斜視手術後に保存強膜を用いて眼瞼形成術を施行した1例

Use of scleral graft for blepharoplasty in a case after strabismus surgery

目的：過去の斜視手術後に生じた下眼瞼後退に対し，保存強膜を使う眼瞼形成術が奏効した症例の報告。症例と経過：18歳女性が下直筋fibrosisによる右眼下斜視に対し，3歳と16歳時に下直筋後転術を受けた。眼位は改善したが，下直筋大量後転による，下眼瞼後退と内反症が生じた。1年前にlower eyelid retractorsの切断術を行い，いったん改善したが数か月で再発した。これに対し，保存強膜を瞼板として使う眼瞼形成術を施行した。以後9か月間経過は良好である。結論：斜視手術後の下眼瞼後退に対し，保存強膜を使った眼瞼形成術が奏効することがある。

Purpose：To report a case of blepharoplasty using preserved sclera for lower eyelid retraction after strabismus surgery. Case and Findingns：A 18-year-old female had received surgery for vertical strabismus at the age of 3 and 16 years. The strabismus was due to fibrosis of inferior rectus muscle in the right eye. Two sessions of surgery induced ocular alignment but also lower eyelid retraction and entropion because of large amount of muscle recession. Resection of lower eyelid retractors was effective for a short period. She underwent blepharoplasty with preserved sclera as substitute for the tarsus. She has been doing well for 9months until present. Conclusion：This case illustrates that blepharoplasty using preserved sclera may be effective for lower eyelid retraction after strabismus surgery.