表層角膜移植および角膜上皮形成術を行った蚕食性角膜潰瘍の1例

A case of Mooren's ulcer treated by lamellar keratoplasty and keratoepithelioplasty

　51歳男性の穿孔に至った蚕食性角膜潰瘍に対し，病巣周囲の結膜切除，輪部上強膜を含む潰瘍部掻爬，表層角膜移植および角膜上皮形成術を施行した1例を報告した。術後，潰瘍の再発は認められず，良好な視力を回復し，角膜の透明治癒が得られた。切除組織を光顕にて検索したところ，結膜の血管周囲に多数の好中球，リンパ球，形質細胞の浸潤を認めた。更に潰瘍付近の輪部上強膜にも多数のリンパ球の浸潤がみられた。このことから，潰瘍掻爬時に，輪部上強膜を合併切除する方法は有効な治療法であると思われた。

We treated a 51-year-old male with Mooren's ulcer and corneal perforation. Permanent cure without recurrence resulted after excision of adja-cent conjunctiva, debridement of the ulcerated cornea and perilimbal episclera, lamellar kerato-plasty and keratoepithelioplasty. The corneal graftbecame transparent and the visual acuity improved from 0.1 to 0.9 at the final examination. Histopatho-logical study of the excised tissue showed numerous neutrophils, lymphocytes and plasma cells sur-rounding conjunctival vessels. Neutrophils had in-filtrated the limbal episclera adjacent to the ulcer. The findings illustrate the value of debridement of the ulcerated cornea and the surrounding episcleral tissue in the treatment of Mooren's ulcer.