臨床眼科67巻8号

2013年08月発行

連載 基礎からわかる甲状腺眼症の臨床

甲状腺眼症の治療「眼窩減圧術（ブルっ…）」の巻！

著者： 高橋靖弘¹

所属機関： ¹愛知医科大学眼科学教室

ページ範囲：P.1264 - P.1272

はじめに

　眼窩減圧術は，眼窩内の除圧を図る手術です。眼窩減圧術には眼窩壁を構成する骨を除去して眼窩容積を拡大させる方法と，眼窩脂肪を切除して眼窩内のボリュームを減少させる方法があります。甲状腺眼症における眼窩減圧術は，圧迫性視神経症，眼球突出に伴う角膜障害，および眼球突出による醜形に対して施行されます。

　眼窩減圧術では，複視，髄液漏，視神経障害などの合併症を発生する可能性があります。これらの合併症を起こさずに手術を遂行するためには，眼瞼・眼窩の解剖を理解しておくことが必須です。

　今回は，眼窩減圧術の各術式の詳細，実際の手術の流れを踏まえたうえで，「ブルっ……」とならないための解剖学的なポイントを解説していきます。

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