裂孔原性網膜剝離に対するバックリング術後晩期に発症した黄斑円孔の2症例

Two cases of macular hole formation years after scleral buckling surgery for rhegmatogenous retinal detachment

要約　目的：裂孔原性網膜剝離に対してバックリング手術を施行した晩期症例に，後部硝子体剝離の存在下で黄斑円孔を生じた2例の報告。

症例：76歳の男性と73歳の女性がバックリング術後10年以上の経過で視力低下と歪視を生じた。

所見と経過：2例とも光干渉断層計で1/5乳頭径大の黄斑円孔と黄斑前膜が認められ，硝子体手術を施行し後部硝子体剝離の存在が確認された。症例1では術後7か月に黄斑円孔が再発し再手術となったが，2症例とも最終的に円孔閉鎖を確認した。

結論：後部硝子体剝離の発症後でも，黄斑前膜が存在すると長期経過で黄斑円孔が生じる可能性が示された。

Abstract　Purpose：To report two cases who developed macular hole more than 10 years after scleral buckling surgery for rhegmatogenous retinal detachment.

Cases：One was a 76-year-old male and the other was a 73-year-old female. They were referred to us for impaired vision and metamorphopsia in the right eye respectively. They had received surgery for rhegmatogenous retinal detachment 10 and 15 years before respectively.

Findings and Clinical Course：Both cases showed macular hole and epiretinal membrane in the affected eye by optical coherence tomography. Diameter of macular hole was 0.2 disc diameter. Both cases received pars plana vitrectomy with peeling of internal limiting membrane. Macular hole recurred in the first case 7 months later and closed 3 months after another surgery. The second case showed closure of macular hole 2 months after initial surgery.

Conclusion：The present cases show that macular hole may develop even after posterior vitreous detachment and retinal detachment surgery. Peeling of epiretinal membrane seemed to have induced closure of macular hole.