有茎結膜被覆術が奏功した角膜辺縁溝形成の1例

Conjunctival bridge flap was effective in a case with marginal corneal furrows

　慢性関節リウマチを有する78歳の女性の両眼のmarginal furrowsに続発した片眼角膜穿孔の1例を報告した．

　Marginal furrowsの名称は角膜周辺部の一部あるいは全周が菲薄化した結果，角膜辺縁に沿って溝形成が生じることから呼ばれている．根治的な治療方法がないとされており，本症例においても保存療法と免疫抑制剤（cyclophosphamide）の使用により寛解が得られていたが，ステロイド剤併用により角膜穿孔を来した．これに対し有茎結膜被覆術を施行し，角膜穿孔の治癒だけでなくmarginal furrowsにも改善が認められた．重症例に対しては輪部帯状結膜除去を単独で行うよりも，輪部帯状結膜除去を併用した有茎結膜被覆術の方が有効であると考えられた．

A 78-year-old female presented with bilateral marginal furrows of the cornea of presumed 4

The left eye was treated by covering the furrow-ing and the perforated area by conjunctival bridge. The anterior chamber was reformed on the follow-ing day. When the conjunctival flap fell off 10 days after surgery, the perforated cornea was in a healed state.

The conjunctival bridge flap method is recom-months' duration. The thin peripheral cornea was sickle-shaped, was well demarcated centrally, and was about one-third in thickness of the intact area.

The corneal lesion temporally subsided with sys-temic cyclophosphamide. Systemic corticosteroid triggered an excerbation and resulted in perforation of the left cornea.mended as a treatment of choice for marginal cor- neal furrows.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(8) : 1033-1036, 1987