白内障手術中にサイドポートが裂けた青色強膜の1例

Rupture of side port during cataract surgery in a case of blue sclera

要約　目的：白内障手術中にサイドポートが裂け，かつ縫合が困難であった青色強膜の症例の報告。

症例：75歳の女性が白内障手術を目的に受診した。既往歴に幼少時の足指の骨折，家族歴に長女の青色強膜と幼少時の骨折があった。

所見：矯正視力は右0.6，左0.06で，両眼に白内障と青色強膜がみられた。左眼の白内障手術中，サイドポートが裂け，縫合を試みるも角膜が裂け，前房形成が困難となった。手術中はサイドポートを指で，術直後は結膜で被覆し，前房は形成された。術後1か月でサイドポートは自然閉鎖し，術後6か月時矯正視力は0.1，眼圧は5mmHgと改善した。

結論：青色強膜の症例では強角膜の脆弱性を考慮した手術をすることが大切である。

Abstract　Purpose: To report rupture of side port during cataract surgery in a case of blue sclera.

Case: A 75-year-old female presented with cataract. She had fracture of toes during infancy. Her daughter had blue sclera and suffered fracture of toes during childhood.

Findings: Corrected visual acuity was 0.6 right and 0.06 left. Both eyes showed blue sclera and cataract. During cataract surgery on the left eye, the side port ruptured and the splitting extended to the cornea after efforts to suture the rupture. The anterior chamber became flat but reformed after coving with the conjunctiva. The area of side port closed spontaneously one month later. Corrected visual acuity was 0.1 6 months after surgery with intraocular pressure at 5 mmHg.

Conclusion: This case illustrates that utmost precaution is needed for cataract surgery in an eye with blue sclera with brittleness of sclera and cornea in mind.