水晶体脱臼と虹彩前癒着を生じたホモシスチン尿症の1例

A case of homocystinuria associated with lens dislocation and anterior synechia

　ホモシスチン尿症に伴う水晶体脱臼で，経過観察中に顕著な虹彩前癒着をきたした3歳男児の1例を報告した。初診時右水晶体は外上方に，左水晶体は外下方に偏位する程度であったが，経過観察中に左水晶体が前房側に脱臼して虹彩を圧迫し，浅前房，角膜との虹彩前癒着をきたした。視力の変化や眼圧上昇はなかった。毛様体皺襞部からレンゼクトミー，前部硝子体切除術を施行し，虹彩前癒着を粘弾性物質の使用および鈍的に解除した。術後経過は良好で，視力は矯正にて1.0を得ている。水晶体脱臼では本症のような急激な合併症を起こすことがあり注意が必要と思われた。

A 3-year-old boy presented with homocystinuria who sufferd from lens dislocation and anterior synechia. The lenses in both eyes had been slightly dislocated at the first visit. The lens in the left eye subluxated anteriorly to attach to the cornea to make a synechia between the iris and cornea during the follow-up period. However, the patient had no visual loss or pain. A lensectomy was performed, and the synechia was relieved with viscoelastic material and a spature. The patient's left vision is now 1.0 without any postoperative complications. The anterior synechia as in the present case may be a significant complica-tion in patients with lens dislocation.