積極的治療を施行した毛様体膜形成を伴う小児片眼性ぶどう膜炎の1例

Outcome of energetic treatments in a case of chronic iridocyclitis in young girls

要約　目的：“chronic iridocyclitis in young girls”の1例に対して，種々の積極的治療を行った結果の報告。症例：6歳女児。右眼に帯状角膜変性，虹彩後癒着を伴う前房炎症，併発白内障を認め，治療的レーザー角膜切除術，水晶体再建術を施行した。術中に毛様体膜を確認した。術後低眼圧と眼内炎症が持続するため硝子体手術＋眼内レンズ摘出術を施行したが，毛様体膜は切除不能のため切開を入れて終了した。術後眼圧上昇および後極部に増殖膜を生じたため，硝子体手術＋線維柱帯切開術とともにシクロスポリン内服を行った。その後は眼圧が下降し，眼内炎症も軽減した。結論：“chronic iridocyclitis in young girls”における眼内炎症の消炎には硝子体手術とシクロスポリン投与が有効であった。

Abstract.　Purpose：To report a case of“chronic iridocyclitis in young girls”treated by various therapeutic modalities. Case：A 6-year-old girl presented with band keratopathy,anterior uveitis with posterior synechia,and complicated cataract in her right eye. She received therapeutic laser keratectomy and phacoemulsification-aspiration followed by intraocular lens（IOL）implantation. Cyclitic membrane was detected during surgery. Vitrectomy with extraction of IOL was performed for postoperative ocular hypotony and persistent intraocular inflammation. She received another vitrectomy,trabeculectomy and peroral cyclosporine for raised intraocular pressure（IOP）and proliferative membrane in the posterior fundus. These procedures were followed by regression of intraocular inflammation and control of IOP. Conclusions：Vitrectomy with peroral cyclosporine was effective in a case of“chronic iridocyclitis in young girls”.