ガラスか木片で経過が異なった幼児の眼窩内異物の2例

Different outcome in two infants with intraorbitally retained piece of glass and wood respectively

要約　目的：迷入した眼窩異物がガラスか木片で術後経過が異なった幼児の2症例の報告。症例と所見：症例1は2歳11か月の女児で18か月前に左下眼瞼に外傷の既往がある。CT検査で左眼窩内に高吸収の異物が認められたために，眼窩手術を行ってガラス片を摘出した。術後には眼合併症はなかった。症例2は2歳1か月男児で1か月前に草地で転倒し，以後左下眼瞼に膿瘍を伴った肉芽形成と左眼の内方偏移を認めた。MRIで左外直筋付近に異物が確認され，眼窩手術により多数の植物性異物を摘出した。左外転障害に対して2回の斜視手術を行って眼球運動は改善した。結論：眼窩内への異物の迷入が疑われる幼児の眼部外傷例に対しては，画像診断による異物の確認が必要である。

Abstract.　Purpose：To report the two cases of intraorbital foreign bodies which were either glass or wood in infants, showing different outcomes. Cases and Findings：Case 1 was a 2-year and 11 month-old girl who suffered a injury to left lower eyelid 18 months ago. Computerized tomography（CT）showed a high density object in her left orbit, suggesting a glass foreign body. After surgical removal of the foreign body, no ophthalmic complication was observed. Case 2 was a 2-year and 1month year-old boy who had fallen down in the bush 1 month ago and subsequently a granulomatous wound with a purulent discharge in his left lower eyelid and an esodeviation of the left eye were observed. Magnetic resonance imaging（MRI）revealed foreign bodies overlying his left lateral rectal muscle and a number of vegetable foreign bodies were extracted. For the correction of motility disorder of the lateral rectal muscle, surgery of esodeviation was undertaken twice. Conclusion：Ophthalmologists should examine by radiological examination including plain X-ray, CT and MRI in the case of intraorbital foreign bodies in infants.