Inverted ILM flap techniqueを用いた黄斑円孔の手術成績

Outcome of surgery with inverted internal limiting membrane for macular hole

要約　目的：黄斑円孔に対して内境界膜翻転法を行った成績の報告。

対象と方法：過去33か月間に内境界膜翻転を併用する硝子体手術を行った黄斑円孔18例18眼を対象とした。男性9例，女性9例で，平均年齢は66歳であった。円孔径は500μm以上，または推定発症後1年以上とした。視力はlogMARとして評価した。

結果：平均視力は，術前0.99±0.45から術後0.55±0.40に有意に改善した（p＜0.01）。初回手術で18眼中16眼（89％）で円孔が閉鎖した。初回非閉鎖の2眼では，内境界膜剝離を行うことで円孔が閉鎖した。

結論：大きな円孔径または陳旧化した黄斑円孔に対し，内境界膜翻転を併用する硝子体手術を行い，初回成績で89％，再手術で100％の円孔閉鎖が得られた。

Abstract　Purpose: To report the outcome of vitreous surgery with inverted internal limiting membrane procedure for macular hole.

Cases and Method: This retrospective study was made on 18 eyes of 18 patients who received vitreous surgery with inverted internal limiting membrane procedure for macular hole in the past 33 months. The series comprised 9 males and 9 females. The age averaged 66 years. All the cases had macular hole larger than 500μm in diameter or had persisted for one year or longer. Visual acuity was evaluated as logMAR.

Results: Visual acuity averaged 0.99±0.45 before surgery and 0.55±0.40 after surgery. The change was significant（p＜0.01）. Macular hole closed in 16 eyes（89％）after initial surgery. In the remaining 2 eyes, macular hole closed after another surgery.

Conclusion: Vitreous surgery with inverted internal limiting membrane procedure resulted in closure of macular hole that had large diameter or that had persisted for one year or longer.