IOL縫着術後にIOL摘出と再縫着を施行したMarfan症候群の2例

Exchange of dislocated intraocular lens in two cases of Marfan syndrome

要約　目的：眼内レンズ（IOL）の縫着後に，IOLの偏位と虹彩捕獲が生じ，IOLの摘出と再縫着を行ったMarfan症候群の2症例の報告。症例：1例は25歳女性，他の1例は41歳男性で，それぞれ18歳と19歳のときに大動脈基部置換術を受けた。第1例は20歳のときに毛様体扁平部経由での水晶体切除術を両眼に受け，その1年後にIOL縫着術を受けた。左眼には3か月後にIOL偏位と虹彩捕獲が生じ，その5年後に交換したIOLを縫着した。以後8年間の経過は良好である。第2例は，13年前に右眼，9年前に左眼に水晶体摘出とIOL縫着術を受けた。9か月前に鈍的外傷を契機として，左眼のIOL偏位と虹彩捕獲が生じたため，交換したIOLが縫着された。以後7か月間の経過は良好である。結論：Marfan症候群では，縫着したIOLの偏位に留意する必要がある。

Abstract.　Purpose：To report 2 cases of Marfan syndrome that received replacement of intraocular lens（IOL）for dislocated IOL. Cases and Findings：One was a 25-year-old female and the other was a 41-year-old male. Replacement of basal portion of the aorta had been performed at the age of 18 and 19 respectively. The first case received pars plana lensectomy in both eyes at the age of 20 years. IOL was inserted one year later. The left eye developed displaced IOL with iris capture 3 months later. IOL was exchanged and sutured 5 years later. She has been doing well for 8 years until present. The other case received lensectomy with IOL insertion 13 years before in the right eye and 9 years before in the left. Because the left eye developed IOL dislocation and iris capture 9 months before following blunt trauma, IOL was exchanged and sutured. He has been doing well for 7 months until present. Conclusion：These cases illustrate that inserted IOL may be prone to dislocation in Marfan syndrome.