白内障手術後に生じた術後壊死性強膜炎の2例

Two cases of surgically induced necrotizing scleritis after cataract surgery

要約　目的：白内障手術後に生じた術後壊死性強膜炎（surgically induced necrotizing scleritis：SINS）の2例の報告。症例と経過：2例とも男性で，それぞれ70歳と71歳であった。小切開による水晶体乳化吸引術と眼内レンズ挿入術を片眼に受けた。強膜創を中心に壊死性強膜炎がそれぞれ2か月と3か月後に発症し，術後壊死性強膜炎と診断した。1例ではプレドニゾロン内服で20か月後に治癒した。他の1例では強膜が穿孔し，プレドニゾロン内服の後に強膜を移植し，穿孔創が閉鎖した。結論：術後壊死性強膜炎では，早期診断と十分な量の副腎皮質ステロイドの全身投与が必要である。

Abstract.　Purpose：To report 2 cases of surgically induced necrotizing scleritis（SINS）after small-incision cataract surgery. Cases：Both were males aged 70 and 71 years respectively who received phacoemulsification and aspiration with intraocular lens implantation. Necrotizing scleritis developed adjacent to the surgical wound 2 and 3 months later respectively. Both were diagnosed with SINS. Peroral prednisolone was followed by cure after 20 months in one case. Scleral perforation developed in the other case. Perforation healed after peroral prednisolone followed by scleral implantation. Conclusion：SINS can be best treated by early diagnosis and long-term treatment with systemic corticosteroid in sufficient dosis.