360度视网膜切开致黄斑转位性斜视的临床分析

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目的 :针对应用 36 0°视网膜切开术治疗复杂性视网膜脱离出现黄斑转位的患者 ,分析发生视网膜旋转、黄斑转位的原因 ,并探讨旋转性斜视和复视的诊断及治疗。方法 :2例因视网膜脱离合并严重前增殖性玻璃体视网膜病变患眼 ,行松弛性 36 0°视网膜切开术后视网膜复位 ,但发生黄斑转位。观察患者手术前后的视力、双眼视功能、主客观偏斜和眼位情况、视网膜旋转度数及黄斑移位程度。结果 :病例 1随诊 2 1个月 ,术后 15个月取出硅油 ,视力从眼前光感提高到 0 0 1;病例 2随诊 3个月 ,硅油存留 ,视力从眼前光感提高到 0 0 3。 2例患者均有垂直和水平斜视 ,黄斑旋转 4 0°~ 5 0° ,黄斑移位约 1 5DD(discdi ameter,视盘直径 ) ,均有主观视物偏斜症状。结论 :36 0°视网膜切开术可能造成视网膜旋转、黄斑转位 ,出现旋转性斜视和复视。 OBJECTIVE: To analyze the causes of retinal rotation and macular translocation in patients with macular translocation of complex retinal detachment treated with 36 ° retinal detachment and to investigate the diagnosis and treatment of rotational strabismus and diplopia. Methods: Two patients suffered from retinal detachment complicated by severe preproliferative vitreoretinopathy. Retinal reattachment was performed after relaxation of 36 0 ° retinal debridement, but macular translocation occurred. Visual acuity, binocular visual function, subjective and objective skewness and eye position, degree of retinal rotation and degree of macular translocation were observed before and after operation. Results: Case 1 was followed up for 21 months, and silicone oil was removed 15 months after surgery. The visual acuity was increased from 0,01 to 0,01. Case 2 was followed up for 3 months. Silicone oil remained and visual acuity increased from 0 to 0 3. Both patients had vertical and horizontal strabismus, macular rotation 40 ° ~ 50 °, and macular translocation about 15DD (discdi ameter, optic disc diameter), there are subjective visual object skew symptoms. Conclusion: 36 ° retinal incision may cause retinal rotation, macular translocation, rotational strabismus and diplopia.
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