濾過胞穿孔例にsuture canalizationを下方に施行した1例

Suture canalization at the inferior limbus in a case of leaking bleb following trabeculectomy

　38歳女性が右流涙で受診した。20歳で緑内障と診断され，22歳のとき両眼に線維柱帯切開術，26歳のとき左眼線維柱帯切除術，30歳のとき右眼に5—フルオロウラシル併用の線維柱帯切除術を受けた。右眼上方に強膜と結膜創の穿孔があり，浅前房であった。結膜被覆術を行ったが眼圧がコントロール不良になった。5か月後に，超音波水晶体乳化吸引術，眼内レンズ挿入術，下耳側にsuture canali—zationを施行した。以後12か月間，眼圧はコントロールされ、重篤な合併症は生じていない。濾過胞を作らないsuture canalizationは線維柱帯切除術と同様な眼圧下降効果が得られ，下方輪部に行っても安全で有効であった症例である。

A 38-year-old woman presented with epiphora in her right eye. She had been diagnosed with glaucoma at age 20. She had received trabeculotomy in both eyes at age 22, trabeculectomy in the left eye at age 26, and trabeculec-tomy with 5-fluorouracil in the right eye at age 30. Her right eye showed shallow anterior chamber and a leaking bleb in the superior limbus. Conjunctival transplantation was followed by elevated intraocular pressure. Five months later, the right eye received phacoemulsificastion-aspiration, intraocular lens implantation, and suture canalization in the in-ferior temporal limbus. She has been doing well without complications during the ensuing 12 months. This case illus-trates that suture canalization may be safe and effective even when performed in the inferior limbus.