偽落屑症候群に合併した両眼水晶体亜脱臼の臨床像と電子顕微鏡的観察

Clinical and ultrastructural features of bilateral lens subluxation in a case of pseudoexfoliation syndrome

（P2-2-38）　偽落屑症候群に両眼水晶体亜脱臼を合併した75歳の女性の摘出水晶体を光学顕微鏡（光顕），透過電子顕微鏡（透過電顕），走査電子顕微鏡（走査電顕）にて観察した。光顕では，赤道部前嚢上に毛羽だったような偽落屑物を認めた。透過電顕では偽落屑物が水晶体嚢外側と水晶体上皮細胞の細胞質，水晶体嚢内に観察された。偽落屑物は線維状で，直径は約10nmであった。走査電顕では，赤道部に断裂したチン小帯線維を認め，その太さは不均一で，表面には偽落屑物の集簇を認めた。既報告における偽落屑症候群に合併した水晶体亜脱臼の頻度は低く，本例のように両眼に高度の水晶体亜脱臼を認めた症例はもっと少ない。

A 73-year-old female presented with bilateral lens subluxation and pseudoexfoliation syndrome. She underwent removal of subluxated lenses. By light microscopy, the lens showed flappy exfoliative material along the anterior equator. Transmission electron microscope showed pseudoexfoliation fibers which were about 10 nm in diameter. They were present on the lens capsule. Scanning electron microscopy showed damaged zonular fibers along the equator. The zonular fibers were variable in thickness with numerous pseudoexfoliative masses on their surface.