特異な経過を示したlens-induced glaucomaの1例

An unusual case of lens-induced glaucoma

　67才女子の左眼に発症したlens-in-duced glaucomaの症例につき報告した．明らかな誘因もなく水晶体皮質が一塊として前房内に脱出し，細隙灯顕微鏡所見ではあたかも水晶体全体が脱臼したかのように見え，急激な緑内障症状を呈した．消炎および眼圧下降の処置を行い前房内の皮質は吸収されたが，モルガン白内障の存在が証明された．第20病日に水晶体摘出術を施行し，視力の回復を得ることができた．

　このような症例は文献上でも報告のないきわめて稀な例である．

A 67-year-old female developed acute glaucoma in her left eye. When seen 6 days after onset, a large opaque mass, which appeared to be the lens body, occupied the anterior chamber. The intraocular pres-sure could be brought to normal range by conventional medical treatment. During the following 7 days, the discoid mass was gradually absorbed to allow obser-vation of the pupil. We then identified the anterior lens capsule behind the pupil, suggesting that the opaque mass in the anterior chamber was the lens cortex only.We found a Morgagnian cataract in situ, which we removed, and her corrected visual acuity recovered to 0.8.

We presumed that the intraocular pressure rise in this case was due to mechanical obstruction of the chamber angle by the large lens cortex, because the intraocular pressure could be maintained within the normal range after onset of phacolytic process. This case thus seemed to represent a unique, hitherto unkown type of lens-induced glaucoma.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40(10) : 1138-1140, 1986