特発性黄斑円孔硝子体手術後の視力と円孔径

Visual acuity as related to hole size following vitrectomy for idiopathic macular hole

　特発性黄斑円孔21眼の術後視力と円孔径の関係を比較検討した。円孔径は術中に眼内に挿入した20Gの硝子体カッターの外径と比較する方法により直接計測した。術後視力と円孔径の間には有意の相関が認められ（r＝0.838,p＜0.0001），20Gの1／3以下の小円孔例8眼では全例術後2段階以上の視力改善を認め，術後0.4以上の良好な矯正視力を得た。一方，大きな円孔例13眼中術後2段階以上の視力改善を認めたのは4眼（31％）のみであり，また術後0.4以上の矯正視力を得た症例は1眼（8％）のみであった。黄斑円孔の術後視力を予測する上で円孔径は有効な指標となり、小円孔例は硝子体手術の良い適応であることが判明した。

We reviewed the visual outcome after vitrectomy for idiopathic macular hole in 21 eyes as related to the hole size which was measured during surgery. The final visual acuity was significantly correlated with the hole size (r=0.838, p＜0.0001). In all 8 eyes with macular holes smaller than 0.3mm in diameter, the visual acuity improved by 2 lines or more and was 20/50 or better. In 13 eyes with macular holes larger than 0.3mm, the postoperative visual acuity improved by 2 lines or more in 4 eyes, 31%, and was 20/50 or better in 1 eye, 8%. The findings show that the hole size serves as an indicator for the postoperative visual acuity and that smaller holes have a better chance of surgical improvement.