【摘要】：目的：以虹膜定位技術(shù)為客觀定量檢查方法,結(jié)合臨床觀察斜視患者手術(shù)前、后眼球的客觀旋轉(zhuǎn)狀態(tài),探討其在手術(shù)中的作用和意義,為手術(shù)改善和完善、測(cè)量標(biāo)準(zhǔn)提供新的依據(jù)。 方法：收集本院2009年10月～2011年01月收入院的共同性外斜視、上斜肌麻痹的患者各40例,并隨機(jī)分為顯微手術(shù)組、非顯微手術(shù)組,使用WaveScan波前像差儀取坐位行虹膜識(shí)別,獲得虹膜圖像和數(shù)據(jù),使用美國威視公司VISX Star S4-IR準(zhǔn)分子激光系統(tǒng)行仰臥位定位,記錄術(shù)前、術(shù)后虹膜(眼球)旋轉(zhuǎn)的角度。 結(jié)果：主斜眼、主視眼手術(shù)前、手術(shù)后眼球的旋轉(zhuǎn)度進(jìn)行配對(duì)t檢驗(yàn),主斜眼、主視眼的非顯微手術(shù)組與顯微手術(shù)組進(jìn)行兩樣本t檢驗(yàn)。①共同性外斜視非顯微手術(shù)組：主視眼手術(shù)前、手術(shù)后眼球旋轉(zhuǎn)度分別為(4.88±2.55)。、(4.76±2.62)°,差別無統(tǒng)計(jì)學(xué)意義。主斜眼手術(shù)前、手術(shù)后眼球旋轉(zhuǎn)度分別為(2.70±2.36)°、(6.00±2.76)°,差別有統(tǒng)計(jì)學(xué)意義。顯微手術(shù)組：主視眼手術(shù)前、手術(shù)后眼球旋轉(zhuǎn)度分別為(2.86±2.28)。、(3.12±2.17)°,差別無統(tǒng)計(jì)學(xué)意義。主斜眼手術(shù)前、手術(shù)后眼球旋轉(zhuǎn)度分別為(2.08±1.86)°、(3.28±2.04)°,差別有統(tǒng)計(jì)學(xué)意義。主斜眼非顯微手術(shù)組與顯微手術(shù)組進(jìn)行兩樣本t檢驗(yàn),術(shù)前差異無統(tǒng)計(jì)學(xué)意義,術(shù)后差異有統(tǒng)計(jì)學(xué)意義。②上斜肌麻痹非顯微手術(shù)組：主視眼手術(shù)前、手術(shù)后眼球旋轉(zhuǎn)度分別為(2.88±3.58)。、(2.08±2.36)。,差別無統(tǒng)計(jì)學(xué)意義。主斜眼手術(shù)前、手術(shù)后眼球旋轉(zhuǎn)度分別為(2.48±2.51)°、(5.73±1.98)。,差別有統(tǒng)計(jì)學(xué)意義。顯微手術(shù)組：主視眼手術(shù)前、手術(shù)后眼球旋轉(zhuǎn)度分別為(4.90±3.60)°、(4.56±1.12)°,差別無統(tǒng)計(jì)學(xué)意義。主斜眼手術(shù)前、手術(shù)后眼球旋轉(zhuǎn)度分別為(3.12±3.07)。、(4.26±1.98)°,差別有統(tǒng)計(jì)學(xué)意義。主斜眼非顯微手術(shù)組與顯微手術(shù)組進(jìn)行兩樣本t檢驗(yàn),術(shù)前兩組差異無統(tǒng)計(jì)學(xué)意義,術(shù)后兩組差異有統(tǒng)計(jì)學(xué)意義。 結(jié)論：①顯微手術(shù)可以提高斜視手術(shù)的精細(xì)度。②虹膜定位技術(shù)可以客觀地描述斜視患者的眼球旋轉(zhuǎn)狀態(tài),減少手術(shù)源性旋轉(zhuǎn),并且為臨床手術(shù)效果做出評(píng)價(jià)。
[Abstract]:Objective: to investigate the role and significance of the objective rotation of the eyeball in strabismus patients before and after operation by using the iris localization technique as the objective quantitative examination method, so as to improve and perfect the operation. The measurement standard provides a new basis. Methods: 40 patients with concomitant exotropia and superior oblique palsy were collected from October 2009 to January 2011. They were randomly divided into two groups: microsurgical group and non-microsurgical group. The sitting position of iris was identified by WaveScan wavefront aberration instrument. The iris images and data were obtained, and the position of supine position was located by VISX Star S4-IR excimer laser system. The angle of iris rotation was recorded before and after operation. Results: the rotation of the eye before and after the operation was tested by paired t test. Two samples were tested in the non-microsurgical group and the microsurgical group. 1 in the concomitant exotropia non-microsurgery group, the degree of ocular rotation was (4.88 鹵2.55)., (4.76 鹵2.62) 擄before and after the operation, respectively. The difference was not statistically significant. The degree of ocular rotation was (2.70 鹵2.36) 擄and (6.00 鹵2.76) 擄before and after the operation respectively, and the difference was statistically significant. In the microsurgery group, the degree of ocular rotation was (2.86 鹵2.28)., (3.12 鹵2.17) 擄before and after the operation, and there was no significant difference between the two groups. The degree of ocular rotation was (2.08 鹵1.86) 擄and (3.28 鹵2.04) 擄before and after the operation respectively, and the difference was statistically significant. T test of two samples was performed in the main oblique non-microsurgical group and the microsurgical group. There was no significant difference before operation, but there was significant difference after operation. There was no significant difference in the degree of ocular rotation (2.88 鹵3.58)., (, 2.08 鹵2.36).,) after operation. Before and after operation, the degree of ocular rotation was (2.48 鹵2.51) 擄and (5.73 鹵1.98)., respectively. In the microsurgery group, the degree of ocular rotation was (4.90 鹵3.60) 擄and (4.56 鹵1.12) 擄before and after the operation, respectively, and there was no significant difference. Before and after operation, the degree of ocular rotation was (3.12 鹵3.07)., (鹵4.26 鹵1.98) 擄, and the difference was statistically significant. There was no significant difference between the two groups before operation, but there was statistical difference between the two groups after operation. Conclusion: 1 microsurgery can improve the fineness of strabismus surgery. 2 iris localization technique can objectively describe the state of eye rotation of strabismus patients, reduce the operative origin rotation, and evaluate the effect of clinical operation.
【學(xué)位授予單位】：濱州醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R779.6

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