白内障術後に生じた穿孔性強膜軟化症に対する治療経験

Therapeutic outcome in a case of scleromalacia perforans after cataract surgery

要約　目的：白内障術後に発症した穿孔性強膜軟化症に対し強膜移植術が奏効した1例の報告。症例：78歳男性が2か月前からの頭痛と左眼の眼痛で受診した。4か月前に両眼の白内障手術を受け，2か月前から抗菌薬とステロイド点眼などを受けていた。所見と経過：矯正視力は右1.2，左0.5で，左眼上方の球結膜に充血と強膜の菲薄化があった。強膜菲薄化部に穿孔があり，保存強膜を移植した。症状は直ちに改善し，4か月後の左眼視力は0.8に改善した。結論：保存強膜の移植が白内障術後に発症した穿孔性強膜軟化症に奏効した。

Abstract.　Purpose：To report the therapeutic outcome in a case of scleromalacia perforans after cataract surgery. Case：A 78-year-old male presented with headache and pain in the left eye since 2 months before. He had received cataract surgery in both eyes 4 months before. He had been treated by topical and systemic antibiotics and topical corticosteroid for the last 2 months. Findings and Clinical Course：Corrected visual acuity was 1.2 right and 0.5 left. The left eye showed hyperemia and scleral thinning in the upper sector. Surgical exploration showed scleral perforation. The area was treated by transplantation of preserved sclera. Subjective symptoms started to improve the following day. Visual acuity improved to 0.8 four months later. Conclusion：Implantation of preserved scleral was effective for scleromalacia perforans after surgery.