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要約 目的:網膜剝離に対する強膜バックリング手術後に生じる網膜上膜(ERM)の頻度,要因,視力転帰の報告。
対象と方法:網膜剝離に対する強膜バックリング手術が2016年までの42か月間に行われ,3か月以上の経過を追えた137例141眼を対象とした。男性81例83眼,女性56例58眼で,平均年齢は40.0±16.9歳であった。
結果:術後の続発性ERMは9眼(6.4%)に発症し,男性5眼(6.0%),女性4眼(6.9%)であった。執刀医8人中3人が行った症例に続発性ERMが発症し,A医師では49眼中6眼(12.2%),B医師では30眼中2眼(6.7%),C医師では18眼中1眼(5.6%)であった。裂孔の位置は耳側5眼,上側2眼,下側2眼で,2眼には裂孔が複数個あった。黄斑剝離は2眼にあった。網膜下液の排液と冷凍凝固は全例に行った。続発性ERMの発症後,2段階以上の視力低下が2眼(22.2%)に生じた。
結論:網膜剝離に対する強膜バックリング後に生じるERMの発症要因または視力が増悪する要因は同定できなかった。
Abstract Purpose:To report the incidence, etiological factors, and visual outcome of epiretinal membrane(ERM)following scleral buckling surgery for retinal detachment.
Cases and Method:This retrospective study was made on 141 eyes of 137 cases who received scleral buckling surgery for retinal detachment during 42 months through end of 2016 and who could be followed up for 3 months or longer. The series comprised 83 eyes of 81 males and 58 eyes of 56 females. The age averaged 40.0±16.9 years.
Results:ERM developed in 9 eyes(6.4%)after surgery, involving 5 male eyes(6.0%)and 4 female eyes(6.9%). ERM developed in patients who were operated by 3 out of 8 surgeons. ERM developed in 6 out of 49 eyes(12.2%)operated by surgeon A, in 2 out of 30 eyes(6.7%)operated by surgeon B, and in one out of 18 eyes(5.6%)operated by surgeon C. Retinal break was located in the temporal sector in 5 eyes, superiorly in 2 eyes, and inferiorly in 2 eyes. Two eyes had multiple retinal breaks. All the 9 eyes received drainage of subretinal fluid and cryoapplication. Visual acuity decreased by 2 scales or more in 2 eyes(22.2%).
Conclusion:No definite factor could be identified in the occurrence or visual impairment related to ERM after scleral buckling for retinal detachment.
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