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目的探讨甲状腺相关眼病(TAO)致限制性斜视患者眼外肌后徙松解术后,视力、眼压、视野、视网膜中央动脉血流速度的变化。方法选择2002年1月至2004年1月于北京协和医院眼科诊治的17例(20只眼)因TAO致限制性斜视行手术治疗的患者,其中1例行上直肌断腱术、1例行上直肌悬吊术、1例行右下直肌后徙联合左上直肌后徙术,余14例(17只眼)行下直肌后徙术。20只患眼手术前、后均检查视力、眼压、视野,测量视网膜中央动脉血流速度,并进行对照比较。结果术后5只眼视力提高≥2行,15只眼维持术前视力;术前、后眼压和视野平均缺损情况比较,差异有统计学意义(P<0.01);术前、后视网膜中央动脉血流参数比较:术后收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)增加及阻力指数(RI)降低(P<0.05)。结论TAO致限制性斜视患者于静止期行眼外肌后徙松解术治疗,不仅可消除复视,使眼球运动好转,而且能提高裸眼视力、缓解眼压、改善视野和视网膜中央动脉血流速度.
Objective To investigate the changes of visual acuity, intraocular pressure, visual field and the central retinal artery blood flow velocity after the extraocular muscle remodeling in patients with restrictive strabismus caused by thyroid associated ophthalmopathy (TAO). Methods From January 2002 to January 2004, Peking Union Medical College Hospital ophthalmology diagnosis and treatment of 17 cases (20 eyes) due to TAO caused by limited strabismus surgery patients, 1 case of rectus tendon surgery, 1 case Rectus abdominis suspension was performed in one patient. Retrograde right lower rectus muscle combined with left superior rectus muscle transplantation was performed in one patient. In the remaining 14 patients (17 eyes), the rectus muscle was operated under rectus muscle. Visual acuity, intraocular pressure, visual field were measured in 20 eyes before and after surgery. The central retinal artery blood flow velocity was measured and compared. Results The postoperative visual acuity of 5 eyes increased by 2 lines and 15 eyes maintained preoperative visual acuity. The preoperative and postoperative IOP and visual field average defects were significantly different (P <0.01); preoperative and postretinal central Arterial blood flow parameters: postoperative systolic peak blood flow (PSV), end diastolic blood flow (EDV) increased and resistance index (RI) decreased (P <0.05). Conclusions TAO-induced restrictive strabismus patients in the quiescent period after extra-ocular muscle relaxation release surgery, not only can eliminate diplopia, so that eye movement improved, and can improve uncorrected visual acuity, relieve intraocular pressure, improve visual field and central retinal artery blood flow speed.