低眼圧黄斑症を伴う毛様体解離に対し硝子体手術を施行した2例

Vitreous surgery in two cases of cyclodialysis with hypotony maculopathy

要約　目的：低眼圧黄斑症を伴う毛様体解離に対し，硝子体手術，眼内レンズ挿入と縫着，ガスタンポナーデ，毛様体冷凍凝固術が奏効した2症例の報告。

症例：1例は50歳男性で，1年前に左眼白内障手術を受けた。最近眼圧の上昇と，囊外固定されていた眼内レンズの偏位が生じた。その整復術を受けた翌日に低眼圧が生じて紹介受診した。他の1例は42歳男性で，野球ボールによる鈍性外傷から18日後，低眼圧で紹介受診した。

所見と経過：1例には隅角の上方180°に，他の1例には下方120°に毛様体解離があった。1例には眼内レンズ整復から14日後，他の1例には受傷から82日後に，硝子体手術，眼内レンズ挿入と縫着，ガスタンポナーデ，毛様体冷凍凝固術を行った。2例ともに，毛様体解離と低眼圧黄斑症はそれぞれ1か月後に治癒し，手術から6か月後まで良好な視力と眼圧を維持した。

結論：低眼圧黄斑症を伴う毛様体解離の2症例に対し，硝子体手術，眼内レンズ挿入と縫着，ガスタンポナーデ，毛様体冷凍凝固術が奏効した。

Abstract　Purpose：To report two cases of cyclodialysis with hypotony maculopathy treated by vitreous surgery, intraocular lens（IOL）implantation, gas tamponade, and cyclocryotherapy.

Cases：One was a 50-year-old male who had received IOL implantation one year before. IOL dislocated recently followed by ocular hypotony with maculopathy. The other was a 42-year-old male who suffered blunt trauma by a flying baseball in the right eye. He was referred to us 18 days after injury.

Findings and Clinical Course：One case showed cyclodialysis extending over 180 degrees in the upper segment. The other case showed cyclodialysis over 120 degrees in the lower segment. Both cases were treated by vitreous surgery, insertion and suturing of IOL, gas tamponade with sulfur hexafluoride, cyclocryocoagulation followed by supine position for 24 hours. Cyclodialysis and hypotony maculopathy in both cases disappeared one month after surgery followed by good visual acuity and intraocular pressure for 6 months until present.

Conclusion：Cyclodialysis with hypotony maculopathy was brought to cure after vitreous surgery, insertion and suturing of IOL, gas tamponade with sulfur hexafluoride, cyclocryocoagulation followed by supine position.