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要約 目的:白内障術中にinfusion misdirection syndromeを呈し,解除に25ゲージ硝子体切除術が有効であった症例の報告。症例:62歳男性の右眼に白内障手術を施行した。短眼軸長(右眼20.83mm)で,右鼻骨骨折の既往がある。超音波乳化吸引後に眼圧が上昇,前房が消失し,手術続行は困難になった。術中の眼底検査で脈絡膜に異常がなかったためinfusion misdirection syndromeと判断し,25ゲージ硝子体切除術を施行した。これにより前房が形成され,白内障手術を完遂することができた。術後視力は良好である。結論:Infusion misdirection syndromeによって白内障手術が継続できなくなることがある。眼底所見を確認し,脈絡膜出血などを否定したうえで低侵襲に硝子体切除をすることが治療の1つの選択肢となると考えられた。
Abstract. Purpose:To report a case of infusion misdirection syndrome during cataract surgery with fair outcome following 25-gauge vitrectomy. Case:A 62-year-old male received cataract surgery in his right eye. The right eye had short axial length of 20.83 mm. He had fractured right nasal bone following trauma at the age of 12 years. Findings:After completion of phacoemulsification-aspiration,the anterior chamber was lost with elevated intraocular pressure. Infusion misdirection syndrome was suspected after funduscopy showed no choroidal detachment. The right eye was treated by 25-gauge vitrectomy to avoid ocular hypertension. Surgery was completed with normal anterior chamber. Conclusion:This case illustrates that cataract surgery may be completed without interruption after onset of infusion misdirection syndrome by performing minimally-invasive measures including 25-gauge vitrectomy.
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