Hemi-Inverted ILM flap technique手術を行った黄斑円孔の1年後経過

One-year outcome of macular hole treated by hemi-inverted internal limiting membrane flap technique

要約　目的：陳旧性黄斑円孔に対して，半周の内境界膜を反転させる術式を行った1年後の成績の報告。症例と方法：過去7か月間に本法を行った黄斑円孔の難治例9例9眼を対象とした。術式の適応基準は，黄斑円孔径が最小450μm以上で，最大800μm以上であり，矯正視力が0.3以下とした。手術1年後の所見を検索し，視力はlogMARとして評価した。結果：全9眼で円孔が閉鎖し，矯正視力は術前の0.85±0.33が，術後の0.33±0.21に有意に改善した（p＝0.003）。光干渉断層計で観察した外境界膜と，視細胞の内外節接合部の所見は，2例のみで改善した。結論：陳旧性黄斑円孔に対する半周の内境界膜を反転させる術式により，9眼全例で円孔閉鎖が得られた。網膜外層の改善は9眼中2眼のみであり，機能回復は不十分であった。

Abstract.　Purpose：To report the outcome one year after surgery for macular hole by hemi-inverted internal limiting membrane technique. Cases and Method：This retrospective study was made on 9 eyes of 9 cases who received above surgery for recalcitrant macular hole in the past 7 months. These eyes met the following inclusion criteria. The minimum diameter of macular hole was more than 450μm and the maximum diameter was more than 800μm. Best-corrected visual acuity was 0.3 or less. The outcome was evaluated one year after surgery. Visual acuity was evaluated as logMAR. Results：Macular hole was closed in all the 9 eyes. Visual acuity averaged 0.85±0.33 before and 0.33±0.21 one year after surgery. The difference was significant（p＝0.003）. Findings of external limiting membrane and of outer/inner segment junction of visual cells improved in 2 out of 9 eyes when observed by optical coherence tomography. Conclusion：Macular hole closed in all the 9 eyes after surgery by hemi-inverted internal limiting membrane technique. Findings of external retinal layers improved in 2 out of 9 eyes only. Visual function failed to fully recover.