外傷を契機に角膜穿孔を生じた強皮症の1症例

Posttraumatic corneal perforation in a case of progressive systemic sclerosis

（18-P2-38）　5年前から強皮症のある70歳女性の右眼に点眼瓶の先端が接触し，角膜欠損が生じ，その7日後に穿孔した。約2×4mmの角膜潰瘍の中央に穿孔創があった。治療用ソフトコンタクトレンズの装着，抗生物質の点眼，ステロイド薬の点眼と内服で角膜実質が再生し，1週後に穿孔創は閉鎖した。角膜穿孔は外傷を契機とし，上皮修復に伴って炎症性メディエー夕が過剰に放出された結果である可能性が推定された。

A 70-year-old woman developed a corneal ulcer after the tip of eyedrop dispenser came into contact with the right eye. She had a 5-year history of progressive systemic sclerosis. The cornea perforated 7 days after the accident. The perforation was located in the center of corneal ulcer of about 2mm×4mm in size. Wearing of therapeutic soft contact lens, topical antibiotics, and topical and systemic corticosteroid resulted in regeneration of corneal stroma and closure of perforated wound one week later. It appeared that the corneal perforation was caused by excessive production of inflam-matory mediators during corneal epithelialization.