Uveitis-glaucoma-hyphema（UGH）症候群に対して糸張り法を施行した1例

A case of uveitis-glaucoma-hyphema（UGH）syndrome managed with the rectangular loop suture technique

要約　目的：Uveitis-glaucoma-hyphema（UGH）症候群は，眼内レンズ（IOL）と虹彩の機械的接触によって遷延性ぶどう膜炎，続発緑内障，前房および硝子体出血を生じる疾患である。UGH症候群に糸張り法を施行し，良好な経過を得た1例を経験したので報告する。

症例：73歳，男性。白内障手術（IOL囊内固定）の8年後に硝子体出血を生じたが自然軽快した。12年後にIOL脱臼に対しIOL強膜内固定が施行されたのち，眼圧上昇と硝子体出血を繰り返すようになり，聖隷浜松病院眼科を受診した。

所見：右眼の前房・硝子体出血と，両眼の逆瞳孔ブロックによる深い前房，IOL虹彩捕捉，隅角色素沈着を認めた。右眼に糸張り法を施行したところ再出血は軽快し，眼圧も落ち着いた。

結論：糸張り法は低侵襲でIOLと虹彩の接触を抑制でき，UGH症候群の有効な治療法の1つと考えた。

Abstract　Background：Uveitis-glaucoma-hyphema（UGH）syndrome is a relatively rare condition caused by mechanical contact between the iris and intraocular lens（IOL）. It typically develops uveitis, secondary glaucoma, hyphema, and vitreous hemorrhage. A patient with UGH syndrome underwent rectangular loop suture technique with an uneventful postoperative course.

Case：A 73-years-old man underwent IOL implantation in the capsular bag in both eyes. Eight years later, he developed vitreous hemorrhage in the right eye, which resolved spontaneously. Twelve years later, he experienced IOL dislocation in the right eye and underwent intrascleral IOL fixation. Following the surgery, he developed recurrent vitreous hemorrhage and elevated intraocular pressure, prompting him to seek care at our facility.

Findings：In addition to hyphema and vitreous hemorrhage, the right eye exhibited reverse pupillary block, iris capture, and hyperpigmentation of the trabecular meshwork. After the rectangular loop suture technique, the recurrent bleeding improved, and intraocular pressure stabilized.

Conclusion：Rectangular loop suture technique is considered to be a minimally invasive approach that can suppress contact between IOL and the iris, making it an effective treatment option for UGH syndrome.