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要約 目的:LS-313 MF15(Oculentis社)眼内レンズ(IOL)を挿入する白内障手術併用黄斑前膜(ERM)手術について報告する。
対象と方法:対象は,2019年5月〜2020年8月に高須眼科でLS-313 MF15を挿入する白内障手術併用ERM手術を施行した連続20名22眼である。全例,白内障と屈折異常,特発性ERMの他に眼科疾患はなく,術中合併症はなかった。術前と術後1か月に中心窩網膜厚(CMT),M-CHARTS®,遠方視力,中間(1m)視力,近方(40cm)視力を測定した。
結果:本IOL挿入下での硝子体手術中,焦点が2つに分かれて見えたが,意図する範囲のERM剝離および内境界膜剝離が可能であった。術前の裸眼logMAR視力(矯正logMAR視力)は,遠方0.67±0.49(0.10±0.15),中間0.48±0.34(0.10±0.10),近方0.51±0.22(0.15±0.14)に対して,術1か月後のlogMAR視力は,遠方0.15±0.20(0.00±0.08),中間0.08±0.13(0.03±0.06),近方0.24±0.15(0.12±0.16)であった。術前に比して術後1か月で遠方と中間視力は裸眼・矯正ともに有意に改善した。CMTとM-CHARTS®に有意差はなかった。
結語:本IOLを挿入する白内障手術併用ERM手術は術中視認性に問題なく,術1か月後に遠方から中間まで視力は有意に改善した。
Abstract Purpose:To report the outcomes of epiretinal membrane(ERM)surgery combined with cataract surgery implanted with LS-313 MF15(LENTISTM Comfort, Oculentis Inc.)intraocular lens(IOL).
Methods:Twenty-two eyes of 20 patients who had an idiopathic ERM and a cataract consecutively underwent vitrectomies combined with cataract surgery implanted with IOL. All of these eyes had no ocular disorder without cataract, refractive errors and ERM before surgery. There was no intraoperative complication. Before surgery and 1 month after surgery, uncorrected and corrected visual acuity at 5 meter, 1 meter and 40 centimeter was measured on the basis of subjective refractive values. Central macular thickness(CMT)and metamorphopsia test of M-CHARTSTM were also evaluated at the same time.
Results:ERM and internal limiting membrane peeling were performed in the intentional range of those membranes after the IOL implantation. Before surgery, uncorrected visual acuity(best corrected visual acuity)was 0.67±0.49(0.10±0.15)at 5 meter, 0.48±0.34(0.10±0.10)at 1 meter and 0.51±0.22(0.15±0.14)at 40 cm. At 1 month after the surgery, visual acuity significantly improved to 0.15±0.20(0.00±0.08)at 5 meter, 0.08±0.13(0.03±0.06)at 1 meter. Near visual acuity became 0.24±0.15(0.12±0.16). CMT and the results of M-CHARTS were not significantly reduced at 1 month after the surgery.
Conclusion:The visibility during ERM surgery after implanting LS-313 MF15 IOL was good enough to peel the membranes. Distant and intermediate visual acuities were significantly improved 1 month after the surgery.
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