瘢痕期未熟児網膜症，第1次硝子体過形成遺残に続発閉塞隅角緑内障をきたした2例

Acute angle-closure glaucoma in a case each of cicatricial retinopathy of prematurity and persistent hyperplastic primary vitreous

要約　目的：瘢痕期未熟児網膜症および第一次硝子体過形成遺残において続発閉塞隅角緑内障を発症し，水晶体摘出により眼圧が下降した2例を検討する。症例：症例1は第一次硝子体過形成遺残の28歳女性。水晶体の前方偏位，Shaffer 0°の閉塞隅角を認め，続発閉塞隅角緑内障を発症し，右眼眼圧が48mmHgと上昇した。症例2は瘢痕期未熟児網膜症の20歳男性。14歳時に続発閉塞隅角緑内障を発症し，周辺虹彩切除術を施行されたが，20歳時に水晶体が前方偏位し，水晶体後部線維増殖を認め，眼圧が34mmHgと上昇した。2例とも水晶体の摘出により前房深度の増加と隅角の開大を認め，眼圧下降が得られた。結論：水晶体後部線維増殖を伴う眼圧上昇では，レーザー虹彩切開術や周辺虹彩切除術によっても瞳孔ブロックの解除が奏効しない可能性があるため，水晶体摘出を考慮すべきである。

Abstract.　Purpose：To report acute angle-closure glaucoma in an eye with cicatricial retinopathy of prematurity and in another with persistent hyperplastic primary vitreous（PHPV）. Cases：One was a 28-year-old female with PHPV in both eyes. Her right eye developed acute angle-closure glaucoma with intraocular pressure（IOP）of 48 mmHg. The chamber angle was closed in all the circumference. Lens extraction resulted in increased anterior chamber depth with decreased IOP. The other case was a 20-year-old male with cicatricial retinopathy of prematurity. He had received peripheral iridectomy in the right eye due to elevated IOP at the age of 14. IOP in the right eye rose to 34 mmHg after anterior dislocation of the lens. Lens extraction induced increased anterior chamber depth with decreased IOP. Conclusion：These cases illustrate that lens extraction may be effective for pupillary block after laser iridotomy or peripheral iridectomy has failed.