CAJ | 학술논문

目的探讨急性共同性内斜视早期进行安全有效处理的方法.方法选取2010年4月至2011年3月在眼肌科门诊就诊的急性共同性内斜视患者6例.平均年龄24.5岁,平均病程10周.治疗前三棱镜+马氏杆检查内斜视度数平均为+25△(33 cm,),远、近距离内斜视角度基本相等.同视机检查融合范围较正常小,平均为-3.3°～+9.2°.排除中枢神经系统、内分泌系统异常及其它疾病后,在外科手术显微镜下使用我们自创的眼表微创注射法将肉毒毒素注入眼外肌肌腹.结果 6例患者随访时间6～18个月.一次注射后5例眼位正,自觉复视症状消失,融合范围不同程度增加,且病情稳定未见复视再次发生.另1例在注射后3个月复视再次出现,再次行该药物注射.此患者在发病后11个月因内斜视和复视的反复发作而行内斜矫正手术.药物注射后6例患者均未发生外斜视和上睑下垂等并发症.结论急性共同性内斜视发病早期行眼外肌肉毒杆菌类毒素注射治疗,可以达到有效地消除和缓解复视和斜视的作用,对大多数患者可以达到治愈目的.
목적 탐토급성공동성내사시조기진행안전유효처리적방법.방법 선취2010년4월지2011년3월재안기과문진취진적급성공동성내사시환자6례.평균년령24.5세,평균병정10주.치료전삼릉경+마씨간검사내사시도수평균위+25△(33 cm,),원、근거리내사시각도기본상등.동시궤검사융합범위교정상소,평균위-3.3°～+9.2°.배제중추신경계통、내분비계통이상급기타질병후,재외과수술현미경하사용아문자창적안표미창주사법장육독독소주입안외기기복.결과 6례환자수방시간6～18개월.일차주사후5례안위정,자각복시증상소실,융합범위불동정도증가,차병정은정미견복시재차발생.령1례재주사후3개월복시재차출현,재차행해약물주사.차환자재발병후11개월인내사시화복시적반복발작이행내사교정수술.약물주사후6례환자균미발생외사시화상검하수등병발증.결론 급성공동성내사시발병조기행안외기육독간균류독소주사치료,가이체도유효지소제화완해복시화사시적작용,대대다수환자가이체도치유목적.
Objective To investigate the effect of injection of botulinum toxin A (BTXA) on acute comitant esotropia (ACE) at early stage. Methods The injection of BTXA in 6 patients with ACE from April 2010 to March 2011 in Shandong Eye Institute were retrospectively analyzed.The mean age at presentation was 24.5 years,and the average time from onset of acute esotropia to injection was 10 weeks.The mean angel of esotropia was equal for distance and for near fixation (differing by ＜5 prism diopters),measurd by the prism and cover tests,which was +25△.The range of fusion was lower than normal,which was -3.3°～ +9.2°.A minimal conjunctival incision was made under a microscope,followed by the injection of BTXA in the medial rectus of the squinting eye.Results After the injection,all patients did not develop ptosis and exotropia during the follow-up of 6 to 18 months.Five patients obtained eye orthotroplia,disappearance of diplopia and increasing fusion.One patient who suffered from diplopia received the injection again 3 months after first injection.This patient underwent a surgical treatment at 11 months after onset because of esotropia and diplopia which repeatedly occurred. Conclusions Injection of BTXA is satisfactory and effective management of ACE at early stage.