輪部デルモイドに対する周辺部表層角膜移植

Peripheral lamellar keratoplasty in limbal dermoid

　8眼の輪部デルモイドに対して周辺部表層角膜移植術を施行し，術後2〜4.6年の経過観察を行った．その結果，デルモイドの再発は1眼も認められなかった．移植片は8眼中6眼で完全に透明治癒を示した．透明治癒しなかった2眼の内訳は，1眼は拒絶反応による移植片実質混濁を生じ，他の1眼は強膜側の移植片融解を示し，再移植した．移植片への血管侵入が検討できた7眼については，全例でgraftの表層結膜側に血管侵入を認めた．Graftの表層角膜側およびgraft実質内への血管侵入は，移植片混濁を示した1眼にのみ認めた．Graft bed （graftとhost深層実質の間）には7眼中5眼に明らかな血管侵入（ghostvesselを含む）を認めた．この結果より，周辺部に置かれた移植片組織は高率に透明性を維持し，存続できるものと考えられた．またgraftは角膜内への血管侵入を抑制していると考えられた．

We treated 8 eyes with limbal dermoid by peripheral lamellar keratoplasty using a lamellar corneal button, 6 to 10 mm in diameter, as graft. There was no recurrence of dermoid or formation of pseudopterygium during the postoperative follow-up for 2 to 4.6 years. The trans-planted graft retained its transparency in 6 eyes. In the remaining 2 eyes, cloudy graft resulted either from immunological reaction or graft melting of unknown nature. Marked vessel ingrowth into the graft was seen in only 1 of 7 cases examined. In 5 of 7 eyes, vessels were located in the graft bed, or host-graft interface.

These findings suggest that the lamellar corneal grafts on the sclera tend to retain their transparency and to resist vessel ingrowth.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(1) : 69-72, 1987