釘打機による穿孔性眼外傷の2例

Two cases of penetrating ocular injury by nail guns

要約　目的：釘打機で穿孔性眼外傷を生じた2症例の報告。

症例と経過：1例は43歳男性で，鉄材に釘を打ち付ける作業中に釘が跳ね返り，左眼を受傷した。長さ3cmの釘が角膜輪部に刺入し，眼底の血管アーケードの下耳側で再度強膜を穿孔していた。釘の頭部は眼外にあった。水晶体を摘出し，硝子体切除，異物除去ののちに角膜と強膜の穿孔創を縫合した。6か月後に1.0の矯正視力を得た。他の1例は41歳男性で，長さ5mmの針金が左眼角膜輪部から2mm後方の位置に刺入していた。異物は釘打機の釘を束ねるワイヤーであった。1か月後に1.2の矯正視力を得た。

結論：釘打機により生じた眼外傷は，1例では釘による穿孔であり，他の1例では釘を束ねるワイヤーによる穿孔であった。

Abstract　Purpose：To report two cases of penetrating ocular injury by nail guns.

Case：One was a 43-year-old male. He was injured in the left eye when a nail bounced back while working with a nail gun. When seen by us, a 3 mm-long nail had penetrated the limbus and the fundus at the temporal vascular arcade. The eye was treated by removal of the nail, removal of the lens, vitrectomy and suture of the scleral wound. He regained visual acuity of 1.0 six months later. The other was a 41-year-old male who was injured in the left eye while working with a nail gun. A foreign body, 5 mm in length, was found stuck 2 mm posterior to the limbus. It was identified as a portion of steel wire bundling the nails. He regained visual acuity of 1.2 one month later.

Conclusion：Penetrating ocular injury developed while working with nail guns. Injury was due to a piece of flying nail in one case and to a broken steel wire.