眼内レンズ毛様溝縫着術後に周辺虹彩切除術を施行したにもかかわらず瞳孔捕獲を繰り返した1例

A case of repeated pupil capture after sulcus fixation of intraocular lens and peripheral iridectomy

要約　目的：眼内レンズの毛様溝縫着術後に，瞳孔捕獲を繰り返した症例の報告。症例：59歳男性が左眼の特発性水晶体脱臼で紹介され受診した。硝子体切除ののち水晶体乳化吸引術を行い，眼内レンズを毛様溝に縫着した。術後4日目に瞳孔捕獲が生じ，散瞳で治癒した。縮瞳薬の点眼を行っていたが，その翌日に瞳孔捕獲が再発し，眼圧が上昇した。6時に小さな周辺虹彩切除を置き，眼内レンズを整復した。以後9か月間に3回の瞳孔捕獲が生じた。11時に大きな周辺虹彩切除術を行い，以後8か月後の現在まで再発はない。結論：眼内レンズの毛様溝縫着術後に瞳孔捕獲を繰り返した症例に大きな虹彩切除術が奏効した。

Abstract.　Purpose：To report a case of repeated pupil capture after sulcus fixation of intraocular lens（IOP）and peripheral iridectomy. Case：A 59-year-old male presented with spontaneous lens luxation in the left eye. He received vitrectomy,phacoemulsification-aspiration,and sulcus fixation of IOL. Pupil capture developed 4 days after surgery. It resolved by instillation of mydriatics but recurred the following day with elevated intraocular pressure. IOL was repositioned after performing small peripheral iridectomy at 6 o'clock position. Attacks of pupil capture recurred 3 times during the ensuing 9 months. Large peripheral iridectomy at 11 o'clock position was followed by cure for 8 months until present. Conclusion：Large peripheral iridectomy was effective for recurrenet pupil capture following cataract surgery with sulcus-fixated IOL.