眼内レンズ2次挿入術後に生じた虹彩捕獲に対する眼内レンズと糸の接する長さを計算した予防手術

Prevention of iris capture by modifying the length of thread touching the intraocular lens after secondary implantation

要約　目的：眼内レンズ（IOL）2次挿入術後に生じる虹彩捕獲に対して新しい予防整復手術を考案した。

症例：58歳，男性。IOLの硝子体中への落下に対して，硝子体切除併用IOL毛様溝縫着術を施行した。術翌日に虹彩捕獲を認め，ピロカルピン点眼にて整復するも，すぐに再発し，瞳孔形成術を施行した。その後，レーザー虹彩切開術を施行したが，虹彩捕獲が持続していた。虹彩捕獲の整復目的でIOLと糸の接する長さを計算し，全周に糸の効果が及ぶ手術を行った。術後良好に推移し，虹彩捕獲は術後3年間生じていない。

結論：360°全周に糸の効果が及ぶ本手術は効果が高いと考える。

Abstract　Purpose：To present a case and to report a new surgical method to prevent the iris capture after secondary implantation of intraocular lens（IOL）.

Case：A 58-year-old male had received cataract surgery with IOL implantation in the left eye 18 years before. As he complained of impaired vision recently, the IOL was replaced by fixating at the ciliary sulcus by Z suture. He showed iris capture the next day and received laser iridotomy. Iris capture persisted followed by elevated intraocular pressure. He was then treated by calculating the length of thread touching the IOL before surgery, and received surgery in order to make the thread to reach the entire circumerence of IOL. No iris capture occurred for 3 years after the new procedure.

Conclusion：The new procedure with the thread touching the whole circumference of IOL promises to be useful to prevent iris capture after secondary IOL implantation.