原発閉塞隅角緑内障を伴う白内障に対する隅角癒着解離術と眼内レンズ挿入手術

Treatment of primary closed angle glaucoma with cataract by lysis of peripheral anterior synechia and intraocular lens implantation

　瞳孔ブロックを解除しても眼圧コントロールの不良な原発閉塞隅角緑内障と白内障の合併症例14眼に対し隅角癒着解離術と眼内レンズ挿入手術を行い，全例で眼圧コントロールを得た。開放された隅角は150°〜270°で術後観察期間（6か月以上，平均13か月）中に再閉塞したものはなかった。合併症として術中の前房出血が64％に，術後の一過性眼圧上昇が36％にフィブリン析出が21％にみられたが予後に影響を与えなかった。

We treated 14 eyes with primary closed angle glaucoma with cataract. The intraocular pressure could not be brought under control after release of pupil block. For these eyes, we performed surgical lysis of peripheral anterior synechia, extraocularlens extraction with intraocular lens implantation. Intraocular pressure could be controlled in all the eyes after surgery. Reopening of the chamber angle ranged from 150 to 270 degrees. The chamber angle remained patent during the follow up for 6 months or more. Hemorrhage in the anterior chamber occurred in 9 eyes, 64%. Postsurgically, transient rise in intraocular pressure developed in 5 eyes, 36%, and fibrinous exudation occurred in 3 eyes, 21%. These complications did not affect the final surgical outcome.