角膜潰瘍および角膜穿孔病態の臨床的検討

Clinical features of corneal ulcer and corneal perforation

要約　目的：角膜潰瘍と角膜穿孔の自験例についての，病態と社会的背景の報告。対象と方法：2011年5月までの5年間に受診した角膜潰瘍と角膜穿孔の131例135眼を診療録の記録に基づいて検索した。結果：角膜感染は95眼（男性35眼，女性60眼）であった。60歳代が最も多かった。非感染性潰瘍は18眼（男性8眼，女性10眼）で，9眼（50％）に自己免疫疾患があり，うち7眼では関節リウマチが関係していた。外傷性穿孔が15眼（男性13眼，女性2眼）にあった。治療前と治療後の視力には正の相関があった。外傷性角膜穿孔では農作業中の頻度が多かった。結論：角膜感染では重症化する前の治療開始が望ましい。角膜潰瘍と角膜穿孔では，診療と予防に関し，地域性と医療環境に留意する必要がある。

Abstract.　Purpose：To present a review on clinical features and social background of corneal ulcer and corneal perforation. Cases and Method：This retrospective study was made on 135 eyes of 131 patients of corneal ulcer and perforation seen by us in the past 5 years. Results：There were 95 eyes of corneal infection,involving 35 male and 60 female eyes. Persons in the seventh decade were more frequently affected. There were 18 eyes of noninfectious corneal ulcer involving 8 males and 10 females. Out of the 18 eyes,9 eyes（50％）were related with autoimmune diseases including 7 eyes of rheumatic arthritis. There were 15 eyes with traumatic corneal perforation,involving 13 males and 2 females. Final visual acuity was positively correlated with visual acuity before treatment. Traumatic corneal perforation was prone to occur during farm activities. Conclusion：Early treatment is imperative in corneal infections. Regional and social background must be considered in treating corneal ulcer or perforation.