular hole closure and that ILM peeling does not significantly affect the postoperative visual acuity.