CAJ | 학술논문

目的在白内障手术中因球后或球周麻醉时药物可能导致眼外肌毒性而产生术后斜视及治疗.方法对5例局部麻醉白内障术后患者,均于术后第一天去除眼罩时发现复视.于白内障术后3个月后在全麻下行受累肌肉的后徙及可调节缝线手术.结果白内障术中局部注射布比卡因导致的眼肌麻痹于术后即发复视并持续存在.在观察病例中2例上直肌受累、3例下直肌受累.4例左眼,1例右眼.在受累肌肉行足量的肌肉后徙并可调节缝线,术后大部分注视方向复视消失,眼位调正.结论白内障术后斜视应当注意到术中局麻药物肌肉毒性所致的斜视.早期由于肌肉麻痹产生复视,后期由于肌肉纤维化和(或)肥大产生与初始复视相反方向的复视.对受累肌肉的足量后徙和可调节缝线可以获得满意的术后效果.
목적 재백내장수술중인구후혹구주마취시약물가능도치안외기독성이산생술후사시급치료.방법 대5례국부마취백내장술후환자,균우술후제일천거제안조시발현복시.우백내장술후3개월후재전마하행수루기육적후사급가조절봉선수술.결과 백내장술중국부주사포비잡인도치적안기마비우술후즉발복시병지속존재.재관찰병례중2례상직기수루、3례하직기수루.4례좌안,1례우안.재수루기육행족량적기육후사병가조절봉선,술후대부분주시방향복시소실,안위조정.결론 백내장술후사시응당주의도술중국마약물기육독성소치적사시.조기유우기육마비산생복시,후기유우기육섬유화화(혹)비대산생여초시복시상반방향적복시.대수루기육적족량후사화가조절봉선가이획득만의적술후효과.
Objective A well-documented strabismus developing after retrobullbar or peribullbar anesthesia for Cataract Surgery is secondary to unintentional injection into an extraocular muscle.we reported five cases of local-anesthetic-induced strabismus after cataract surgery and therapy.Methods Five cases of strabismus after cataract surgery were reported.All of them received either retrobulbar or peribulbar anesthesia.Results Local-anesthetic-induced strabismus after cataract surgery was found almost immediately upon the removal of the patch the day after surgery,it persisted and worsened.Of 3 cases were inferior rectus muscle affected,the other 2 cases were superior rectus muscle affected.Four cases were left eyes,one case was right eye.All of them were performed with a large recession and an adjustable suture of the involved muscle.Diplopia of most gaze position disappeared after strabismus surgery with good alignment.Conclusions Strabismus immediately after cataract surgery should be noted as myotoxicity from the local anesthetic agent used at the time of surgery.Usually a large recession on an adjustable suture of the involved muscle yields gratifying correction.