Nd：YAGレーザーにて硝子体索状組織切断を行った増殖性糖尿病性網膜症の1例

Vitreolysis of vitreous band in a case of proliferative diabetic retinopathy using Q-switched Nd-YAG laser

　Q-switched Nd：YAGレーザーを用いて，牽引性網膜裂孔および牽引性網膜剥離を合併した糖尿病性網膜症に対する硝子体索状物の切断を試みた．使用した機器はCoherent社製Nd：YAG laser，コンタクトレンズはPeyman lens（焦点距離25mm）を用いた．切断面は網膜面より約2〜6mm離れた緊張した索状物に設定した．照射出力は4.0から5.6mJ，照射回数は約1,000発を要した．術中エイミングが困難であり照射回数の増加を見た．術後硝子体索状物の切断と牽引の減弱が確認でき，術中・術後の合併症は認められなかった．

We performed vitreolysis of vitreous bands in the left eye of a 35-year-old female with proliferative diabetic retinopathy using Nd : YAG laser vitreolysis. A Q-switched Nd : YAG laser (Coher-ent 9900) and Peyman 25 contact lens were used to disrupt the taut vitreous band which caused a trac-tion retinal tear and detachment. Aiming was focused on the bands 2 to 6 mm anterior to theretina. 1000 shots at 5 to 5.6 mJ were needed to attain complete disruption and relief of the trac-tion. Most of the shots were ineffective because of ill focusing due to oversize of the beam at pupillary plane and scattering of the laser beam by hazy vitreous. No retinal complications occurred, and the patient regained postoperative visual acuity of 0.8.

Nd : YAG laser vitreolysis may be useful in carefully selected patient and with suitable method.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(6) : 721-724, 1988