眼球破裂後眼内レンズが結膜下に脱出した1例

Subconjunctival luxation of intraocular lens following eyeglobe rupture by blunt trauma

　93歳男性が転倒して顔面左側を強打し，眼内レンズが上方の結膜下に脱出した。7年前に左眼の超音波水晶体乳化吸引術と眼内レンズ挿入術，2年前に硝子体手術を受けていた。左眼視力は光覚弁で，眼底は透見できなかった。超音波検査で網膜剝離や脈絡膜出血はなかった。自己閉鎖創より囊内に挿入されていた6.5mmのPMMAワンピースレンズが，虹彩とともに水晶体囊ごと結膜下に脱出していた。受傷から6日後に眼内レンズを除去し，強膜縫合と硝子体腔洗浄を行った。術中所見として，白内障自己閉鎖創の強膜トンネルと硝子体手術時の強膜創が連続して離開していた。

A 93-year-old man was hit on the left side of his face while falling down. He had received phacoemulsification and aspiration with intraocular lens（IOL）implantation in the left eye 7 years before. Vitreous surgery had been performed 2 years before. When seen by us,his left visual acuity was light perception. The fundus could not be examined. Ultrasound examinations showed no retinal detachment or choroidal hemorrhage. The one-piece PMMA IOL was present in the subconjunctival space together with the iris and lens capsule. The IOL was removed 6 days after the injury followed by suture of the scleral opening and irrigation of the vitreous. As an intraoperative finding,the scleral tunnel and the vitrectomy wound formed a common opening.