白内障術後濾過胞の自己血液注射による治療

Treatment of bleb after cataract surgery by direct injection of autologous blood

　慢性関節リウマチのため免疫抑制薬を内服している74歳女性の白内障に対して，計画的嚢外法により眼内レンズを挿入し，順調に経過していた。術後3週目に術眼を自身の手で擦り，強角膜切開創が一部開口した。保存的治療で順調に経過していたが，術後9か月目に強角膜切開部に濾過胞が生じた。濾過胞は拡大し，感染の危険が危惧された。濾過胞を縮小させる目的で濾過胞内に自己血液を0.6ml注射した。濾過胞は瘢痕化し，3か月後には消失した。本法は強角膜創の再縫合を行う前に試みられる価値があると考えられる。

A 74-year-old female underwent uneventful planned extracapsular cataract extraction with posterior chamber lens implantation. She had chronic rheumatoid arthritis and had been treated by systemic immunosuppressants. Three weeks after surgery, she rubbed her operated eye and induced partial opening of the corneoscleral flap. The flap could be closed by conservative therapy. Nine months after later, a filtering bleb appeared and enlarged showing imminent signs of infection. In order to cure the filtering bleb,0.6 ml of autologous blood was injected into the bleb. The bleb gradually decreased in size and disappeared three months later. This procedure promises to be of value as an alternative to surgical closure in such situations.