滲出型加齢黄斑変性への光線力学療法に対する同時期白内障手術の影響

Influence of cataract surgery prior to photodynamic therapy on age-related macular degeneration

要約　目的：加齢黄斑変性に対する光線力学療法の直前に行った白内障手術が治療経過に及ぼす影響の報告。対象と方法：白内障手術をまず行い，14日以内に滲出型加齢黄斑変性に対し，トリアムシノロン併用で光線力学療法を施行した16例19眼を対象とした。男性13眼，女性6眼で，年齢は63～87歳（平均75歳）である。小数視力は平均0.073であり，手術6か月後の視力をlogMARで評価し，0.3以上の変化を改善または悪化とした。結果：治療回数は，平均1.1回であり，視力は1眼（5％）で改善，16眼（84％）で不変，2眼（11％）で悪化した。手術3か月後の黄斑の平均体積は有意に減少した。重篤な合併症はなかった。結論：光線力学療法と同時期に白内障手術を行っても，6か月後の視力と黄斑体積に悪影響はない。

Abstract.　Purpose：To report influence of cataract surgery on visual outcome performed before photodynamic therapy for age-related macular degeneration（AMD）. Cases and Method：This retrospective study was made on 19 eyes of 16 cases who received cataract surgery followed by triamcinolone-assisted photodynamic therapy for AMD within 14 days. The series comprised 13 males and 6 females. The age ranged from 63 to 87 years,average 75 years. Their visual acuity averaged 0.073. Visual acuity 6 months after treatment was evaluated in terms of logMAR. Change by 0.3 or over was defined as improvement or deterioration. Results：Treatment was performed on average of 1.1 sessions. Visual acuity improved in 1 eye（5％）,remained unchanged in 16（84％）,and deteriorated in 2（11％）. The macular volume decreased significantly after 3 months of treatment. There were no serious complications throughout. Conclusion：Cataract surgery prior to photodynamic therapy showed no impact on visual acuity of macular volume up to 6 months after treatment.