輪状締結術と毛様体冷凍凝固術が奏効した外傷性低眼圧黄斑症の1例

A case of traumatic hypotony maculopathy treated by scleral encircling and cyclocryocoagulation

要約　目的：輪状締結術と毛様体冷凍凝固術で回復した外傷性低眼圧黄斑症の症例の報告。症例：30歳男性が水球の試合中に相手の指が右眼に当たった。直後からの眼痛と霧視で受診した。所見：矯正視力は右0.06，左1.0，眼圧は右6mmHg，左16mmHgであった。右眼に前房出血と網膜振盪症があった。ステロイドの点眼と内服後も低眼圧が持続し，受傷52日後に毛様体を冷凍凝固し，シリコーンスポンジを強膜に縫着した。その6日後に視力は0.9になり，毛様体解離が改善し，9か月後の現在1.5の視力と眼圧16mmHgを維持している。結論：黄斑症を伴う外傷性低眼圧に対し，毛様体冷凍凝固と輪状締結術が有効であった。

Abstract.　Purpose：To report a case of traumatic ocular hypotony with maculopathy treated by scleral encircling and cyclocryocoagulation. Case：A 30-year-old male was hit by a finger on his right eye while playing water polo. He sought advice for ocular pain and blurring. Findings：Corrected visual acuity was 0.06 right and 1.0 left. Intraocular pressure（IOP）was 6 mmHg right and 16 mmHg left. The right eye showed hyphema and concussion retinopathy. Ocular hypotony persisted after systemic and topical treatment with corticosteroid. The right eye received cryocoagulation of ciliary body and scleral encircling with a silicone sponge 52 days after the accident. Visual acuity improved to 0.9 six days later followed by disappearance of cyclodialysis. The visual acuity is 1.5 with IOP of 16 mmHg 9 months after the accident. Conclusion：Scleral encircling with cyclocryocoagulation was effective for posttraumatic hypotony with maculopathy.