重度Zinn小帯脆弱白内障に対して強膜固定型カプセルエキスパンダーを使用した2例

The use of modified capsule expander to reposition and fixate capsular bag to the scleral wall in two eyes with severe weak zonule

要約　目的：重度Zinn小帯脆弱白内障に対し，強膜固定型カプセルエキスパンダー（M-CE）を使用した2例の報告。症例：症例1は85歳男性。偽落屑症候群，水晶体動揺を伴う左眼白内障に対し超音波水晶体乳化吸引術（PEA）を行い眼内レンズ（IOL）を囊内固定後，水晶体囊をM-CEにて毛様溝経由で3か所縫着固定した。症例2は70歳女性。180°Zinn小帯断裂を伴う左眼白内障に対しPEAを行い，2か所M-CEを固定し，IOLを囊内固定した。結果：重篤な合併症なくIOL・水晶体囊の良好な固定を得た。結論：M-CE使用により支えを失った水晶体囊を強膜に固定し，IOLを囊内固定することが可能であった。

Abstract.　Purpose：To evaluate the use of the modified capsule expander（M-CE）to reposition and fixate capsular bag to the scleral wall in eyes with severe weak zonule. Cases and methods：Case 1；A 85 year old man was diagnosed cataract with pseudoexfoliation syndrome and phacodonesis in his left eye. Phacoemulsification-aspiration and in-the-bag implantation of intraocular lens（IOL）was performed,followed by suturing the capsular bag to the scleral wall via ciliary sulcus using M-CE at 3 points. Case 2；70 year old woman was diagnosed cataract with 180-degree of zonular dialysis in her left eye. After phacoemulsification-aspiration was performed,M-CE was used to suture the capsular bag to the scleral wall at 2 points,and then,IOL was implanted in the capsular bag. Results：In both cases,the capsular bag and IOL were well centered without severe intraoperative and postoperative complications. Conclusion：M-CE was useful in fixating the capsular bag to the scleral wall in eyes with severe weak zonule.