翼状片手術後に近視化し眼内レンズ交換を行った1例

A case who needed exchange of intraocular lens for myopia after pterygium surgery

要約　目的：翼状片術後に近視化し眼内レンズ（IOL）交換が必要になった症例の報告。

症例：73歳，女性。2008年にA病院において左眼の翼状片の手術を受け，さらに2010年にB医院で両眼の白内障手術を受けた。2016年6月に右眼の翼状片手術を目的に当院を初診し，鼻側および耳側の翼状片切除＋結膜弁移植を行った。術後，翼状片は再発することなく治癒したが，右眼屈折値が著しく近視化し，本人が屈折矯正を希望したため，翼状片術後6か月にIOL交換を行った。IOL交換1か月後，右眼はほぼ正視となった。

結論：角膜内に大きく侵入した翼状片を手術する場合，術後に近視化するため，IOL眼では，術後にIOL交換や屈折矯正手術などが必要になる可能性がある。

Abstract　Purpose：To report a case who needed exchange of intraocular lens for myopia after pterygium surgery.

Case：A 73-year-old female had received surgery for pterygium in her left eye 10 years before. She had received cataract surgery in both eyes 8 years before at another clinic. She visited us, 2 years before, requesting surgery for pterygium in her right eye. Accordingly, she received excision of pterygium with conjunctival transplantation in the nasal and temporal sectors by us. Pterygium in her right eye had healed but the right eye showed progression of myopia from −9 diopters before surgery to −13 diopters 3 months after surgery. The right eye received exchange of IOL, resulting in practical emmetropia one month later.

Conclusion：This case illustrates that excision of pterygium may result in progression of myopia. Extensive involvement of the cornea by pterygium appears to have been the cause of this phenomenon.