急性原発閉塞隅角症の初期治療としての角膜圧迫法の有用性の検討

Value of corneal indentation as the primary treatment for acute primary angle-closure

要約　目的：急性原発隅角閉塞症への初期治療としての角膜圧迫法の評価。対象と方法：過去8か月間の急性原発隅角閉塞症5例5眼を対象とした。男性1例，女性4例で，年齢は63～80歳（平均74歳）である。眼圧は38～70mmHg（平均55mmHg）であった。ピロカルピンとキシロカインを点眼し，角膜周辺部と瞳孔付近を1秒間隔で約20回圧迫し，これを8方向に行った。結果：24時間以内に加療した3眼では隅角閉塞が解除され，眼圧が下降した。48時間以後に加療した2症例では解除されず，外科的治療を必要とした。結論：急性原発隅角閉塞症への角膜圧迫法は簡便かつ低侵襲であり，早期例での初期治療として有用である。

Abstract.　Purpose：To report the outcome of corneal indentation as the primary treatment for acute primary angle closure. Cases and Method：This study was made on 5 eyes of 5 patients treated by us in the past 8 months. The series comprised one male and 4 females. The age ranged from 63 to 80 years,average 74 years. Intraocular pressure（IOL）ranged from 38 to 70 mmHg,average 55 mmHg. The affected eyes were treated,after instillation of pilocarpine and xylocaine,by compressing the limbus and central cornea alternately for one second. This procedure was repeated about 20 times and was applied to each of 8 sectors of the cornea. Results：Angle closure was relieved and IOP normalized in 3 eyes that were treated within 24 hours of onset. The other 2 eyes needed surgical treatment. Conclusion：Corneal indentation was useful for acute primary angle closure when applied within 24 hours after onset.