臨床眼科76巻11号

2022年10月発行

増刊号 最新臨床研究から探る眼科臨床のギモンQ＆A 5　網膜硝子体

難治性黄斑円孔に対する手術法は何が適切ですか？

著者： 塩出雄亮¹ 森實祐基¹

所属機関： ¹岡山大学大学院医歯薬学総合研究科眼科学

ページ範囲：P.229 - P.233

「難治性黄斑円孔」は，標準的な手術法（硝子体切除＋ILM剝離＋ガスタンポナーデ）では円孔の閉鎖を得ることが難しい黄斑円孔の総称です．近年報告されたメタアナリシスの結果からは，円孔径の大きな黄斑円孔（円孔径＞400μm）や高度近視に伴う黄斑円孔では，内境界膜を剝離するよりも翻転したほうが円孔の閉鎖率が高いといえます．

参考文献

1）Marques RE et al：Complete ILM peeling versus inverted flap technique for macular hole surgery：a meta-analysis. Ophthalmic Surg Lasers Imaging Retina 51：187-A2, 2020

2）Lois N et al；Full-thickness Macular Hole and Internal Limiting Membrane Peeling Study（FILMS）Group：Internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole：a pragmatic randomized controlled trial. Invest Ophthalmol Vis Sci 52：1586-1592, 2011

3）Spiteri Cornish K et al：Vitrectomy with internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole. Ophthalmology 121：649-655, 2014

4）Michalewska Z et al：Inverted internal limiting membrane flap technique for large macular holes. Ophthalmology. 117：2018-2025, 2010

5）Chou HD et al：Nasal or temporal internal limiting membrane flap assisted by sub-perfluorocarbon viscoelastic injection for macular hole repair. Am J Ophthalmol 223：296-305, 2021

6）Tabandeh H et al：Superior wide-base internal limiting membrane flap transposition for macular holes：flap status and outcomes. Ophthalmol Retina 5：317-323, 2021

7）Hirano M et al：Case report：successful closure of a large macular hole secondary to uveitis using the inverted internal limiting membrane flap technique. BMC Ophthalmol 15：83, 2015

8）Shiode Y et al：The role of inverted internal limiting membrane flap in macular hole closure. Invest Ophthalmol Vis Sci 58：4847-4855, 2017

9）Matsumae H et al：Inverted internal limiting membrane flap versus internal limiting membrane peeling for macular hole retinal detachment in high myopia. Ophthalmol Retina 4：919-926, 2020

10）Miller JB et al：Long-term follow-up and outcomes in traumatic macular holes. Am J Ophthalmol 160：1255-1258.e1, 2015

11）Ghoraba HH et al：Comparative study between pars plana vitrectomy with internal limiting membrane peel and pars plana vitrectomy with internal limiting membrane flap technique for management of traumatic full thickness macular holes. J Ophthalmol 2019：1959082, 2019

12）Abou Shousha MA：Inverted internal limiting membrane flap for large traumatic macular holes. Medicine（Baltimore） 95：e2523, 2016

13）Yun C et al：Morphologic characteristics of chronic macular hole on optical coherence tomography. Retina 32：2077-84, 2012

14）Morizane Y et al：Autologous transplantation of the internal limiting membrane for refractory macular holes. Am J Ophthalmol 157：861-869.e1, 2014

15）Peng J et al：Long-term surgical outcomes of lens capsular flap transplantation in the management of refractory macular hole. Retina 41：726-734, 2021

16）Caporossi T et al：Human amniotic membrane to treat macular holes that failed to close, sulfur hexafluoride endotamponade versus air endotamponade：a prospective comparative study. Retina 41：735-743, 2021

17）Grewal DS et al：Autologous retinal transplant for refractory macular holes：Multicenter International Collaborative Study Group. Ophthalmology 126：1399-1408, 2019