CAJ | 학술논문

目的分析开眶术后斜视的临床特点及手术治疗效果.方法回顾性病例研究.回顾分析中山大学中山眼科中心自1998年3月至2003年7月期间住院行开眶术后斜视的诊治病例9例.其中男性5例,女性4例;年龄12～柏岁,平均26.4岁;右眼4例,左眼5例.全部病例随访1～3年(平均1.4年).常规行远、近标准E视力表检查.眼前后节行裂隙灯显微镜和眼底镜检查.眼位检查包括角膜映光法、同视机检查法和视野弧检查法等.结果开眶术后发生的斜视需手术矫正者共9例.大部分为瘢痕粘连引起的限制性斜视,占66.7%.9例患者均采用手术治疗,术式包括受累肌瘢痕松解术、后徙术+缩短术、Jensen术等.术后眼位完全矫正6例,轻度欠矫2例,明显欠矫1例.4例术前有复视者,术后2例自觉复视消失,2例仅向某个方位有轻微复视,可耐受.所有患者眼球运动均较术前明显好转.结论眼眶术后发生的斜视需手术治疗者多为瘢痕粘连引起的限制性斜视,松解并后退粘连的眼外肌联合对抗肌缩短术或直肌联结术或肌移位术,术终用固定缝线将眼位固定于过矫位可获得理想的矫正效果.
목적 분석개광술후사시적림상특점급수술치료효과.방법 회고성병례연구.회고분석중산대학중산안과중심자1998년3월지2003년7월기간주원행개광술후사시적진치병례9례.기중남성5례,녀성4례;년령12～백세,평균26.4세;우안4례,좌안5례.전부병례수방1～3년(평균1.4년).상규행원、근표준E시력표검사.안전후절행렬극등현미경화안저경검사.안위검사포괄각막영광법、동시궤검사법화시야호검사법등.결과 개광술후발생적사시수수술교정자공9례.대부분위반흔점련인기적한제성사시,점66.7%.9례환자균채용수술치료,술식포괄수루기반흔송해술、후사술+축단술、Jensen술등.술후안위완전교정6례,경도흠교2례,명현흠교1례.4례술전유복시자,술후2례자각복시소실,2례부향모개방위유경미복시,가내수.소유환자안구운동균교술전명현호전.결론 안광술후발생적사시수수술치료자다위반흔점련인기적한제성사시,송해병후퇴점련적안외기연합대항기축단술혹직기련결술혹기이위술,술종용고정봉선장안위고정우과교위가획득이상적교정효과.
Objective To analyze the clinical features and therapeutic outcome in patients with strabismus due to orbitototmy. Methods Retrospective case series. Nine cases of strabismus following orbital operation seen between March 1998 and July 2003 in Zhongshan Ophthalmic Center,Sun Yat-sen University were reviewed retrospectively. Results All of the 9 cases were treated by strabismus surgery. Among them,5 cases were male and 4 were female, with their age ranging from 12 to 40 years (average 26. 4 years). The right eye was involved in 4 cases and the left one in 5 cases. Most of them belonged to restrictive strabismus secondary to the formation of surgical scar,accounting for 66. 7% of them. The methods of surgery included the excision of fibrous tissue around the involved extraocular muscle, the routine recession and resection and the Jeneen procedure,combined with the fixation suture. Six cases obtained excellent results. Two cases were slightly undercorrected and one case was remarkably undereorrectod. Of the 4 eases with diplopia before operation, the diplopia disappeared in 2 cases after surgery. The other 2 cases had diplopia only in one direction far away from the primary position. All of the ocular movement improved obviously after strabismus surgery. Conclusions Most of the deviation happened after orbitotomy was restrictive strabismus caused by the muscle fibrosis and scar formation around the muscle. Excision of fibretie tissue, combined with the routine recession and resectiou,Jenasn procedure,and the fixation suture can have quite satisfactory results.