视网膜脱离外路手术后斜视患者的临床特点、手术方案和斜视度常见相关因素的探讨

发布时间：2018-10-22 10:57

【摘要】：目的观察视网膜脱离外路手术后继发斜视患者的临床特点和斜视手术方案,探讨影响斜视度的常见相关因素。方法收集视网膜脱离外路手术后继发斜视并行手术矫正者25例,随访5~41个月。术前对患者进行详细的眼部检查,通过术中探察及术前、术后斜视度和眼球运动等情况来观察患者的临床特点,并探讨视网膜脱离手术次数、术后矫正视力及直肌悬吊后徙术对斜视度的影响。结果斜视术前所有患者均有眼球运动受限,复视者8例,术中发现受累眼外肌均有瘢痕粘连。手术方式单纯行眼外肌减弱术者7例,直肌减弱联合加强术者18例,其中共10例行悬吊后徙术。术后1周及末次随访时正位眼者分别为21例和15例,欠矫者分别为4例和9例,眼球运动明显受限者分别为5例和7例,复视者分别为2例和1例。视网膜脱离手术次数多于1次较1次者术中可见更严重的瘢痕粘连,且术前及术后1周斜视度差异均有统计学意义(P=0.01、0.00)。视网膜脱离术后视力0.5与≥0.5者术后随访期末斜视度差异有统计学意义(P=0.03)。直肌悬吊后徙术使用与否对术后1周及末次随访时斜视度均无影响(P=0.26、0.63)。结论视网膜脱离手术后斜视患者的主要临床特点为眼球运动受限、复视和眼外肌瘢痕粘连。视网膜脱离手术次数、术后矫正视力可影响患者斜视度,悬吊后徙术为安全有效的斜视手术方法。
[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，

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