小眼球に伴う閉塞隅角緑内障に対する内眼手術

Surgical treatment in a case of closed angle glaucoma with microphthalmos

　小眼球に伴う閉塞隅角緑内障に対して内眼手術を行い，術中に前房形成不金を生じたため手術をいったん中断したものの，その後複合手術を行って眼圧がコントロールできた症例を報告した。右眼は隅角癒着解離術，超音波乳化吸引術，眼内レンズ移植同時手術を行い眼圧はコントロールされた。左眼も同様の手術を予定し，core　vitrectomy後，隅角癒着解離術を施行した。Con—tinuous circular capsulorhexisを行っているさい，前房形成不全となり手術をいったん中断し，同日約12時間後，D-mannitol, acetazolamideを点滴し手術を再開し超音波乳化吸引術を終了した。2週後，眼内レンズ移植，後嚢切除，core vitrec—tomyを追加し，その3日後laser gonioplastyを施行し眼圧コントロールを得ることができた。術後uveal effusion，網膜剥離などの併発症はみていない。

A 45-year-old female was referred to us for chronic closed angle glaucoma after unsuccessful laser iridotomy and medication. Nanophthalmos was present bilaterally, the corneal diameter measuring 10.5mm and the axial length of the eyeglobe 20.4mm in either eye. The correct visual acuity was 0.7 each and the intraocular pressure measured 28 mmHg under medication. The right eye was successfully treated with goniosyne-chiolysis, phacoemulsification and intraocular lensimplantation. The left eye was treated by core vitrectomy, goniosynechiolysis and continuous cir-cular capsulorhexis. After temporary closure of the wound due to rise in intraocular pressure, phaco-emulsification was performed with posterior cham-ber lens implantation 2 weeks later. These proce-dures induced control of intraocular pressure with-out medication in both eyes.