外傷性低眼圧症の手術治療経験

Surgical treatment for traumatic ocular hypotony

　鈍的眼外傷後に毛様体解離による低眼圧が持続した症例に毛様体ジアテルミー凝固，虹彩根部強膜縫合，前房内空気注入を行い良好な結果がえられた．また自験例ならびに従来よりの外傷性低眼圧症についての報告からその治療法について考察した．

　外傷性低眼圧症で保存的療法では改善が見られない場合は，なるべく早期に手術的に回復を試みる．毛様体解離が小さく狭い例では解離部へのアルゴンレーザー光凝固を行い，毛様体解離が大きかったり光凝固が無効な例では毛様体強膜縫合あるいは虹彩根部強膜縫合と毛様体ジアテルミー凝固の併用が良い．

We successfully treated the left eye of a 31-year-old male with persistent ocular hypotony by means of cyclodiathermy, suturing the peripheral iris to the sclera, and air injection into the anterior cham-ber. We propose following guidelines in the treat-ment of persistent ocular hypotony secondary to blunt ocular trauma.

Medical treatment in the first choice. Everyattempt is to be made to induce spontaneous cure. Should ocular hypotony persist and ocular complications develop, surgical management is to be initiated without too much delay.

The purpose of surgical approach is to close the cyclodialysis cleft. When the cleft is not very wide, argon laser photocoagulation is to be attempted. When the cleft is large or argon laser fails, we advocate cyclodiathermy combined with suturing of the ciliary body or the iris root to the sclera.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(1) : 43-47, 1988