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소아에서 전신마취하 측와위 자세에서 시행한 야그레이저후낭절개술의 유용성

Other Titles
 Lateral Decubitus Position for Pediatric Nd:YAG Laser Capsulotomy under General Anesthesia 
Authors
 김정동  ;  강현구  ;  김태영  ;  이준원  ;  김민 
Citation
 JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY, Vol.62(7) : 998-1002, 2021-07 
Journal Title
JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY(대한안과학회지)
ISSN
 0378-6471 
Issue Date
2021-07
Keywords
Cataracts ; Neodymium-doped yttrium aluminum garnet laser capsulotomy ; Posterior capsulotomy
Abstract
Purpose
To report a successful case of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy performed in a noncompliant pediatric patient using the lateral decubitus position and a conventional slit-lamp-based laser system under general anesthesia.
Case summary
Progression of a thick posterior capsular opacity with associated vision loss (best-correct visual acuity of 0.1) was detected in a nine-year-old child with a past history of cataract surgery in his right eye. Diagnosed with pediatric uveitis at the age of five, he had been treated previously using a combination of topical and systemic corticosteroids, which led to the development of the cataract and subsequent surgery 16 months later. Severe photophobia prevented outpatient-based laser treatment, and the patient underwent our modified procedure. Under general anesthesia, the patient was placed in a lateral decubitus position with the use of a long intubation tube. The height of the bed and table-based laser system was adjusted so as to minimize strain when positioning the child’s head. Successful laser capsulotomy was performed within 10 minutes, and the entire anesthesia time was less than 30 minutes. The patient experienced immediate improvement in symptoms, showing a visual acuity of 1.0, which has been sustained as of his most recent visit, 3 months postoperatively. The patient experienced no ocular or anesthesia- related complications.
Conclusions
Nd:YAG laser capsulotomy performed by careful positioning (lateral decubitus) under general anesthesia is a viable strategy for the safe and efficient removal of posterior capsular opacities in children with poor compliance.
Files in This Item:
T202104078.pdf Download
DOI
10.3341/jkos.2021.62.7.998
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Hyun Goo(강현구) ORCID logo https://orcid.org/0000-0001-8359-9618
Kim, Min(김민) ORCID logo https://orcid.org/0000-0003-1873-6959
Lee, Jun Won(이준원) ORCID logo https://orcid.org/0000-0003-0543-7132
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/185412
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