羊膜移植を併用したconjunctival intraepithelial neoplasiaの4症例

Four cases of conjunctival intraepithelial neoplasia treated by excision and amniotic membrane transplantation

角膜輪部に接する球結膜に生じたconjunctival intraepithelial neoplasia（CIN）4例4眼を治療した。男性3例，女性1例で，初発が2例，再発が2例であり，年齢は53～72歳，平均64歳であった。病理組織学的検索を全例に行い，CINの診断が確定した。ローズベンガル染色で腫瘍の範囲を同定し，健常結膜を含めて腫瘍を切除し，結膜欠損部に冷凍保存羊膜を縫着した。全例で0.04％マイトマイシンCを術中に塗布し，再発例である2眼では冷凍凝固を併用した。5～38か月，平均20か月の経過観察で再発はなく，結膜の過剰な瘢痕化もなかった。CINの切除と羊膜移植の併用が奏効した症例群である。

We treated 4 eyes of 4 patients of conjunctival intraepithelial neoplasia（CIN）. The tumor developed in the bulbar conjunctiva adjacent to the limbus in all the eyes. The series comprised 3 males and 1 female. Two cases were primary and the other two were recurrent CIN. Their ages ranged from 53 to 72 years,average 64 years. The diagnosis was confirmed by histopathologic studies in all the cases. After demarcation of the lesion by rose bengal,the tumor was resected including the surrounding healthy conjunctiva. The conjunctival defect was covered by freeze-preserved amniotic membrane followed by 0.04％ mitomycin C. The lesion was cryocoagulated in 2 recurrent cases. There was no recurrence or excessive scarring during the follow up for 5 to 38 months,average 20 months. These cases illustrate that CIN may be cured by complete excision with transplantation of amniotic membrane.