모반 제거용 이산화탄소 극초단파 레이저에 의한 각막 화상 1예
Corneal Burn Caused by Carbon Dioxide Ultrapulsed Laser for Nevus Removal
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목적: 피부과에서 흔히 사용되는 이산화탄소 극초단파 레이저에 의해 눈 주위 시술 시 안구에 손상을 줄 수 있는데, 모반 제거용 이산화탄소 극초단파 레이저에 의한 각막 손상을 경험하였기에 보고하고자 한다. 증례요약: 25세 여자가 4일 전 좌안 위눈꺼풀 모반 제거 위해 피부과에서 레이저 치료를 시행 받은 후 발생한 지속적인 좌안 통증,시력저하, 변시증을 주소로 내원하였다. 내원 당시 좌안 시력은 최대교정시력 20/100이었고, 세극등검사에서 좌안 코쪽 부위 중심부에 점상의 각막혼탁과 각막의 상피결손이 관찰되었다. 보존적인 치료를 시행하면서 굴절이상 조절을 위해 안경처방을 시행하였고,2개월 후 최대교정시력은 20/50까지 회복되었다. 각막의 상피결손은 치유되었으나 작은 각막 혼탁은 지속되어 정상적인 시력 회복은되지 않았다. 결론: 피부과에서 사용되는 이산화탄소 극초단파 레이저로 눈 주위 시술 시 안손상이 생길 수 있기에 이를 방지하기 위한 각별한 주의와 안구 보호구의 사용이 반드시 필요하다.
Abstract
Purpose: Periocular carbon dioxide ultrapulsed laser surgery can induce ocular damage. Herein we report a rare case of cornealburn after carbon dioxide ultrapulsed laser for nevus removal. Case summary: A 25-year-old female patient presented with ocular pain, decreased visual acuity, and metamorphopsia in theleft eye after laser surgery for nevus removal at a dermatology clinic 4 days prior. The patient’s best corrected visual acuity in theleft eye was 20/100. Central corneal haziness and corneal epithelial defect were observed on biomicroscopic examination. Antibiotics, steroid and artificial tear eye drops were administered for treatment. Glasses were prescribed to correct refractionerrors. After 2 months of treatment, the best corrected visual acuity in the left eye recovered to 20/50, and corneal epithelial defectwas mostly healed, however corneal haziness remained. Conclusions: Carbon dioxide ultrapulsed laser is commonly used in dermatological treatments. The use of an eye shield is importantduring this procedure, and possibility of ocular surface damage from laser treatment should be considered.
참고문헌 (15)
- Goldbaum AM, "The CO2 laser in oculoplastic surgery", Surv Ophthalmol, 42, pp.255~267 (1997)
- Apfelberg DB, "Summary of the 1997 ASAPS", ASPRS Laser Task Force Survey on laser resurfacing and laser blepharoplasty. American Society for Aesthetic Plastic Surgery. American Society of Plastic and Reconstructive Surgeons, 1998, pp.101, 511~518
- Stewart WB, "Surgery of the eyelid, orbit, and lacrimal system. Vol.1", pp.79~81 (1993), American Academy of Ophthalmology
- Wohlrab TM, "Argon laser therapy of benign tumors of the eyelid", Am J Ophthalmol, 125, pp.693~697 (1998)
- Hehar SS, "Endoscopic holmium:YAG laser dacryocystorhinostomy-safe and effective as a day-case procedure", J Laryngol Otol, 111, pp.1056~1059 (1997)
- Clymer MA, "Interstitial Nd:YAG photocoagulation for vascular malformations and hemangiomas in childhood", Arch Otolaryngol Head Neck Surg, 124, pp.431~436 (1998)
- Apfelberg DB, "The ultrapulse carbon dioxide laser with computer pattern generator automatic scanner for facial cosmetic surgery and resurfacing", Ann Plast Surg, 36, pp.522~529 (1996)
- Fitzpatrick RE, "Pulsed carbon dioxide laser resurfacing of photo-aged facial skin", Arch Dermatol, 132, pp.395~402 (1996)
- Bass LS, "Erbium:YAG laser skin resurfacing: preliminary clinical evaluation", Ann Plast Surg, 40, pp.328~334 (1998)
- Ziering CL, "Cutaneous laser resurfacing with the erbium YAG laser and the char-free carbon dioxide laser: a clinical comparison of 100 patients", Int J Aesthetic Restorative Surg, 5, pp.29~37 (1997)
- Goldberg RA, "The carbon dioxide laser in oculoplastic surgery and sliced bread", Arch Ophthalmol, 114, pp.1131~1133 (1996)
- Lim HW, "Complication of CO2 Laser Resurfacing and treatment", J Korean Soc Laser Med, 9, pp.33~40 (2005)
- Blanco G, "The ocular complications of periocular laser surgery", Curr Opin Ophthalmol, 10, pp.264~269 (1999)
- Miedziak AI, "Exposure keratopathy after cosmetic CO2 laser skin resurfacing", Cornea, 19, pp.846~848 (2000)
- Widder RA, "Corneal injury after carbon dioxide laser skin resurfacing", Am J Ophthalmol, 125, pp.392~394 (1998)