結露防止剤により誘発されたと思われた蚕食性角膜潰瘍の1例

A case of Mooren's ulcer caused apparently by dew-proof chemicals

　結露防止剤により誘発されたと思われる蚕食性角膜潰瘍の1症例を報告した．

　症例　は33歳の男性で，6カ月前に結露防止剤が右眼に飛入した既往があった．当科初診時には，右眼の角膜下方に新生血管を伴う深い潰瘍を認めた．保存療法で経過観察していたが，潰瘍は進行し穿孔の危険があったため，右結膜部分被覆術を施行した．しかし潰瘍は再発した．角膜の進行縁にundermined borderを伴うことなどから蚕食性角膜潰瘍と考え，健常部の角膜上皮も剥離し結膜で被覆して潰瘍を治癒させることができた．

　結露防止剤の成分は硅酸カルシウム，防カビ剤等を含んでいる．これらの物質により角膜と結膜の上皮に変性が起こり，本人の素因も関与して自己抗体の発生が引き起こされたと考える．

A 33-year-old male presented with severe ocular pain in his right eye of 5 month's duration. The complaint started one month after the eye was accidentally splashed with dew-proof chemical spray containing calcium silicate and mold-proof chemicals.

We observed a deep ulcer with neovasculariza-tion in the lower cornea. The ulcer exacerbated inspite of topical antibiotics, cysteine and sodium chondroitin hydrosulfate solution. We treated the eye with particial conjunctival flap after the ulcer showed signs of imminent perforation. As this procedure proved to be ineffectively, we scraped all the remaining epithelium of the cornea and covered with adjacent conjunctiva and the Tenon's capsule. We diagnosed the case as Mooren's ulcer. Topi-cal eye contact with the dew-proof chemical seemed to have triggered the corneal ulcer.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(3) : 283-286. 1988