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要約 目的:両眼にぶどう膜炎,続発緑内障,そして角膜混濁を併発した強皮症患者に行った,超音波白内障手術を行った術後10年の経過報告。
症例:70歳で強皮症と診断された89歳女性。
所見と経過:77歳の初診時に,両眼にぶどう膜炎,続発緑内障,角膜混濁,白内障が認められた。右眼は病的近視もあった。ぶどう膜炎と緑内障は点眼により沈静化した。術前矯正視力は,右0.01,左0.2であった。78歳時に両眼に超音波水晶体乳化吸引術(PEA)と眼内レンズ(IOL)挿入術を施行した。両眼とも術中合併症はなかった。術後最高矯正視力は,右0.04,左0.9であった。角膜上皮障害により視力低下することがあった。術後9年目から主に後発白内障のため左眼は徐々に視力は低下し,最終矯正視力は0.5であった。ぶどう膜炎の再燃はなく,眼圧は安定していた。
結論:ぶどう膜炎と緑内障が併発した強皮症患者の両眼にPEAとIOL挿入術を行い,10年間の経過は良好であった。
Abstract Purpose:To report a case of scleroderma with uveitis and secondary glaucoma who received cataract surgery and was followed up for over 10 years.
Case:A 77-year-old female presented with failing vision in her right eye. She had been diagnosed with scleroderma at the age of 70 years.
Findings and Clinical Course:Corrected visual acuity was 0.01 right and 0.7 left. Both eyes showed uveitis, elevated intraocular pressure(IOP), corneal opacity, and cataract. The right eye showed signs of pathological myopia. Signs of uveitis and elevated IOP normalized after topical treatments. She received phacoemulsification-aspiration(PEA)with intraocular lens(IOL)insertion one year later. There was no complication during surgery. Visual acuity improved to 0.04 right and 0.9 left but fluctuated due to impaired corneal epithelium. Left visual acuity became 0.5 nine years after surgery mainly due to after cataract. There has been no recurrence of uveitis or glaucoma during 10 years after cataract surgery.
Conclusion:Bilateral PEA with IOL insertion was followed by favorable clinical course for over 10 years after PEA and IOL insertion in a patient with scleroderma, uveitis, and secondary glaucoma.
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