Uveal effusionの手術例

Surgical treatment for uveal effusion

　61歳男性，nanophthalmosを伴わない片眼性のuveal effusionに対し，強膜下強膜切除術を行った．術式は鼻下側輪部より4mm後方に4×5mm，厚さ1／3層の強膜弁を形成，この中央に3×2mmの強膜切除を行い，脈絡膜を露出させ，ここより後方に強膜1／3層を残し，1mm幅のトンネルを作成し，網膜下液は穿刺せずに，強膜弁を9-0バージンシルクにて2糸縫合した．輪状脈絡膜剥離は術後より著明に減少，網膜剥離も徐々に吸収され，5カ月後には完全に復位した．Nano-phthalmosを伴わないuveal effusionにおいても，本術式は有効かつ安全な方法と考えられる．

A 61-year-old male presented with annular ante-rior choroidal detachment associated with bullous retinal detachment in the inferior quadrant in his left eye. We diagnosed the condition as uveal effu-sion syndrome. The condition developed into total retinal detachment 6 weeks later after the initial refusal to surgery by the patient. We then perfor-med surgery to create a drainage channel from the choroid to the subconjunctival space.

A rectangular one-third thickness scleral trap-door, 4×5 mm in size, was made in the inferior nasal quadrant with its center 6 mm posterior to the limbus. A sclerostomy, 2 × 3 mm in size, was made in the center of the trapdoor. Posterior to the sclerostomy, a one-third thickness scleral tunnel was created. We made no attempt to perforate the choroid.

The retinal and choroidal detachment disappear-ed 5 months after surgery. The surgical procedure is advocated as a safe and effective one for uveal effusion.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(12) : 1351-1353,1987