4型コラーゲンによる輪部形成術の試み

Limbo-corneal plasty by type Ⅳ collagen

　ヒト胎盤より4型コラーゲンを精製・再重合させてコラーゲンシートを作成し，その臨床応用を試みた。症例は偽翼状片で，結膜切除後にこのシートを10-0ナイロン糸で強膜上に縫着し，結膜組織の侵入を阻止するか否かについて検討した。この結果，コラーゲンシートは最終観察時（術後5か月）まで強膜上に認められ，臨床的に問題となる炎症反応は生じなかった。またシートは結膜組織の侵入を結膜側で完全に阻止していた。

We tested the feasibility of polymerized type 4 collagen in blocking corneal invation of conjun-ctival tissue in a 50-year-old male upon informed consent. The type 4 collagen was obtained from a human placenta and was purified by repolymeriza-tion. It was shaped as a transparent sheet measur-ing 10×20×0.14mm when hydrated. The patientmanifested pseudopterygium with conjunctival invasion along the lower half of the cornea. We resected the invaded conjunctiva and sutured a 2× 8mm sheet of the collagen onto the bared sclera with interrupted nylon sutures. Five months after surgery, the sutured collagen sheet remained stable and silent on the sclera. The conjunctival tissue invasion was completely blocked along the distal margin of the sheet.