角膜・水晶体を貫き硝子体深部まで刺さった銅線刺傷例

Perforating injury through the cornea, lens and anterior vitreous by a piece of copper wire

要約　目的：銅線による眼球刺傷例の報告。症例：34歳男性が電気工事中に1.2mm径の銅線が左眼に刺さった。その4時間後に，銅線が刺入したまま受診した。所見と経過：視力は30cm/指数弁であった。銅線は角膜，虹彩，水晶体を貫き，硝子体まで14mmの深さまで刺さっていた。その1時間後に18mmの長さの銅線を抜去し，角膜創を縫合し，水晶体を乳化吸引した。眼底は正常であった。房水の培養で菌は陰性であった。10か月後に眼内レンズを挿入し，7年後まで経過を観察した。視力は受傷から1週後に0.4，2か月後に1.0，4か月～7年後は1.2であった。視野に異常はなく，眼球銅症は起こらなかった。結論：眼球の穿孔性外傷では，刺入物が栓として機能すれば，眼球内容の脱出や変形が防げる。ただちに抜去せずに，専門医による手術を受けることが良策である。

Abstract.　Purpose：To report a case of eye injury by a piece of copper wire. Case：A 34-year-old male was injured in his left eye by copper wire of 1.2mm in diameter. He visited us 4 hours later with the piece of wire still in his eye. Findings and Clinical Course：Visual acuity in the left eye was counting fingers. The copper wire had perforated the cornea, iris, crystalline lens and anterior vitreous. He underwent emergency surgery one hour later. After removal of copper wire which was 18mm long, the corneal wound was sutured and the lens was aspirated. Funduscopy showed normal findings. Culture of the aqueous was negative. He received implantation of intraocular lens 10 months later. His corrected visual acuity was 0.4 one week after injury, 1.0 two months later, and 1.2 from 4 months to 7 years after injury. There was no visual field defect or ocular chalcosis. Conclusion：In perforating eye injury, the causative foreign body may act as a stopper and may prevent deformation or prolapse of the ocular content. It is advisable not to immediately remove the perforating foreign body in order to receive professional treatment later.