難治性緑内障に対する濾過手術にEx-PRESSTMを用いた1例

Filtration surgery with implantation of Ex-PRESSTM device in a case of refractory glaucoma

要約　背景：Ex-PRESS^TMはステンレススチール製の緑内障用のインプラントで，強膜弁下に留置され，術中と術後の合併症が少ないとされている。目的：複数回の手術の既往がある緑内障眼にEx-PRESS^TMを用いる濾過手術を行った報告。症例：66歳男性の両眼に原発開放隅角緑内障があり，右眼に3回，左眼に2回の線維柱帯切除術と，右眼に2回の硝子体手術などが過去7年間に行われた。眼圧コントロールがなお不良であり，Ex-PRESS^TMによる濾過手術を両眼に行った。結果：術中・術後の合併症はなく，手術7か月後の現在，両眼の眼圧は点眼下で15mmHg前後に維持されている。結論：難治性緑内障に対するEx-PRESS^TMによる濾過手術は，安全で有効であった。

Abstract.　Background：Ex-PRESS^TM is a miniature stainless device to be implanted for glaucoma. It is claimed to have lesser complications before and after surgery. Purpose：To report the outcome of implantation of Ex-PRESS^TM in a case with a history of multiple glaucoma surgeries in the past. Case：A 66-year-old man had received 3 filtration surgeries in the right eye and 2 in the left for primary open-angle glaucoma in the past 7 years. The right eye had also received two vitreous surgeries. Both eyes had still elevated intraocular pressure（IOP）and received implantation of Ex-PRESS^TM. Results：Both eyes were free of intra-or postoperative complications. IOP was controlled around 15 mmHg with topical medication 7 months after surgery. Conclusion：Use of Ex-PRESS^TM was safe and effective for refractory glaucoma.