治療的・整形的全層角膜移植術が奏効した淋菌性角膜潰瘍穿孔の2症例

Therapeutic-tectonic penetrating keratoplasty was effective for corneal perforation in two cases of gonococcal corneal ulcer

　淋菌性角膜潰瘍で薬物治療に抵抗し，短期間で角膜穿孔に至つた2症例に治療的・整形的全層角膜移植術を行った。1例は19歳女性で，急性淋菌性結膜炎が左眼に生じ，8日後に角膜が穿孔した。薬物治療後に全層角膜移植を行い，視力が術前の光覚弁から0.7に回復した。他の1例は23歳男性で，尿道炎後に結膜炎が両眼に生じ，12日後に左眼角膜が穿孔した。角膜実質融解は薬物治療に抵抗し，全層角膜移植を行い，0.8の最終視力を得た。これら2症例での淋菌性角膜潰瘍に続発した角膜穿孔に対して，全層角膜移植術は眼球の形状維持と視力回復に有効であった。

We performed therapeutic-tectonic penetrating keratoplasty in two cases of gonococcal corneal ulcer with perforation. One was a 19-year-old female, with acute gonococcal conjunctivitis in her left eye. Corneal perforation developed 8 days later. Following medications, the affected eye received penetrating kera-toplasty. Cure was obtained with the visual acuity recovering from presurgical light perception to 0.7. The other was a 23-year-old male with conjunctivitis in both eyes following urethritis. Corneal perforation devel-oped in the left eye 12 days later. The melting of corneal stroma was resistant to medications. The left eye re-ceived penetrating keratoplasty, resulting in final visual acuity of 0.8. In both cases of gonococcal corneal ul-cer with perforation, penetrating keratoplasty was effective in saving the ocular structure and visual acuity.