Mooren角膜潰瘍に対する角膜移植手術の臨床成績

Results of keratoplasty for Mooren's ulcer

（17-レセ1-12）　Mooren角膜潰瘍に対する角膜移植手術の臨床成績を，初回手術後の再発率，患者の年齢，潰瘍の範囲，および術式の関連について比較検討した。対象は角膜移植を行ったMooren潰瘍15名19眼（23〜84歳，平均52.3歳）で，初回手術での治癒が10眼，Mooren潰瘍の再発が9眼あった。最終的に17眼で潰瘍の治癒が得られた。初回手術後の潰瘍再発率は50歳未満の群で有意に高かった。手術時の潰瘍の範囲が3象限以上の群のほうが再発率が高い傾向にあった。表層角膜移植のみを施行した群と角膜上皮形成術を併用した群とでは，術後の再発率に有意差はなかった。

We reviewed the clinical outcome of keratoplasty on 19 eyes of 15 patients with Mooren's ulcer during the foregoing 18 years. Lamellar keratoplasty was performed on 9 eyes, keratoepithelioplasty on 2 eyes, both procedures on 6 eyes and sclerocorneal transplantation on 2 eyes. The ages ranged from 23 to 84 years, average 52 years. Clinical cure was obtained in 10 eyes after the initial surgery and the corneal ulcer recurred in 9 eyes. Ultimate cure was obtained in 17 eyes. Recurrence after initial surgery was significantly more frequent in patients under 50 years of age. Recurrence was also more frequent when the ulcer involved more than three quandrants at the time of surgery. There was no difference in the rate of recurrence between lamellar keratoplasty alone and additional keratoepithelioplasty.