白内障手術後に再発したⅡ型uveal effusion syndromeの1例

A case of recurrent type Ⅱ uveal effusion syndrome after cataract surgery

要約　目的：白内障手術後に再発したⅡ型uveal effusion syndrome（UES）の1例を経験したので報告する。

症例：59歳，男性。1週間前から左眼視力低下を自覚した。前眼部，中間透光体に特記事項はなく，左眼後眼部は全周性で胞状の体位変換で容易に可動する非裂孔原性網膜剝離および下方優位の脈絡膜剝離を認めた。網膜光干渉断層検査，超音波断層検査，蛍光眼底造影検査（FA/IA）が施行された。非小眼球で強膜肥厚を認め，Ⅱ型UESと診断され，25Gトロカールによる脈絡膜下液の排液と硝子体切除術が行われ網脈絡膜復位を得た。術16か月後に左眼白内障手術を施行し，術中術後は経過良好であったが，白内障手術1か月後，再度左眼視力低下を自覚し，初発時と同様の所見を認めUES再発と診断された。再びトロカールによる排液と硝子体手術が追加施行され，網脈絡膜復位を得た。その後9か月間再発は認めていない。

結論：本症例は，脈絡膜下液の排液と硝子体切除術がUESの治療，再発後の治療として有効であり，白内障手術はⅡ型UESの再発のきっかけになることも示した。

Abstract　Purpose：We report a case of type Ⅱ uveal effusion syndrome（UES）that recurred after cataract surgery.

Case：A 59-year-old man noticed decreased visual acuity in his left eye 1 week prior to his presentation.

Results：There were no particular findings in the anterior segment and intermediate translucent body. In the posterior segment of the left eye, a non-rhegmatogenous retinal detachment and inferiorly dominant choroidal detachment were observed, which were easy to move with a perimeter and alveolar position change. Retinal optical coherence tomography and ultrasound tomography were performed. A 25 G trocar was used to drain the subchoroidal fluid and a vitrectomy was performed to obtain retinochoroidal reattachment. Sixteen months after the surgery, the left eye underwent cataract surgery, and the intraoperative and postoperative courses were favorable. Drainage with a trocar and additional vitrectomy were performed to obtain retinochoroidal reattachment. No recurrence has been observed since.

Conclusions：This case suggests that invasive cataract surgery triggers the recurrence of type ⅡUES, and that subchoroidal fluid drainage and vitrectomy may be effective in the treatment of UES.