CO2レーザー光による網膜下液排除

Drainage of subretinal fluid with CO2 laser

　網膜剥離手術の網膜下液排除にCO₂レーザー光を用いた．

（1）手術方法は強膜を切開して脈絡膜を露出した後，CO₂レーザー光を照射し網膜下液を排出する方法である．

（2）動物実験で，CO₂レーザー光は出血をきたさずに脈絡膜が穿孔でき，しかも網膜下液に吸収されるため網膜を障害せず，安全に網膜下液排除が行えることを確認した．

（3）裂孔原性網膜剥離18眼，牽引性網膜剥離2眼の計20眼の網膜剥離手術に応用し，合併症を起こさず全例で十分な網膜下液排除が行われた．

（4）安全かつ確実に網膜下液排除を行うことができる有用な操作と考えられた．

We developed a method to drain the subretinal fluid in retinal detachment surgery using CO₂ laser. The procedure involves incision of the sclera for 2mm, exposure of the choroid and perforation with a beam of CO₂ laser with the power output of 1.5 to 2.0W, for 0.05 to 0.1 sec and the diameter of 80 μm.

A preliminary experiment in rabbit eyes has shown that the detached retina is not injured by laser when it is away by 1mm or more. Histological studies showed the choroid to be perforated associ-ated with coagulation effects at the perforated margin.

We employed this procedure in 20 eyes with rhe-gmatogenous retinal detachment. In all the cases, the subretinal fluid was successfully drained without complications. The present method is recommended for its efficacy and safety.