角膜移植後に眼圧上昇をきたした先天緑内障および無水晶体眼に対し非穿孔性線維柱帯切除術を施行した1例

Nonpenetrating keratectomy for elevated intraocular pressure following keratoplasty in an aphakic eye with congenital glaucoma

要約　先天緑内障と人工的無水晶体がある35歳男性の右眼の眼圧が点眼でコントロールされていた。左眼は15年前に眼球癆になっている。右眼が2年前から水疱性角膜症になり，角膜全層移植を行った。術後眼圧が上昇し，視力低下と視野障害が生じたので，1か月後に非穿孔性線維柱帯切除術を行った。その16か月後の現在まで眼圧の経過は良好である。本症例が唯一眼，無水晶体眼，角膜移植直後であったことが，非穿孔性線維柱帯切除術を選択した理由である。この手術手技が角膜移植直後の無水晶体眼に奏効したことを示す1例である。

Abstract.　A 35-year-old male had been receiving eyedrops to control the intraocular pressure（IOP）for congenital glaucoma in his right aphakic eye. His left eye had become phthisic 15 years before. The right eye developed bullous keratopathy since 2 years before. Penetrating keratoplasty was followed by elevated IOP with impaired visual acuity and field. Nonpenetrating trabeculectomy was performed one month later. IOP has been well-controlled during 16 months until present. We opted for nonpenetrating trabeculectomy because the affected eye was his last functional eye,was aphakic,and had recently received penetrating keratoplasty. This case illustrates that nonpenetrating trabeculectomy may be safe and effective for glaucoma in an aphakic eye shortly after keratoplasty.