摘要
目的分析开眶术后斜视的临床特点及手术治疗效果。方法回顾性病例研究。回顾分析中山大学中山眼科中心自1998年3月至2003年7月期间住院行开眶术后斜视的诊治病例9例。其中男性5例，女性4例；年龄12—40岁，平均26。4岁；右眼4例，左眼5例。全部病例随访1—3年（平均1．4年）。常规行远、近标准E视力表检查。眼前后节行裂隙灯显微镜和眼底镜检查。眼位检查包括角膜映光法、同视机检查法和视野弧检查法等。结果开眶术后发生的斜视需手术矫正者共9例。大部分为瘢痕粘连引起的限制性斜视，占66．7％。9例患者均采用手术治疗，术式包括受累肌瘢痕松解术、后徙术＋缩短术、Jensen术等。术后眼位完全矫正6例，轻度欠矫2例，明显欠矫1例。4例术前有复视者，术后2例自觉复视消失，2例仅向某个方位有轻微复视，可耐受。所有患者眼球运动均较术前明显好转。结论眼眶术后发生的斜视需手术治疗者多为瘢痕粘连引起的限制性斜视，松解并后退粘连的眼外肌联合对抗肌缩短术或直肌联结术或肌移位术，术终用固定缝线将眼位固定于过矫位可获得理想的矫正效果。
Objective To analyze the clinical features and therapeutic outcome in patients with strabismus due to orbitototmy. Methods Retrospective ease series. Nine eases of strabismus following orbital operation seen between March 1998 and July 2003 in Zhongshan Ophthalmic Center,Sun Yat-sen University were reviewed retrospectively. Results All of the 9 cases were treated by strabismus surgery. Among them,5 cases were male and 4 were female,with their age ranging from 12 to 40 years （average 26.4 years）. The right eye was involved in 4 cases and the left one in 5 cases. Most of them belonged to restrictive strabismus secondary to the formation of surgical scar, accounting for 66. 7% of them. The methods of surgery included the excision of fibrous tissue around the involved extraocular muscle, the routine recession and resection and the Jensen procedure, combined with the fixation suture. Six cases obtained excellent results. Two cases were slightly undercorreeted and one case was remarkably undercorrected. Of the 4 cases with diplopia before operation, the diplopia disappeared in 2 cases after surgery. The other 2 cases had diplopia only in one direction far away from the primary position. All of the ocular movement improved obviously after strabismus surgery. Conclusions Most of the deviation happened after orbitotomy was restrictive strabismus caused by the muscle fibrosis and sear formation around the muscle. Excision of fibrotic tissue, combined with the routine recession and reseetion,Jensen procedure,and the fixation suture can have quite satisfactory results.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2008年第11期972-975,共4页
Chinese Journal of Ophthalmology
关键词
眶疾病
手术后并发症
斜视
视轴矫正法
Orbital diseases
Postoperative complications
Strabismus
Orthoptics
