臨牀透析 Vol.21 No.6(2)


特集名 透析患者の眼
題名 角結膜と石灰沈着
発刊年月 2005年 06月
著者 神野 早苗 兵庫医科大学眼科
著者 池田 誠宏 兵庫医科大学眼科
著者 檀上 陽子 蒼龍会井上病院眼科
著者 佐藤 圭子 蒼龍会井上病院眼科
【 要旨 】 透析患者ではカルシウムとリンの代謝異常により結膜と角膜に石灰化が生じる.結膜の石灰化は多くの場合無症状であるが,時に充血を起こす.角膜の石灰化は瞼裂部に生じ,角膜中央部にまで至る高度なものは帯状角膜変性と呼ばれ,視力障害の原因となる.治療は化学反応で石灰化を溶解させる方法と,機械的に角膜表層の石灰化を除去する方法がある.透析患者の角膜石灰化は再発し頻回の治療が必要となる可能性があるので,化学反応で溶解させる方法がよい.
Theme The Eye in Hemodialysis Patients
Title Conjunctivial and corneal calcification in hemodialysis patients
Author Sanae Kanno Department of Ophthalmology, Hyogo College of Medicine
Author Tomohiro Ikeda Department of Ophthalmology, Hyogo College of Medicine
Author Yoko Danjo Department of Ophthalmology, Inoue Hospital
Author Keiko Sato Department of Ophthalmology, Inoue Hospital
[ Summary ] Conjunctival and corneal calcification develops in hemodialysis patients who have disorders of calcium and phosphorus homeostasis. Although conjunctival calcification is usually asymptomatic, it sometimes causes conjunctival inflammation. Calcium is deposited in the interpalpebral area. Severe corneal calcification, known as band keratopathy, developing in the center of the cornea causes visual disturbances. There are two treatment options for corneal calcification ; one is dissolving the calcium by chemical agents, and the other is removal of corneal calcification mechanically. The former is better because band keratopathy in hemodialysis patients sometimes recurs after removal and thus require further operations.
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