角膜染血を伴う硝子体出血に広角観察システム併用25G手術が奏効した1例

A case of vitreous hemorrhage with blood staining of the cornea treated by 25-gauge vitrectomy with wide-angle viewing system

要約　目的：白内障手術合併症による硝子体出血と角膜染血の症例に対し，広角観察システム併用25G小切開硝子体手術（MIVS）を行った1例を報告する。症例：81歳，女性。抗血栓薬を3剤内服下に近医で白内障手術を施行中，虹彩毛様体出血と急激な眼圧上昇を呈し，駆出性出血が疑われたため閉創した。40日後に，当院を紹介受診した。初診時に，左眼は光覚弁で強い角膜血染混濁と硝子体出血を認めた。通常のフローティングレンズでは手術遂行が困難であったが，広角観察システムを用いることにより術野が確保され手術に成功し，0.1の視力を得た。結論：強い角膜染血など前眼部状態が不良な症例に，広角観察システム併用25GMIVSは有用であった。

Abstract.　Purpose：To report a case of vitreous hemorrhage with blood staining of the cornea treated by 25-gauge vitrectomy with wide-angle viewing system. Case：An 81-year-old woman received cataract surgery in the left eye. She had had cardiac infarction 3 years before and been receiving three antithrombogenic drugs. During surgery, she developed hemorrhage in the anterior chamber with acutely elevated intraocular pressure suggestive of expulsive hemorrhage. Surgery was interrupted and the corneal wound was closed. She was referred to us 40 days later. Findings：The left eye showed vitreous hemorrhage and dense blood staining of the cornea. The affected eye was treated by 25-gauge microincision vitrectomy with wide-viewing system. The left eye healed with final visual acuity of 0.1. Conclusion：Vitrectomy with wide-viewing system was effective for vitreous hemorrhage with blood staining of the cornea.