トラベクレクトミー既往眼にトラベクトームを施行した2例

Two cases treated by trabectome following failed trabeculectomy

要約　目的：線維柱帯切開術（TLO）と線維柱帯切除術（TLE）が行われた後に眼圧コントロールが不良となり，トラベクトーム手術が行われた2症例の報告。

症例：1例は61歳の男性で，ぶどう膜炎に続発した右眼の緑内障に対し，5年前にTLO，4年前にTLEと眼内レンズ（IOL）挿入が行われた。他の1例は73歳の男性で，右眼の開放隅角緑内障に対し，8年前にTLOとIOL挿入，1年前にTLEが行われた。2例ともその後眼圧が上昇し，最大薬物療法でもコントロールが不良になった。再手術として，結膜と強膜切開を要せず，術野を選んで線維柱帯が切開できるトラベクトーム手術が行われた。合併症はなく，手術から6か月後の眼圧は，薬物療法下で17mmHg前後に下降した。

結論：TLOとTLEの既往があり，眼圧コントロールが不良になった2症例にトラベクトーム手術を行い，6か月後に眼圧下降が得られた。

Abstract　Purpose：To report two cases who received ab interno trabectome surgery following failed trabeculectomy and trabeculotomy.

Case：One was a 61-year-old male with glaucoma secondary to uveitis in the right eye. He had received trabeculotomy 5 years before and trabeculectomy with intraocular lens（IOL）implantation 4 years before. The other was a 73-year-old male with primary open-angle glaucoma in the right eye. He had received trabeculotomy with IOL implantation 8 years before and trabeculectomy one year before. IOP became elevated in both cases and could not be controlled under maximal medication. Both cases were treated by ab interno trabectome surgery. There has been no complications. IOP was controlled at around 17 mmHg with medication 6 months after surgery.

Conclusion：Ab interno surgery with trabectome resulted in controlled IOP in 2 cases after failed trabeculectomy and trabeculotomy.