未熟児網膜症に対する保育器内光凝固治療の成績

Outcome of laser photocoagulation in the incubator for retinopathy of prematurity

　活動性未熟児網膜症に対する保育器内光凝固治療を，双眼倒像鏡半導体レーザー光凝固装置を用いて行）た。対象は保育器内光凝固を施行した35例67眼（Ⅰ型3期55眼，Ⅱ型あるいは中間型12眼）で，生下時体重は981.9±237.9g，在胎週数は28.0±2.1週であった。10眼では冷凍凝固も併用した。治療結果は瘢痕期分類1度60眼（89.6％），2度弱度3眼（4.5％），2度中等度1眼（1.5％），2度強度1眼（1.5％），5度2眼（3.O％）であった。保育器内光凝固は保育器内の限られた空間で，患児を体位変換させながら光凝固を行うため，操作にやや熟練を要するが，全身状態の悪い患児でも早期に治療ができ，有用であると思われた。

We reviewed 67 eyes of 35 infants who received binocular indirect diode laser photocoagulation for retinopathyof prematurity (ROP) through the transparent wall of an incubator. Their birthweight averaged 981.9±237.9 g (mean±S.D.) . Their gestational age at birth averaged 28.0±2.1weeks. The severity of ROP at the time of treatment was type Ⅰstage 3 in 55 eyes and either type Ⅱ or intermediate type in 12 eyes. Subsequent cryopexy had to be performed in 10 eyes. The final outcome of ROP was gradel in 60 eyes (89.6%) , mild grade 2 in 3 eyes (4.5%) , moderate grade 2 in 1 eye (1.5%),severe grade in 1 eye (1.5%) and grade 5 in 2 eyes (3%). In spite of technical difficulties, this method was usefulin treating ROP infants in poor systemic conditions.