高齢者における鈍的眼外傷の検討

Review of blunt ocular trauma in senile persons

要約　目的：高齢者の鈍的外傷による眼障害の報告。対象と方法：過去5年間に経験した鈍的外傷による60歳以上の眼障害28例28眼を検索した。男性13例，女性15例で，男性1例と女性13例の計14例には白内障手術の既往があり，男性12例と女性2例の計14例は有水晶体眼であった。結果：19例（68％）で転倒が受傷の原因であり，うち白内障術後眼が11眼，有水晶体眼が8眼を占めていた。眼球破裂が白内障術後眼では14眼中12眼（86％），有水晶体眼では14眼中4眼（29％）であった。最終視力は，白内障術後眼の9眼と有水晶体眼の3眼で0.1未満であった。眼球破裂の開放創は，白内障術後眼では全例で白内障手術の強角膜創に一致するか，術創が拡大する形をとった。結論：白内障手術の既往がある高齢者では，鈍的外傷で手術創が破裂または開放しやすく，視力予後が不良である。

Abstract.　Purpose：To report ocular injuries due to blunt trauma in persons aged 60 or over. Cases and Method：This retrospective study was made on 28 eyes of 28 patients who were seen by us for ocular injury during the past 5 years. The series comprised 13 males and 15 females. Fourteen patients had had cataract surgery,comprising 1 male and 13 females. The other 14 patients,consisting of 12 males and 2 females,were phakic. Results：Falling down was the most frequent cause of trauma in 19 cases（68％）,comprising 11 cases with past history of cataract surgery and 8 cases with phakic eyes. Eyeglobe rupture occurred in 12 out of 14 eyes（86％）with history of cataract surgery and in 4 out of 14 phakic eyes（29％）. Final visual acuity was lower than 0.1 in 9 eyes with past cataract surgery and in 3 phakic eyes. Site of eyeglobe rupture corresponded with the corneoscleral wound of cataract surgery either as reopening or its enlargement. Conclusion：Senile persons with history of cataract surgery have a high risk of eyeglobe rupture resulting in poor visual outcome.