문신제거용 Nd:YAG 레이저에 의해 발생한 황반원공 1예
A Case of Macular Hole after Exposure to Tattoo Removal by Q-Switched Neodymium:YAG Laser
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초록
목적: 문신제거용 Q스위치방식 Nd:YAG 레이저에 노출된 후 발생한 황반원공 1예를 보고하고자 한다. 증례요약: 43세 남자 환자가 문신제거용 Q 스위치 Nd:YAG 레이저에 노출된 후 발생한 우안의 급격한 시력저하로 내원하였다. 초진 시 안저검사상 망막 부종과 유리체 출혈이 관찰되었고, 수상 후 21일째 황반원공이 발생하였다. 일차적으로 유리체 절제술, 내경계막 제거술 및 가스 충전술을 시행하였으나 원공폐쇄에 실패하였다. 2차 수술로 실리콘기름 주입술을 시행하여 수상 후 4개월째에 원공이 폐쇄되었고 술 후 시력도 호전을 보였다. 결론: 문신제거용 Q스위치방식 Nd:YAG 레이저에 의하여 발생한 황반원공 1예를 보고하며, 1차 수술로 불충분하여 2차 수술로 실리콘 기름주입술을 시행하여 원공의 폐쇄를 이루었으며 비교적 좋은 시력 개선효과를 보았다.
Abstract
Purpose: To report a case of a macular hole resulting from accidental exposure to tattoo removal by the Q-Switched Nd:YAG laser, which was treated successfully by vitrectomy and silicone oil infusion. Case summary: A 33-year-old man presented with decreased visual acuity after accidental exposure to a Q-Switched Nd:YAG laser. According to fundus examination, vitreous hemorrhage and macular edema were observed. After 21 days, a macular hole had developed which was treated by standard pars plana vitrectomy and gas tamponade. Unfortunately, closure was not obtained on the first attempt. Therefore, a second attempt using silicone oil infusion was performed. Four months after the initial visit, BCVA had increased to 20/50, and anatomical occlusion was achieved. Conclusions: The authors of the present study experienced an unusual case of macular hole developed from the Q-Switched Nd:YAG laser used to remove a tattoo. A satisfactory visual acuity was achieved after silicone oil infusion despite failure in the first surgery.
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