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、プロホロフそして（米）タウンズの3氏が受賞した。1973年バーソフ氏が紫外線エキシマレーザーを発明、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100万人余が体験した．
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た上で、角膜上皮から実質にかけて蒸散し、球面の形状を変化させる矯正手術である．
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．
