【摘要】：目的觀察視網膜脫離外路手術后繼發(fā)斜視患者的臨床特點和斜視手術方案,探討影響斜視度的常見相關因素。方法收集視網膜脫離外路手術后繼發(fā)斜視并行手術矯正者25例,隨訪5~41個月。術前對患者進行詳細的眼部檢查,通過術中探察及術前、術后斜視度和眼球運動等情況來觀察患者的臨床特點,并探討視網膜脫離手術次數(shù)、術后矯正視力及直肌懸吊后徙術對斜視度的影響。結果斜視術前所有患者均有眼球運動受限,復視者8例,術中發(fā)現(xiàn)受累眼外肌均有瘢痕粘連。手術方式單純行眼外肌減弱術者7例,直肌減弱聯(lián)合加強術者18例,其中共10例行懸吊后徙術。術后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。視網膜脫離手術次數(shù)多于1次較1次者術中可見更嚴重的瘢痕粘連,且術前及術后1周斜視度差異均有統(tǒng)計學意義(P=0.01、0.00)。視網膜脫離術后視力0.5與≥0.5者術后隨訪期末斜視度差異有統(tǒng)計學意義(P=0.03)。直肌懸吊后徙術使用與否對術后1周及末次隨訪時斜視度均無影響(P=0.26、0.63)。結論視網膜脫離手術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。視網膜脫離手術次數(shù)、術后矯正視力可影響患者斜視度,懸吊后徙術為安全有效的斜視手術方法。
[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