【摘要】：目的觀察視網(wǎng)膜脫離外路手術(shù)后繼發(fā)斜視患者的臨床特點和斜視手術(shù)方案,探討影響斜視度的常見相關(guān)因素。方法收集視網(wǎng)膜脫離外路手術(shù)后繼發(fā)斜視并行手術(shù)矯正者25例,隨訪5~41個月。術(shù)前對患者進行詳細的眼部檢查,通過術(shù)中探察及術(shù)前、術(shù)后斜視度和眼球運動等情況來觀察患者的臨床特點,并探討視網(wǎng)膜脫離手術(shù)次數(shù)、術(shù)后矯正視力及直肌懸吊后徙術(shù)對斜視度的影響。結(jié)果斜視術(shù)前所有患者均有眼球運動受限,復視者8例,術(shù)中發(fā)現(xiàn)受累眼外肌均有瘢痕粘連。手術(shù)方式單純行眼外肌減弱術(shù)者7例,直肌減弱聯(lián)合加強術(shù)者18例,其中共10例行懸吊后徙術(shù)。術(shù)后1周及末次隨訪時正位眼者分別為21例和15例,欠矯者分別為4例和9例,眼球運動明顯受限者分別為5例和7例,復視者分別為2例和1例。視網(wǎng)膜脫離手術(shù)次數(shù)多于1次較1次者術(shù)中可見更嚴重的瘢痕粘連,且術(shù)前及術(shù)后1周斜視度差異均有統(tǒng)計學意義(P=0.01、0.00)。視網(wǎng)膜脫離術(shù)后視力0.5與≥0.5者術(shù)后隨訪期末斜視度差異有統(tǒng)計學意義(P=0.03)。直肌懸吊后徙術(shù)使用與否對術(shù)后1周及末次隨訪時斜視度均無影響(P=0.26、0.63)。結(jié)論視網(wǎng)膜脫離手術(shù)后斜視患者的主要臨床特點為眼球運動受限、復視和眼外肌瘢痕粘連。視網(wǎng)膜脫離手術(shù)次數(shù)、術(shù)后矯正視力可影響患者斜視度,懸吊后徙術(shù)為安全有效的斜視手術(shù)方法。
[Abstract]:Objective to investigate the clinical features and strabismus of patients with secondary strabismus after external retinal detachment surgery, and to explore the related factors affecting the degree of strabismus. Methods 25 cases of secondary strabismus were collected and followed up for 5 ~ 41 months. The patients were examined in detail before operation. The clinical features of the patients were observed by intraoperative exploration, preoperative and postoperative strabismus and eye movement, and the number of times of retinal detachment surgery was discussed. Effect of postoperative corrected visual acuity and rectus suspension on strabismus. Results all the patients had limited eyeball movement before strabismus and 8 patients had diplopia. Scar adhesion was found in all the involved extraocular muscles during the operation. There were 7 cases of simple extraocular muscle weakening and 18 cases of rectus abatement combined with strengthening operation. 10 cases were treated with suspending recession. At 1 week and the last follow-up, 21 cases and 15 cases of orthotopic eyes, 4 cases of undercorrection and 9 cases of undercorrection, 5 cases and 7 cases of obvious limitation of eyeball movement, 2 cases and 1 case of diplopia, respectively. More than one operation on retinal detachment showed more severe scar adhesion, and there was significant difference in strabismus before operation and 1 week after operation (P0. 01%). There was significant difference in strabismus between 0.5 and 鈮，

本文編號：2286958