加齢性眼瞼下垂症手術による視機能改善についての評価

Changes in visual function following surgery for age-related blepharoptosis

要約　目的：加齢性眼瞼下垂手術前後の視機能変化について評価した。対象と方法：過去17か月間に手術を施行した加齢性眼瞼下垂症例66例132眼を対象とした。手術前後のmargin reflex distance（MRD），矯正視力，コントラスト感度，眼球収差，8方向視野を測定した。結果：MDR術前0.73±0.94mm，術後2.89±0.94mm（p＜0.001）。術後コントラスト感度は改善し（p＜0.05），視野は全方向にて改善した（p＜0.001）。結論：加齢性眼瞼下垂症は手術治療によりコントラスト感度の改善，視野改善を認めQOVの改善に有効であった。

Abstract.　Purpose：To report changes in visual function following surgery for age-related blepharoptosis. Cases and Method：This study was made on 132 eyes of 66 cases who received surgery for blepharoptosis in the past 17-month period. The series comprised 44 male and 88 female eyes. The age averaged 69.5±11.6 years. Surgery was performed by tucking Müller muscle using carbon dioxide laser. Cases were evaluated regarding visual acuity, margin reflex distance（MRD）, visual fields in 8 directions by Goldmann perimeter without elevating the eyelid. Results：MRD improved from 0.73±0.94 mm before surgery to 2.89±0.94 mm after surgery. The difference was significant（p＜0.001）. There was no change in visual acuity after surgery. Visual field improved improved in all the 8 directions, particularly in the superior sectors. Area of visual field improved significantly by 27.5％. Contrast sensitivity appeared to be reduced in the presence fo blepharoptosis, mainly due to astigmatism resulting in siffraction. Conclusion：Surgery for age-related blepharoptosis resulted in improved contrast sensitivity and visual field.