重篤な角膜障害を起こした3症例に対する高濃度自己血清点眼

Three cases of severe corneal disorder treated by instillation of high-density autologous serum

要約　目的：高濃度自己血清点眼治療3症例を報告する。症例：症例1は偽眼類天疱瘡例である。左眼白内障手術および内反症手術後，角膜障害が重症化，3年8か月100％自己血清点眼治療施行。現在矯正視力は0.5である。症例2は右眼実質型角膜ヘルペスの症例で，他院で白内障手術後の点眼による重症角膜障害，ヘルペスぶどう膜炎が発症し，抗ウイルス薬と60％自己血清点眼治療を施行。現在矯正視力1.2である。症例3は聴神経腫瘍術後の右眼神経麻痺性角膜症である。初診時矯正視力0.2，60％自己血清点眼を2年間施行。現在矯正視力0.8である。考察：重症角膜障害に高濃度自己血清点眼治療は有効であった。

Abstract.　Background：The serum simulates the lacrimal fluid in composition. Autologous serum has been used in the treatment of eye disorders including dry eye, Stevens-Johnson syndrome, and neurotrophic keratopathy among others. Purpose：To report 3 cases of severe corneal disorder treated by instillation of high-density autologous serum. Cases：The cases were an 81-year-old female suspected of pemphigoid uveitis with keratopathy, a 67-year-old male with herpetic keratitis of 50 years' duration, and a 31-year-old female with neuroparalytic keratopathy following surgery for acoustic neuroma. All were unilaterally affected. After failure of conventional treatments, they were treated by topical instillation of autologous serum. Case 1 was given 100％ and the others received 60％ concentration. Results：After treatment for 3 years and 8 months, Case 1 showed remarkable improvement with corrected visual acuity of 0.5. Case 2 also improved, resulting in visual acuity of 1.2. Case 3 showed remarkable improvement with corrected visual acuity improving from 0.2 to 0.8 after 2 years. Conclusion：Instillation of autologous serum was effective in 3 cases with severe corneal disorders.