鈍的外傷後の黄斑円孔に対する硝子体手術成績

Outcome of vitreous surgery for macular hole secondary to blunt ocular trauma

要約　目的：硝子体手術を行った鈍的外傷後黄斑円孔症例7例7眼の手術成績を報告する。方法：対象の年齢は平均24.9（9～55）歳であった。全例に対して経毛様体扁平部硝子体切除術，内境界膜剝離，SF₆ガスタンポナーデを施行した。受傷から手術までの期間は平均6.6（2～11）か月，術後観察期間は平均9.3（3～24）か月であった。結果：5眼は初回手術後，1眼は2回の手術で円孔が閉鎖した。1眼は術前に網脈絡膜萎縮がみられ受傷後2か月で手術を行うも円孔閉鎖には至らず，視力は最終観察時0.09にとどまった。円孔閉鎖症例では術前平均視力0.26から最終観察時平均0.84に改善した。結論：網脈絡膜萎縮の有無と手術による円孔閉鎖が視力改善のために重要である。

Abstract.　Purpose：To report the outcome of vitreous surgery for macular hole secondary to blunt ocular trauma. Cases and Method：This retrospective study was made on 7 eyes of 7 cases who were treated for macular hole secondary to blunt ocular trauma in the past 77 months. The age ranged from 9 to 55 years, average 24.9 years. The interval between trauma and surgery ranged from 2 to 11 months, average 6.6 months. All the cases received vitreous surgery, peeling of internal limiting membrane, and tamponade with sulfer fluoride. Cases were followed up for 3 to 24 months, average 9.3 months. Results：Macular hole closed after one session of surgery in 5 eyes and after 2 sessions in one eye. The other one eye had retinochoroidal atrophy. Macular hole in this eye persisted after surgery with final visual acuity of 0.09. Visual acuity in 6 eyes averaged 0.26 before surgery and 0.84 after macular hole closure. Conclusion：Visual acuity recovered after surgical closure of macular hole and in eyes without chorioretinal atrophy.