緑内障手術を施行した甲状腺眼症

Glaucoma surgery in cases with thyroid-associated ophthalmopathy

要約　目的：緑内障手術を行った甲状腺眼症の症例の報告。対象と方法：甲状腺機能亢進症があり，緑内障手術を必要とした21例27眼を対象とした。男性11眼，女性16眼で，年齢は21～72歳（平均44歳）である。結果：原発開放隅角緑内障が8眼，正常眼圧緑内障5眼，原発閉塞隅角緑内障が6眼，続発緑内障が8眼にあった。眼球突出度は平均17.6±3.6mmであり，眼症状は眼瞼後退，眼球突出，眼瞼腫脹の順に多かった。手術の術式は，非穿孔性線維柱帯切除術17眼，線維柱帯切除術8眼，線維柱帯切開術2眼であった。結論：緑内障手術を要した甲状腺眼症では，正常眼圧緑内障を含む原発開放隅角緑内障が多かった。

Abstract.　Purpose：To report glaucoma surgery in cases of thyroid-associated ophthalmopathy. Cases and Method：This retrospective study was made on 27 eyes of 21 patients who had thyroid-associated ophthalmopathy and who received glaucoma surgery. There were 11 male and 16 female eyes. The age ranged from 21 to 72 years,average 44 years. Findings：The series comprised primary open-angle glaucoma 8 eyes,normal-tension glaucoma 5 eyes,primary angle-closure glaucoma 6 eyes,and secondary glaucoma 8 eyes. Proptosis averaged 17.6±3.6 mm. Eye symptoms comprised lid retraction,exophthalmos,and eyelid swelling in the descending order. Nonpenetrating trabeculectomy was performed on 17 eyes,trabeculectomy on 8 eyes,and trabeculotomy on 2 eyes. Conclusion：Primary open-angle glaucoma,including normal-tension glaucoma,was the most frequent among thyroid-associated ophthalmopathy that needed glaucoma surgery.