眼内レンズ挿入に伴う計画的後囊切開施行部から経過中に前房に硝子体が嵌頓し，網膜剝離を発症した小児症例

A child with retinal detachment after cataract surgery with posterior continuous curvilinear capsulorrhexis

要約　目的：計画的後囊切開を併用した白内障手術後，徐々に計画的後囊切開部位から前房に前部硝子体膜が保たれた状態で硝子体が嵌頓し，網膜剝離を発症した症例の報告。

症例：アトピー性皮膚炎がある12歳男児。

所見：全身麻酔下で両眼の水晶体超音波乳化吸引術，眼内レンズ挿入術，計画的後囊切開術を施行した。硝子体脱出はなく，眼内レンズは囊内に固定した。術後も瘙痒感のため上眼瞼を搔破しており，両眼とも徐々に前房内へ硝子体嵌頓をきたし，右眼は鋸状縁断裂による裂孔原性網膜剝離を発症した。硝子体手術を施行し，網膜は復位した。

結論：アトピー性皮膚炎を合併する小児症例では，計画的後囊切開の適応は慎重に検討する必要がある。

Abstract　Purpose: To report a case who developed retinal detachment following progressive herniation of the vitreous into the anterior chamber after cataract surgery.

Case: A 12-year-old boy was referred to us for cataract. Atopic dermatitis had been present since infancy.

Findings and Clinical Course: Corrected visual acuity was counting fingers/40 cm in the right eye and 0.15 in the left. Both eyes showed anterior subcapsular cataract. Both eyes received phacoemulsification-aspiration, insertion of intraocular lens（IOL）, and planned posterior capsulorrhexis. There were no complications during surgery. Binocular visual acuity improved to 1.0 one week later. After surgery, the patient habitually rubbed his eyes. Anterior vitreal herniation developed 30 months after surgery with rhegmatogenous retinal detachment. The retina became reattached after vitrectomy and scleral encircling. The left eye received prophylactic surgery.

Conclusion: This case illustrates that retinal detachment surgery in a child may develop later complications due to rubbing of the eye.