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目的探讨视网膜脱离手术后限制性斜视的临床特征和手术效果。方法对17例、20眼视网膜手术后所致的限制性斜视,应用三棱镜加交替遮盖或三棱镜映光法(Krimsky法)测定客观斜视角,并进行眼球运动及复视像检查,观察各类视网膜脱离手术后限制性斜视的特征,并观察该斜视手术的治疗效果。结果①孔源性视网膜脱离术后患者斜视的性质与巩膜外加压物的位置有关;②单纯巩膜局部外加压和环扎联合局部外加压手术后限制性斜视临床特征一致,斜视的方向均与主要牵制肌肉相一致或相反,后者仅限于水平直肌;③限制性斜视手术后可以有效解决原在位斜视,并可以消除或改善复视。结论①视网膜脱离手术后斜视属于限制性斜视,其临床特征有助于指导对运动受限的肌肉做出准确判断和定位并进行斜视手术;②视网膜脱离手术后水平斜视的方向与主要牵制肌肉相反的情况由直肌下过度操作引起;③斜视手术可改善复视症状、矫正眼位。
Objective To investigate the clinical features and surgical outcomes of restrictive strabismus after retinal detachment surgery. Methods Seventeen eyes of 20 cases were treated with retinal detachment. Obstructive strabismus was induced by 20 eyes. The objective strabismus angles were measured by prism or alternate prism or Krimsky method (Krimsky method) Restrictive strabismus after surgery from the characteristics and observe the strabismus surgery treatment. Results ①The nature of strabismus in patients with rhegmatogenous retinal detachment was related to the location of extra-corporeal compressive materials. ② The clinical features of restrictive strabismus after partial scleral external compression and cerclage combined with local external compression were consistent. The direction of strabismus Are consistent with the main containment muscle or the opposite, the latter is limited to the horizontal rectus muscle; ③ restrictive strabismus surgery can effectively solve the original strabismus, and can eliminate or improve diplopia. Conclusions ① Strabismus after retinal detachment surgery is restricted strabismus, its clinical features help to guide the accurate measurement of muscle constrained positioning and strabismus surgery; ② retinal detachment after horizontal strabismus surgery and the main contralateral muscle opposite Of the situation caused by over-rectus muscle operation; strabismus surgery can improve symptoms of diplopia, correction of eye position.