手术治疗甲状腺相关眼病限制性斜视

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目的评价眼外肌后徙术治疗甲状腺相关眼病限制性斜视的疗效。设计回顾性病例系列。研究对象单眼单条眼外肌受累的静止期甲状腺相关眼病限制性斜视患者15例。方法行受累眼外肌后徙术。手术前后用视野弧测定患者的双眼单视野面积;用直尺测量眼球由原在位向受限制方向转动的距离;用同视机测定9方位斜视度。主要指标手术前后双眼单视野面积、受限制方向眼球运动距离、受限制眼注视时原在位和下转15°绝对斜视度。结果9眼行下直肌后徙术,4眼行上直肌后徙术,2眼行内直肌后徙术。手术治疗前的平均双眼单视野面积为(23.99±19.39)°,手术后为(2115.72±527.10)°。手术治疗前受限制方向眼球运动的平均距离为(1.53±0.97)mm,手术后为(6.03±0.74)mm。手术治疗前受限制眼原在位注视时平均绝对斜视度为(22.37±6.63)°,手术后为(1.53±1.47)°。手术治疗前受限制眼下转15°注视时的平均绝对斜视度为(15.67±11.53)°,手术后为(2.17±1.90)°。手术治疗前后上述各观察指标均有统计学差异。5眼术前存在高眼压,术后降至正常范围。术前所有患者存在代偿头位,术后均消失。术后9眼出现眼睑退缩,未出现严重并发症。结论眼外肌后徙术能够明显消除复视和斜视,改善眼球运动。(眼科,2007,16:414-417) Objective To evaluate the efficacy of extraocular muscle reimplantation in the treatment of thyroid associated ophthalmic restriction strabismus. Design retrospective case series. Participants: Monocular single extraocular muscle involvement of the quiescent thyroid-associated ophthalmopathy in 15 patients with restrictive strabismus. Methods Extremities affected by external ophthalmoplegia. Before and after surgery with the field of vision of patients with binocular vision area; with the ruler to measure the eye by the original direction of rotation in the restricted direction of the distance; The main indicators before and after surgery binocular vision area, the direction of eye movement in the restricted direction, the restricted eye when the original position and down 15 ° absolute strabismus. The results of 9 cases under the line of rectus muscle resettlement surgery, 4 cases of rectus rectus after line operation, 2 line rectus after rectus surgery. The average area of ​​binocular vision before surgery was (23.99 ± 19.39) ° and (2115.72 ± 527.10) ° after surgery. The mean distance of eye movement before the operation was (1.53 ± 0.97) mm in the restricted direction and (6.03 ± 0.74) mm after the operation. The mean absolute strabismus was (22.37 ± 6.63) ° after eyesight surgery and (1.53 ± 1.47) ° after surgery. The mean absolute strabismus at 15 ° fixation was (15.67 ± 11.53) ° after surgery and (2.17 ± 1.90) ° after surgery. Surgical treatment before and after the above indicators were statistically significant differences. 5 eyes preoperative presence of intraocular hypertension, postoperative reduced to normal range. All patients before surgery there is compensatory head position, disappeared after surgery. Nine patients had eyelid withdrawal, no serious complications. Conclusion Extraocular muscle reimplantation can significantly eliminate diplopia and strabismus and improve eye movement. (Ophthalmology, 2007, 16: 414-417)
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