Faden手術を併用した甲状腺眼症による上斜視の1例

Faden procedure for hypertropia in a case of thyroid ophthalmopathy

要約　目的：甲状腺眼症で発症した片眼の上転障害と強い上斜視に対してFaden手術を行った報告。症例：68歳女性が眼位異常で受診した。Basedow病の既往があり，33年前に上下斜視に対し左眼に手術を受けた。所見と経過：左眼に55Δの上斜視があり，右眼の下直筋を5mm後転した。左眼に30Δの上斜視が残存し，18か月後にFaden手術を併用して左眼の上直筋を5mm後転した。術後1年目では左眼に20Δの上斜視があり，改善と判断した。結論：Faden手術は非共同性斜視に用いられるが，本症例では左眼の上斜視が顕著であり，左眼上直筋の後転術にFaden手術を併用し，効果があった。

Abstract.　Purpose：To report a case of thyroid ophthalmopathy with unilateral hypertropia treated by Faden procedure as adjunct to conventional surgery. Case：A 68-year-old female presented with abnormal eye position. She had a history of Graves disease. She had received surgery for vertical strabismus in the left eye 33 years before. Finding：The left eye had hypertropia by 55Δ. The right eye received recession of inferior rectus muscle by 5 mm. She received another recession of superior rectus in the left eye for residual hypertropia by 30Δ 18 months later. Her vertical strabismus improved by hypertropia of left eye by only 20Δ one year later. Conclusion：Vertical strabismus in the present case improved by Faden procedure as adjunct to conventional surgery.