中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2010年
4期
307-310
,共4页
假性上睑下垂%眼外肌%外科手术%体层摄影术,X线计算机
假性上瞼下垂%眼外肌%外科手術%體層攝影術,X線計算機
가성상검하수%안외기%외과수술%체층섭영술,X선계산궤
Pseudoptosis%Extraocular muscle%Surgery%Tomography,X-ray computed
目的 探讨垂直斜视引起的假性上睑下垂患者的眼外肌影像学特点及临床处理.方法 回顾性病例研究.2007年8月至2009年10月间收治的假性上睑下垂伴垂直斜视患者12例,对其行眼眶CT检查,根据CT表现及临床检查结果设计不同手术方式,观察手术前后的上睑下垂和垂直斜视变化.结果 术前CT检查,75%(8/12)患者的眼外肌发生明显变化,表现为受累眼上直肌-提上睑肌群最大截面积为(15.11±7.11)mm2,明显小于对侧眼[(24.93±6.43)mm2,P＜0.01].全部患者经个性化斜视矫正手术,垂直斜视均得到治愈;斜视术后上睑下垂治愈10例,好转2例.结论 上直肌-提上睑肌群萎缩性改变是垂直斜视引起的假性上睑下垂的影像学特征之一;伴有假性上睑下垂的垂直斜视需要设计个性化的手术方案;眼外肌CT检查可为临床分析垂直斜视引起的假性上睑下垂提供有价值的信息.
目的 探討垂直斜視引起的假性上瞼下垂患者的眼外肌影像學特點及臨床處理.方法 迴顧性病例研究.2007年8月至2009年10月間收治的假性上瞼下垂伴垂直斜視患者12例,對其行眼眶CT檢查,根據CT錶現及臨床檢查結果設計不同手術方式,觀察手術前後的上瞼下垂和垂直斜視變化.結果 術前CT檢查,75%(8/12)患者的眼外肌髮生明顯變化,錶現為受纍眼上直肌-提上瞼肌群最大截麵積為(15.11±7.11)mm2,明顯小于對側眼[(24.93±6.43)mm2,P＜0.01].全部患者經箇性化斜視矯正手術,垂直斜視均得到治愈;斜視術後上瞼下垂治愈10例,好轉2例.結論 上直肌-提上瞼肌群萎縮性改變是垂直斜視引起的假性上瞼下垂的影像學特徵之一;伴有假性上瞼下垂的垂直斜視需要設計箇性化的手術方案;眼外肌CT檢查可為臨床分析垂直斜視引起的假性上瞼下垂提供有價值的信息.
목적 탐토수직사시인기적가성상검하수환자적안외기영상학특점급림상처리.방법 회고성병례연구.2007년8월지2009년10월간수치적가성상검하수반수직사시환자12례,대기행안광CT검사,근거CT표현급림상검사결과설계불동수술방식,관찰수술전후적상검하수화수직사시변화.결과 술전CT검사,75%(8/12)환자적안외기발생명현변화,표현위수루안상직기-제상검기군최대절면적위(15.11±7.11)mm2,명현소우대측안[(24.93±6.43)mm2,P＜0.01].전부환자경개성화사시교정수술,수직사시균득도치유;사시술후상검하수치유10례,호전2례.결론 상직기-제상검기군위축성개변시수직사시인기적가성상검하수적영상학특정지일;반유가성상검하수적수직사시수요설계개성화적수술방안;안외기CT검사가위림상분석수직사시인기적가성상검하수제공유개치적신식.
Objective To investigate pseudoptosis with a vertical deviation of the extraocular muscles and to evaluate different outcomes based on imaging and clinical findings. Methods This was a retrospective study that included 12 patients who were treated between August 2007 and October 2009. Preoperative ophthalmologic examination and orbital CT scan were performed. The choice of surgical procedure was based on the results of the clinical evaluation and CT imaging.Results Of the patients, 75%(8/12) showed significant changes in their extraocular muscles. In patients' coronal images, the maximum cross-sectional area of the superior rectus-levator complex in the affected eyes became thinner than that of the contralateral eyes [(15.11±7.11)mm2 vs (24.93±6.43)mm2, P＜0.01]. The vertical misalignment was completely corrected in all patients. Pseudoptosis totally disappeared in 10 patients and partially improved in 2 patients. Conclusion Either congenital hypoplasia or paresis of the superior rectus-levator complex in the affected eye may be the main cause of pseudoptosis with vertical deviation. Surgical procedures for pseudoptosis with vertical deviation must be individualized according to the clinical evaluation and imaging. CT imaging of the extraocular muscles may provide clinically valuable information for choosing the appropriate surgical procedure.
