前部型第一次硝子体過形成遺残に対する手術例

Surgery in a case of anterior persistent hyperplastic primary vitreous

　前部型第一次硝子体過形成遺残の1例を経験し，その手術手技の要点を報告した。症例は生後2週，男児。角膜は透明だが小眼球であり，浅前房，毛様体突起の延長を伴う水晶体後面の線維性血管膜，および膜に接する部位の水晶体混濁がみられた。眼底は透見不能であり生後4週に経角膜輪部法にて手術を施行した。

　手術手技の要点は，（1）粘弾性物質の使用による前房形成や角膜内皮保護，（2）水晶体皮質の硝子体内落下防止のため，後嚢をできるだけ維持，（3）線維性血管膜と延長した毛様体突起との間を360度にわたり切断，（4）硝子体出血防止のため，硝子体動脈を凝固後に切断，（5）前部硝子体切除と水晶体嚢の完全切除，であった。

A 2-week-old male infant was diagnosed as anterior persistent hyperplastic primary vitreous in the right eye. The eye was treated, 2 weeks later, by the following procedures. Viscoelastic fluid was used to maintain the anterior chamber and to protect the corneal endothelium. The lens was removed with a vitreous cutter leaving posterior capsule. Fibrovascular tissue was excised with vitreous scissors from the elongated ciliary processes along the whole circumference. The hyaloid artery was cauterized and severed, followed by anterior vitrectomy and posterior capsulectomy. There was minimum postsurgical inflamma-tion. The patient started wearing a soft contact lens the day after surgery.