シリコーンバンドによる輪状締結術が有効であった低眼圧黄斑症の2例

Scleral encircling with silicone band was effective in two cases of hypotensive maculopathy

要約　目的：低眼圧黄斑症にシリコーンバンドによる輪状締結術が奏効した2例の報告。症例：1例目は13歳男児で，野球ボールが右眼に当たり，低眼圧が生じた。右眼圧は2mmHg，矯正視力は0.3であった。2例目は41歳男性で，15年前に野球ボールが右眼に当たって低眼圧になり，1週間前に転倒して右眼を打撲した。右眼圧は5mmHg，矯正視力は0.25であった。両症例に＃240シリコーンバンドを用いた輪状締結術を行った。結果：症例1では眼圧が10mmHgになり，視力は1.0に改善したが，－3.50Dの近視が生じた。症例2では，眼圧が8mmHgになったが，網脈絡膜皺襞が残った。2か月後の白内障手術のときにバンドを調整し，15mmHgの眼圧になった。結論：本術式は毛様体の近くにバックルが設置でき，位置と長さの再調整が可能であり，低眼圧黄斑症の治療での選択肢になる。

Abstract.　Purpose：To report two cases of posttraumatic hypotensive maculopathy treated by scleral encircling. Cases：One was a 13-year-old boy. He was hit by a flying baseball in the right eye one week before, resulting in ocular hypotony. The right eye showed intraocular pressure（IOP）of 2 mmHg with corrected visual acuity of 0.3. The other case was a 41-year-old male. He had been hit by a flying baseball in the right eye 15 years before resulting in asymptomatic ocular hypotony. He fell down one week before followed by right ocular pain. Visual acuity was 0.25 with IOP of 5 mmHg. Both cases received scleral encircling using＃240 silicone band. Results：In Case 1, IOP improved to 10 mmHg with visual acuity of 1.0 corrected by －3.5 diopters. In Case 2, IOP improved to 8 mmHg with residual retinochoroidal folds. He received cataract surgery 2 months later with adjustment of silicone band. IOP improved to 15 mmHg. Conclusion：This surgical modality may be performed anteriorly in the vicinity of ciliarybodies. The placed silicone band can be adjusted later. It promises to be useful for hypotensive maculopathy.