回折型多焦点眼内レンズ挿入眼の黄斑上膜に対する硝子体手術

Vitreous surgery for epiretinal membrane in an eye implanted with diffractive intraocular lens

要約　目的：回折型多焦点眼内レンズ挿入眼に発症した黄斑上膜に対して硝子体手術を行った報告。症例：65歳男性に右眼視力低下と変視症が生じた。2年前に右眼に白内障手術を受け，回折型多焦点眼内レンズが挿入されていた。所見：右眼の矯正視力は，遠方0.6，近方0.4であった。眼底に黄斑上膜があり，光干渉断層計（OCT）による検査で黄斑陥凹が消失していた。23G硝子体手術を行った。接触型のフラットコンタクトレンズでは膜に焦点が合わず，広角観察システムで倍率を上げて膜を剝離した。6か月後に1.2の遠方視力を得た。結論：回折型多焦点眼内レンズ挿入眼での黄斑上膜に対する硝子体手術で，広角観察システムが有用であった。

Abstract.　Purpose：To report vitreous surgery for epiretinal membrane in an eye implanted with diffractive intraocular lens. Case：A 65-year-old male was diagnosed with impaired visual acuity and metamorphopsia in the right eye. He had received cataract surgery with implantation of diffractive intraocular lens 2 years before. Findings：Corrected visual acuity was 0.6. The right eye showed epiretinal membrane with absent foveal concavity. He was treated by 23G vitreous surgery. Epiretinal membrane could not be observed distinctly using conventional flat contact lens. It was removed using wide-angle viewing system under high magnification. The right eye regained visual acuity of 1.2 six months later. Conclusion：Wide-angle viewing system was useful as an adjunct to vitreous surgery for epiretinal membrane in an eye implanted with multifocal diffractive intraocular lens.