翼状片手術後の結膜充血

Conjunctival hyperemia following pterygium surgery

要約　目的：翼状片手術後の結膜充血の原因と予防の報告。対象と方法：翼状片手術を受けた49例56眼を対象とした。男性後23例，女性26例で，年齢は35～95歳，平均69歳である。上方から有茎結膜弁を作製し，強膜に固定する手技を用いた。術中に0.04％マイトマイシンCを点眼し，術後1か月以上ステロイドを点眼した。手術から1年以上，平均2年5か月の経過を追った。結果：3眼で翼状片が再発し，この3眼を含めた6眼（11％）で結膜充血が顕著であった。結膜弁の幅が広く弁が確実に強膜に縫着できた46眼中1眼（2％）が再発した。9眼では結膜が脆弱または出血があったため，予定通り弁の作製または縫着ができず，うち2眼で再発し，これを含む5眼で充血が顕著であった（56％）。結論：翼状片手術では有茎結膜弁の幅が広く，確実に強膜に縫着できた症例で再発が少なく，1年後の充血が少なかった。

Abstract.　Purpose：To report factors related to conjunctival hyperemia following pterygium surgery. Cases and Method：This retrospective study was made on 56 eyes of 49 cases that received surgery for pterygium. The series comprised 23 males and 26 females. The age ranged from 35 to 95 years, average 69 years. Pedunculated conjunctival flap was sutured to the sclera. 0.04％ mitomycin was applied during surgery. Corticosteroid was instilled for one month or longer after surgery. Cases were followed up for one year or longer, average 29 months. Results：Conjunctival hyperemia was evident in 6 eyes（11％）including 3 eyes that showed recurrence of pterygium. Pterygium recurred in 1 out of 46 eyes（2％）after conjunctival flap was wide enough and was sutured firmly to the sclera. Out of 9 eyes with conjunctival flap of insufficient width or suturing, conjunctival hyperemia was evident in 5 eyes（56％）including 2 eyes that showed recurrence. Conclusion：Conjunctival hyperemia one year after surgey was less evident in eyes with conjunctival flap of smfficient width and firm suturing to the sclera.