硝子体非切除黄斑上膜剥離術の長期予後

Long-term outcome of nonvitrectomizing vitreous surgery for epimacular membranes

　硝子体を切除せずに膜剥離術を行った特発性黄斑上膜34例34眼の長期経過を検索した。年齢は50歳から75歳1平均63歳であった。術後観察期間は1年以上とした。術前と比較して，術後1年と2年で核白内障進行による近視化があった。対側眼との比較で、高度に近視化した1眼の影響で術1年後に屈折度に有意差があったが，術2年後には術眼と対側眼に有意な屈折度の差はなかった（p＝0.26）。黄斑上膜の再発が13眼（38％）にあり，硝子体切除を併用する膜剥離術で筆者らが報告した19％よりも有意に高率であった（p＝0.03）。以上，硝子体を切除しない膜剥離術では近視化が生じるが，その程度は小さいと結論される。

We reviewed 34 eyes of 34 patients of idiopathic epimacular membrane treated by membrane peeling with-out vitrectomy. Their ages ranged from 50 to 75 years, average 63 years. They were followed up for one year or longer. A shift towards myopia was present one and two years after surgery associated with progression of nuclear sclerosis. When compared with the non-operated fellow eyes, the myopic shift one year after surgery was greater in operated eyes probably due to one eye that a highly myopic change (p=0.03). There was no difference in refraction be-tween the operated and fellow eyes two years after surgery (p=0.26). The epimacular membrane recurred in 13 eyes (38%). This incidence was significantly higher than 19% in our previous series treated by membrane peeling with vitrectomy (p=0.03). Above findings show that myopic shift in a limited amount occurs following nonvitrectomized membrane peeling.