アトピー性皮膚炎に伴う網膜剥離に対する強膜バックリング術後の再発例

Recurrence of atopic retinal detachment after successful scleral buckling surgery

　初回手術で強膜バックリングを施行し，網膜復位が得られたが，後日再剥離をきたしたアトピー性皮膚炎に伴う網膜剥離6例8眼について，初回手術時および再剥離時の所見につき検討した。初回の手術時には全例で硝子体基底部に裂孔があったが，再発時には赤道部，硝子体基底部，毛様体皺襞部に新裂孔が生じていた。初回手術時には4眼が無水晶体眼であったが，再発時には全例が無水晶体眼で，正常な後嚢の形状が保たれていたものは1眼もなく，後嚢破損が5眼に，後嚢の混濁と収縮が5眼にあった。後嚢の破損ないし収縮は，アトピー性皮膚炎に伴う網膜剥離の再発に関与していると考えられた。

We reviewed 8 cases in 6 patients of rhegmatogenous retinal detachment associated with atopic dermatitis. Retinal breaks were located along the vitreous base in all the eyes. Cataract was present in 4 eyes and aphakia in the other 4. All the eyes were successfully treated by scleral buckling procedure. The 4 phakic eyes were later operated for cataract. When retinal redetachment developed, all the 8 eyes had become aphakic. The posterior lens capsule was disrupted in 5 eyes and was opacified or contracted in 5 eyes. The redetachment was due to new breaks located in the equator, along the border of the vitreous base, or in the pars plicata. It appeared that the disruption or contracture of the posterior capsule was related to the new retinal breaks and to the recurrence of atopic retinal detachment.