治療が遅れた上眼瞼結膜下異物肉芽腫の6例

Six cases of foreign body granulation of upper palpebral conjunctiva being late for treatment

要約　目的：治療が遅れた上眼瞼結膜異物肉芽腫6例の報告。症例と経過：症例は異物感を主訴に受診し，病歴と角結膜所見から異物の存在が疑われた女性6例，年齢は35.0±12.9歳であった。6例中5例は埋没法重瞼術，残りの1例は歩行中に異物飛入の既往があった。全症例で角膜上皮障害があり，対応する上眼瞼結膜に肉芽腫を認めた。異物の露出は全例でなかった。病歴と所見から角膜障害の原因は肉芽腫内に埋入された異物と判断した。異物摘出術施行後，どの症例も翌日には自覚症状，他覚所見ともに改善がみられた。結論：異物を直接確認できなくても病歴と所見から異物の存在が疑われる場合は，積極的に肉芽腫を切除し異物を摘出するべきである。

Abstract.　Purpose：To report six cases of foreign body granulation of upper palpebral conjunctiva being late for treatment. Cases and Findings：Six women presented with foreign body sensation. It is suspicious of the existence of foreign body in their upper eyelid judging from the history of them and the findings of cornea and conjunctiva. The average age is 35.0±12.9 years old. 5 cases are after double lid operation using buried suture and 1 case has a history of some foreign body getting into her eye. All of them presented corneal epithelium disorder and granulation of upper eyelid. We couldn't find any foreign bodies under the slit-lamp biomicroscopy. Judging from their history and corneal findings, we thought that buried foreign body causes granulation and corneal epithelium disorder. After operation of removal of foreign body, all cases show improvement of symptoms and corneal findings on the next day. Conclusion：Even though there is no exposure of foreign body, we must resect granulation and remove foreign body judging from their history and ophthalmic findings.