獨協医大式滑車型マイボーム腺鑷子が有効であった涙小管炎の1例

A case of lacrimal canaliculitis treated by meibomian gland forceps

要約　目的：涙小管炎に対し滑車型マイボーム腺鑷子を使って菌石の排出に成功した症例の報告。症例：80歳女性が7か月前からの右眼の目頭の疼痛と腫脹で受診した。同様の病変は3年前から悪化と寛解を繰り返していた。所見：右眼の涙点下に腫脹と硬結があり，その他に異常所見はなかった。CTで硬結部に15mm×10mm大の低信号の結節性病変があった。涙小管炎と診断した。獨協医大式滑車型マイボーム腺鑷子で多数の菌石が容易に排出された。菌石の嫌気培養で，Actinomyces israeliiとPeptostreptococcusが検出された。病状は軽快し，以後1年後の現在まで再発はない。結論：陳旧化した涙小管炎の涙小管内に多数の菌石が存在し，鑷子による菌石の除去で治癒が得られた。

Abstract.　Purpose：To report a case of protracted lacrimal canaliculitis. Cure was obtained by removal of tear stones by a pair of forceps designed for meibomian gland. Case：An 80-year-old female presented with painful swelling in the inner canthus of her right eye since 7 months before. She had has similar episodes in the past 3 years. Findings：Indurated swelling was present below the lower punctum of the right eye. No other anomaly was present. Computed tomography（CT）showed a low-signal nodule at the site of swelling. Its size was 15 mm×10 mm. The condition was diagnosed with lacrimal canaliculitis. Numerous tear stones were removed using meibomian gland forceps. Anaerobic culture of the stones showed Actinomyces israelii and Peptostreptococcus. There has been no recurrence for one year until present. Conclusion：Chronic lacrimal canaliculitis was cured by removal of tear stones by forceps.