表層角膜移植と角膜上皮移植同時手術の適応について

Indications for simultaneous lamellar katoplasty and keratoepithelioplasty

　翼状片，膠様滴状角膜変性症の表層角膜移植後再発した各1眼と，瞼球癒着を伴った偽翼状片1眼の3例3眼に表層角膜移植と角膜上皮移植同時手術を施行し，経過を観察した。3例とも約6か月の経過では移植片の混濁を認めず，合併症も見られない。巨大翼状片例では，翼状片の再発がない。膠様滴状角膜変性症例では視力がm．m．より0.2と改善し，開瞼困難などの自覚症状が軽減した。瞼球癒着を伴った偽翼状片例では結膜組織の再侵入，瞼球癒着はない。難治性再発性の角膜，および輪部，球結膜に病変の波及している疾患，特に膠様滴状角膜変性症において，表層角膜移植と角膜上皮移植同時手術は有効な治療法と考えられた。

We performed simultaneous keratoplasty and keratoepithelioplasty on 3 eyes. Surgery was neces-sitated either by pterygium, recurrent gelatinous drop-like corneal dystrophy after lamellar kerato-plasty, or pseudopterygium with symblepharon. The patients were aged 64, 36 and 16 years each.

During the follow-up of 6 months or more after surgery, there was no incidence of opacity of trans-planted cornea or of other complications. The eye with pterygium showed no recurrence. The eye with corneal dystrophy responded by remarkable improvement in visual acuity and difficulty in opening the eyelids. The third case remained free of reinfiltration of pseudopterygium or symblepharon. Lamellar keratoplasty with simultaneous keratoe-pithelioplasty is recommended as an effective surgi-cal means for obstinate and recurrent lesions of the cornea including the limbus and the bulbar conjun-ctiva.