粘液分泌性の虹彩囊腫による続発緑内障の1例

A case of secondary glaucoma due to mucous-secreting iris cyst

要約　目的：虹彩囊腫からの粘液分泌により続発緑内障が生じた症例の報告。症例と経過：14歳女児が2か月前からの右眼霧視で受診した。右眼の矯正視力は1.2，眼圧は14mmHgであったが，前房に結晶性物質を含む粘液と，虹彩前の上鼻側に破裂した虹彩囊腫があった。3か月後に眼圧が上昇し，囊腫前壁を切除した。2年後に眼圧が再上昇し，囊腫前壁を追加切除した。さらに3年後に眼圧が上昇し，囊腫を含めた虹彩全幅切除を行った。その14か月後に眼圧上昇があり，硝子体カッターで残存囊腫を切除した。以後17か月後の現在まで眼圧は安定し，視力1.2を維持している。結論：数回にわたる眼圧上昇は，虹彩囊腫からの粘液分泌によるものと解釈され，本症例では，囊腫の全切除が有効であった。

Abstract.　Purpose：To report a case of iris cyst with repeated rise in intraocular pressure（IOP）presumably due to secretion of mucous from the cyst wall. Case and Findings：A 14-year-old girl presented with blurring of right eye since 2 months before. The right eye showed visual acuity of 1.2 with IOP of 14mmHg. The anterior chamber contained mucous material with crystalline floaters. A ruptured cyst was present in upper-nasal quadrant of the iris. The anterior cyst wall was resected due to raised IOP 3 months later. A similar surgery was repeatedd 2 years later after increased IOP. Total iridectomy including the cyst was performed another 3 years later to control the IOP. The residual cyst was performed using a vitreous cutter 14 months later after another episode of increased IOP. She has been doing well for 17 months until present. Conclusion：Repeated IOP rise in this patient appears to be due to secretion of mucous from the iris cyst. Total resection of the cyst was effective to ensure lasting IOP control.