水晶体囊外摘出術の20年後に水晶体起因性緑内障を生じた1例

A case of lens-induced glaucoma twenty years after extracapsular cataract surgery

　79歳女性が5日前からの左眼視力低下と眼痛で受診した。幼時から強度近視があり，20年前に左眼に水晶体囊外摘出術を受けていた。受診2か月前の診察では，左眼は無水晶体眼であり，矯正視力は0.2，眼圧は正常であった。今回受診時の左眼視力は0.01で，眼圧は43mmHgであった。広隅角であり，後囊と前部硝子体膜の間に白色物質が大量に貯留していた。水晶体起因性開放隅角緑内障と診断し，後発白内障切除と前部硝子体切除術を行った。眼圧は翌日に正常化し，以後2年間は安定した状態にある。白内障手術から長期経たあとに生じた水晶体起因性緑内障発作に対し，後発白内障切除と前部硝子体切除が奏効した1例である。

　A 79-year-old woman presented with headache,blurred vision and pain in her left eye. She had had high myopia since childhood. She had received extracapsular lens extraction in her left eye 20 years before. When seen 2months before,her left eye was aphakic with visual acuity of 0.2 and normal intraocular pressure（IOP）. She had now visual acuity of 0.01 left with IOP of 43mmHg. The chamber angle was wide open. There was a massive accumulation of white material between the posterior capsule and anterior vitreous membrane. She was diagnosed with lens-induced open-angle glaucoma. Resection of aftercataract and anterior vitrectomy induced normalized IOP the following day. She has been doing well for 2 years thereafter. This case illustrates that resection of aftercataract and anterior vitrectomy may be effective for late-onset acute lens-induced glaucoma.