特発性黄斑上膜の術後経過

Outcome of surgery for idiopathic epiretinal membrane

要約　目的：黄斑上膜の術後の長期経過の報告。対象と方法：過去44か月間に手術を行った特発性黄斑上膜95例97眼を対象とした。男性39眼，女性58眼で，年齢は42～85歳（平均67歳）である。平均18か月の術後経過を追った。86眼では水晶体乳化吸引と眼内レンズ挿入を行った。視力はlogMARで評価した。結果：黄斑上膜の再発はなかった。視力改善は，70％の症例で術後2か月以内に起こった。術前視力と術後視力には正の相関があった（p＜0.01）。高齢であるほど術後視力が不良であった。発症から手術までの平均罹病期間は，視力が改善した症例では9.5か月，改善しない症例では22.4か月で有意差があった。両群の間に中心窩厚に差はなかった。術前に光干渉断層計（OCT）でCOSTラインが見える症例では，術後視力が良好であった。結論：特発性黄斑上膜への硝子体手術では，術前視力が良好であり，年齢が低く，COSTラインが見える症例で視力転帰が良好であった。

Abstract.　Purpose：To report the long-term of outcome of surgery for idiopathic epiretinal membrane. Cases and Method：This retrospective study was made on 97 eyes of 95 patients who received surgery for epiretinal membrane in the past 44 months. The series comprised 39 male and 58 female eyes. The age ranged from 42 to 85 years, average 67 years. Eighty-six eyes received phacoemulsification-aspiration with intraocular lens implantation. Visual acuity was evaluated in terms of logMAR. Cases were followed up for 18 months after surgery. Results：There was no recurrence of epiretinal membrane. Visual acuity improved within 2 months after surgery in 70％ of cases. A positive correlation was present between visual acuity before and after surgery（p＜0.01）. Visual outcome tended to be poor in patients of advanced age. Duration between presumed onset and surgery averaged 9.5 months in cases with improved visual acuity and 22.4 months in those without. Central foveal thickness was not associated with visual outcome. Visual acuity was better in eyes with manifest COST line by optical coherence tomography before surgery. Conclusion：Visual outcome was better in younger age, in eyes with better initial visual acuity, or with manifest COST line.