白内障手術併用の有無による特発性黄斑前膜手術の再発率の検討

Rate of recurrence after surgical removal of idiopathic epiretinal membrane with or without simultaneous cataract surgery

要約　目的：特発性黄斑前膜（ERM）に対する硝子体手術後の再発率について白内障手術併用の有無で検討した。

対象と方法：2014〜2017年の4年間に和歌山県立医科大学附属病院で4名の術者により硝子体手術を施行し，1年以上にわたり光干渉断層計（OCT）で観察できた特発性黄斑前膜 93例93眼。同症例を白内障手術併用の有無と内境界膜剝離の有無で4群に分け，術後1年間のERMの再発率と術後最高矯正視力を比較検討した。術後に中心窩にかかるERMを認めたものを「再発」と定義した。

結果：術後1年間の再発率は白内障手術併用の有無で各群間に有意差はなかったが，内境界膜（ILM）剝離未施行群間で超音波乳化吸引術（PEA）施行群の再発率がPEA未施行群に比べて高い傾向にあった。術後最高視力は各群間で有意差はなかった。

結論：特発性ERMに対する硝子体手術における白内障手術併用で術後の黄斑前膜の再発率に有意差はなかったが，白内障手術併用ではILM剝離の有無で再発率が変わる可能性があるため注意を要する必要がある。

Abstract　Purpose：To report the rate of recurrence after surgical removal of idiopathic epiretinal membrane with or without simultaneous cataract surgery.

Cases and Method：This study was made on 93 eyes of 93 cases who received surgical removal of idiopathic epiretinal membrane during 4 years through 2017. The inner retinal membrane（ILM）was also removed in 59 eyes and was left intact in 34 eyes. Simultaneous cataract surgery was performed in 74 eyes and not in 19 eyes. Cases were followed up for one year or longer to evaluate the possible recurrence of epiretinal embrane.

Results：There was no significant difference in the rate of recurrence between eyes with and without simultaneous cataract surgery. There was no difference in visual acuity between eyes that received ILM removal or not. There was no difference in visual acuity with or without simultaneous cataract surgery.

Conclusion：There was no difference in rate of recurrence after surgery for epiretinal membrane with or without simultaneous cataract surgery. Rate of recurrence may differ depending on whether ILM is removed or not.