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学会・論文発表 |
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１９９７年１１月 日本レーザー学会発表
エキシマレーザーの蒸散作用による近視手術
奥山 公道 S・ﾌｨﾖﾄﾞﾛﾌ
参宮橋アイクリニック ﾓｽｸﾜ顕微手術眼科研究所
Excimer laser ablation in Refractive Surgery of myopic
eye.
Abstract
I
Excimer Laser Ablatiorn used in Refractive Corneal Surgery,
named Photo Refractive Keratectomy(PRK). PRK is an eye operation
that reshapes or flattens the cornea, which changes the focus
point and will decrease myopia. Since 1993, I have operated
on more than 1600 eyes with myopia of 1-25D. 65% have been male
and 35% have been female.
I used Lambda Phisics LPX301 Excimer Laser, with
Fyodorov delivery gas cell system. Under the following
conditions; energy density 175-250mj/cm2, 10Hz/sec frequency
number of pulses needed 400-800 pulses working diameter 6. 3mm.
With myopia from 1-12D, one PRK operation gives a good result.
With a myopia of 12D or more it may be necessary to have two
PRK operations, with an interval of not less ttlan 6 months.
My PRK hit rate for
士0.5D is 86.5%. The other l3.5% has a hit rate of 士2.0D, due
to varying degrees of subepitelial hyperplasia-corneal haze.
Corneal haze is temporary and subsides over a period of time.
Even with a high degree of corneal haze, the patient can
be reoperated on using PTK(Photo Therapecitic Keratectomy).
However, at this moment prevention of haze is a major stepping
stone.
「まえがき」
1963年にノーベル物理学賞を（露）バーソフ、バラホーロフそして（米）タウンズの3氏が受けた．1973年バーソフ氏が紫外線エキシマレーザーを発明し、1983年、米国の眼科医トロッケル氏が近視の治療に応用し、現在までに世界で100万人余が受沫ﾃした．
エキシマレーザーはフッ素とアルゴンガスによる励起二量体形成後に発生する6．4electronⅤ．エネルギーの波形を加工して、角膜上皮実質にかけて蒸散し、表面の形状を変化させる球面度の矯正を行う手術である．
エキシマレーザーによる角膜屈折矯正手術（Photorefractive Keratectomy、以下PRKと略す）の臨床を中心に報告する．
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