黄斑円孔の硝子体手術における腹臥位期間の検討

Duration of prone position after vitreous surgery for macular hole

　過去16か月間に，特発性黄斑円孔32眼に対して硝子体手術を行った。15眼はstage3，17眼はstage4の円孔であった。15眼では術後に硝子体を20％SF6で置換し，約10日間，腹臥位を維持させた。17眼では，同じく100％の空気で置換し，約4日間，腹臥位をとらせた。SF6群では，stage 3円孔の83％とstage 4円孔の63％が閉鎖した。空気群では，同じく78％と67％の閉鎖率であった。視力改善は，SF6群ではstage3円孔では83％，stage4円孔では63％で得られた。空気群では，同じく89％と67％で得られた。両群間には円孔閉鎖率と視力改善率について有意差がなかった。黄斑円孔の硝子体手術の腹臥位期間を短縮することが可能である。

We performed vitreous surgery on 32 eyes of idiopathic macular hole during the past 16 months. The series comprised 15 eyes with stage 3 hole and 17 eyes of stage 4 hole. At the end of surgery, the vitreous was filled by 20% SF₆ gas in 15 eyes followed by face-down position for 10 days. The vitreous filled by air in 17 eyes followed by face-down position for 4 days. The macular hole closed in 83% of stage 3 eyes and in 63% of stage 4 eyes after SF₆ treatment. The hole closed in 78% and 67% of eyes respectively after replacement of the vitreous by air. The visual acuity improved in 83% of eyes with stage 3 and in 63% of stage 4 eyes when treated by SF₆. It improved in 89% and 67% respectively when treated by air. There was no significant difference in the rate of hole closure or improvement of visual acuity between the two groups. This result suggests that the duration of prone position after surgery can be reduced.