観血的に除去した両眼瞳孔膜遺残の1例

Successful surgery in a case of bilateral persistent pupillary membrane

　38歳の患者の両眼性の高度の瞳孔膜遺残症に対して，ヒアルロン酸ナトリウムを用いて，観血的瞳孔膜除去術を施行した。主訴であった昼盲・差明は消失し，特異な容貌は正常になり，視力が術前両眼ともに0.4（0.5）であったものが術後約9か月を経て右眼0.7（1.0）左眼0.5（0.8）に次第に改善するなど，自他覚的視機能の改善をみた。また，両眼の瞳孔は対称的に中程度の散瞳および縮瞳も可能となった。術後1年9か月の経過観察期間中，白内障などの合併症は起こらなかった。

A 38-year-old female presented with photo-phobia and day blindness secondary to bilateral persistent pupillary membrane. Her visual acuity was 0.5 in either eye. The pupillary membrane was removed through a corneoscleral incision 3.5 mm in width. Injection of hyperviscous material facilitat-ed the surgery by lifting the bridges between the pupillary membrane and the iris and by maintain-ing the anterior chamber intact. The surgery was a success as day blindness disappeared and the pupil regained full function. The visual acuity improved to 1.0 in the right eye and 0.8 in the left. There was no cataract or other complications during the fol-low up for 21 months. We advocate surgical removal with the above technique in the manage-ment of persistent pupillary membrane.