蚕蝕性角膜潰瘍に対するkeratoepithelioplastyと表層角膜移植の治療成績

Treatment of rodent ulcer with keratoepithelioplasty and lamellar keratoplasty

　難治性の蚕蝕性角膜潰瘍に対して，ker—atoepithelioplasty （KEP）と表層角膜移植lamellar keratoplasty （LKP）を同時に行った4例5眼の術後成績を報告する。観察期間は8か月から3年，平均2.0年であった。術後2眼では角膜中央部の透明治癒がえられた。他の3眼では，上皮移植片の融解と，表層移植を行った部分の上皮欠損，潰瘍の再発などを生じ，最終的に角膜全面が結膜組織で覆われた。これらの症例でも，痛みの軽減，角膜穿孔の予防などの意味で手術は効果があったと考えられた。

We treated 5 eyes of severe rodent ulcer of the cornea by keratoepithelioplasty combined with lamellar keratoplasty. As standard procedure, we performed deep lamellar excision of the affected corneal area, resected the adjacent cojunctiva, and performed keratoepithelioplasty and lamellar ker-atoplasty. This procedure was repeated twice on 2eyes, so that a total of 7 surgeries were performed.

Two eyes followed uneventful and favorable postoperative course. Three eyes were beset with postoperative complications including graft melt-ing, recurrence of ulcer and epithelial defect. Finally, the whole corneal surface was covered by conjunctival tissue. Even in these cases, the surgical procedure was effective in reducing the pain and preventing perforation of the cornea.