人工水晶体移植術後にみられたlight-induced maculopathyの1症例

A case of light-induced maculopathy following intraocular lens implantation

　人工水晶体移植術後にみられたlight-induced maculopathyの1症例を経験した．症例は68歳，女性で術前視力は0.1であった．水晶体摘出術ならびに人工水晶体移植術の翌日に，視力は0.03に低下した．検眼鏡的には黄斑部下方に約1／2乳頭径×1乳頭径大の極めて軽度な網膜の混濁浮腫がみられ，螢光眼底造影では網膜浮腫に一致して脈絡膜からの螢光漏出による過螢光像がみられた．視野検査では中心暗点を呈した．術後1カ月には視力は0.6に改善し，螢光眼底造影ではwindow dcfectによる過螢光像がみられ，視野検査では傍中心暗点を呈した．

　本症は臨床所見に乏しく見逃されやすいが，偽水晶体眼の合併症として注意すべき疾患の一つと考えられる．診断には中心視野測定および螢光眼底造影が有用であると思われる．

A 68-year-old female underwent extracapsular cataract extraction with posterior chamber lens implantation. The surgery was performed under surgical microscope over a 55-minute duration. The visual acuity was 0.1 prior to surgery, 0.03 the day after surgery and 0.4 on the 5th day after surgery. Funduscopically, subtle retinal edema, one half disc diameter in size, was noted inferior to the fovea. Fluorescein angiography showed multiple foci of dye leakage from the retinal pigment epithelium in the edematous area. Perimetry showed para-cental scotoma corresponding to the edema. Further spontaneous recovery took place, with the visual acuity improving to 0.61 month after surgery. The initially edematous area showed mottled hyper-fluorescence indicating degenerated retinal pigment epithelium.