Short-pulsed炭酸ガスレーザーによる低侵襲眼瞼下垂症手術

Minimally invasive surgery for blepharoptosis with adjunct use of short-pulsed carbon dioxide laser

要約　目的：炭酸ガスレーザーによる低侵襲眼瞼下垂手術前後の視機能の報告。対象と方法：宮田法に準拠してMüller筋タッキングを行った21例40眼を対象とした。炭酸ガスレーザーで余剰皮膚を切除した。術前後にmargin reflex distance（MRD）とGoldmann視野を測定し，上方視野を評価した。結果：MRDは術前0.55±0.73mm，術後2.42±0.73mmであり，上方垂直視野は術前19.4±8.9°，術後39.7±7.8°で有意に改善した（p＜0.001）。従来の方法と比べ，術中の出血が少ないために解剖学的視認性が向上し，術後の腫脹と皮下出血が軽度であった。眼瞼下垂の再発はなく，整容的な満足が得られた。結論：炭酸ガスレーザーによる低侵襲眼瞼下垂手術は有効で，術中の出血と術後の合併症が少なかった。

Abstract.　Purpose：To report the outcome of surgery for blepharoptosis with adjunct use of short-pulsed carbon dioxide laser. Cases and Method：This study was made on 40 eyes of 21 cases who received tucking of Müller muscle after Miyata. The redundant skin of the eyelid was resected using a carbon dioxide laser. The vertical eyelid opening was measured by margin reflex distance（MRD）and by Goldmann perimetry. Results：MRD averaged 0.55±0.73 mm before and 2.42±0.73 mm after surgery. Superior vertical visual field significantly improved from presurgical 19.4±8.9°to postsurgical 39.7±7.8°（p＜0.001）. When compared with the conventional method,anatomical visibility improved due to lesser hemorrhage with minimum swelling or ecchymosis after surgery. There was no case of recurrence of blepharoptosis. Conclusion：Surgery for blepharoptosis with adjunct use of short-pulsed carbon dioxide laser was effective with lesser hemorrhage and postoperative complications.