水晶体嚢内摘出術が有用であった外傷性水晶体亜脱臼による緑内障

Intracapsular cataract extraction was effective in a case of glaucoma secondary to traumatic subluxation of the lens

　58歳男性が右眼の視力低下で受診した。4か月前に右眼への鈍的外傷があった。右眼矯正視力は0.3，眼圧は38mmHgであった。水晶体は上方約半周が脱臼しており，緑内障性視野狭窄があり，角膜内皮細胞密度が640個／mm²に減少していた。角膜内皮と毛様体の保護を最優先に考え，白内障嚢内摘出術，前部硝子体切除，眼内レンズ毛様溝縫着を同時に行った。術後矯正視力は1.0に回復し，眼圧は3剤点眼で15mmHg以下に保たれている。角膜内皮細胞密度に変化はない。このような状態に対して白内障嚢内摘出術が有用であることを示す症例である。

A 58-year-old male presented with decreasing vision in his right eye. His right eye suffered from blunt trauma 4 months before. His corrected visual acuity was 0.3 right. The intraocular pressure (IOP) was 38mmHg. The lens was subluxated along the upper half of circumference. Perimetry showed glaucomatous visual field defect. The corneal endothelial cell density had decreased to 640/mm². In order to protect the corneal endothelium and ciliary body, we performed intracapsular lens extraction, anterior vitrectomy, and sulcus-fixated intraocular lens implanta-tion. The visual acuity improved to 1.0 after surgery. The IOP has been kept below 15mmHg with topical medication. There has been no change in corneal endothelial cell population. This case illustrates that intracapsular lens extraction may be effective for such situations.