真性小眼球に伴うuveal effusionに対するマイトマイシンC併用強膜開窓術

Sclerostomy with adjunct mitomycin C for nanophthalmic uveal effusion

　38歳女性が，両眼の視力低下で受診した。8か月前に両眼の真性小眼球に伴うuveal effusionと診断され，左側に強膜開窓術が3回行われたが，脈絡膜剥離は消退しなかった。当科初診時の矯正視力は右0.07，左0.3で，右＋18D，左＋16Dの遠視があり，眼軸長は左右とも15mmであった。両眼に脈絡膜剥離を伴う胞状の網膜剥離があった。右眼に8か所の強膜開窓術を行い，網膜剥離は消失したが，1年後にuveal effusionが再発した。各象限に一辺4mmの正方形の強膜切除を行い，0.04％マイトマイシンCを3分間塗布し，中心部に径1mmの強膜開窓を作った。4か月後に脈絡膜剥離は消退した，左眼にも同様の手術を行い，3週後に脈絡膜剥離は消退した。右眼は術後41か月間，左眼は33か月間再発がなく，右0.5，左0.4の矯正視力を維持している。真性小眼球に伴うuveal effusionに対して，マイトマイシンC併用の強膜開窓術が有効であった症例である。

A 38-year-old female presented with decreased vision in both eyes. She had been diagnosed with nanophthalmic uveal effusion 8 months before. Choroidal detachment persisted after having received sclerotomy 3 times in her left eye. Her corrected visual acuity was 0.07 right and 0.3 left. The refraction was +18D right and+16D left. The axial length was 15 mm in either eye. Both eyes showed bullous retinal and choroidal detachment. Sclerectomy in 8 sites in her right eye induced disappearance of retinal detachment. Uveal effusion recurred one year later. The right eye then received lamellar sclerectomy measuring 4×4 mm in each quadrant, application of 0.04%mitomycin C for 3 minutes, and full-thickness sclerostomy of 1 mm in diameter in its center. Choroidal detachment disappeared 4 months later. The left eye received the same pro-cedure. Choroidal detachment disappeared 3 weeks later. There has been no recurrence for 41 months in the right eye and 33 months in the left, with corrected visual acuity of 0.5 right and 0.4 left. This case shows that sclerectomy with adjunct mitomycin C was effective for nanophthalmic uveal effusion.