Guyton斜视钩下穹窿结膜小切口斜视手术纠正儿童水平斜视的效果  

Clinical study on the effect of squint surgery on the horizontal strabismus in children with Guyton strabismus

作　　者：张新霞[1] 王小敏[1] 陆丽红[1] 王海波 ZHANG Xin-xia;WANG Xiao-min;LU Li-hong;WANG Hai-bo(Department of Ophthalmology,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,Henan,China)

机构地区：[1]新乡医学院第一附属医院眼科,河南新乡453100 [2]郑州市第三人民医院眼科,河南郑州450000

出　　处：《广东医学》2020年第2期148-151,共4页Guangdong Medical Journal

基　　金：河南省医学科技攻关计划项目(162102310307).

摘　　要：目的分析Guyton斜视钩下穹窿结膜小切口斜视手术对儿童水平斜视的影响。方法回顾性分析2017年9月至2018年9月间在新乡医学院第一附属医院接受斜视手术的患儿98例,共130眼,患儿年龄1.5~16.5岁,平均(6.59±1.57)岁,男性患儿55例(78眼),女性患儿43例(52眼),其中眼球震颤10例、外斜视63例、眼球后退综合征2例、麻痹性斜视8例、内斜15例;患儿均行Guyton斜视钩下穹窿结膜小切口手术,术后对患儿随访6个月,观察患儿视力、结膜切口、眼球运动、眼位和并发症状况。结果切口干预,51眼行结膜切口干预,有2眼缝合3针,12眼缝合2针,37眼缝合1针,剩余79眼均未行结膜切口干预。手术后患儿切口状况,有2眼手术区内球结膜水肿严重,其中1眼是二次手术患儿,1眼是眼球后退综合征外直肌Y形劈开后退手术,13眼手术区域内结膜出现轻度水肿,在球结膜下出血少许;剩余115眼结膜切口的对位理想,无显著切口瘢痕,球结膜下出血少许;手术后6个月98例患儿眼球的运动均正常。91例(119眼)治愈,第一眼位均获取理想眼位;5例(8眼)为好转;2例(3眼)为未愈,均是手术前视力欠佳共同性斜视者。82例患儿有不同程度双眼单视功能,5例无法查看双眼单视,11例无双眼单视。结论患儿行斜视手术时,采用Guyton斜视钩下穹窿结膜小切口在确保疗效的同时,可降低患儿并发症与刺激症状,手术切口减小,符合最佳美容效果,且安全性高。Objective To analyze the effect of small incision strabismus surgery on the lower sacral conjunctiva of Guyon strabismus on children′s horizontal strabismus.Methods A retrospective analysis of 98 children(130 eyes)who underwent strabismus surgery in our hospital from September 2017 to September 2018.The children were aged between 1.5 and 16.5 years(6.59±1.57 years old).There were 55 male children(78 eyes)and 43 female patients(52 eyes).There were 10 cases of nystagmus,63 cases of exotropia,2 cases of retrobulbar syndrome,8 cases of paralytic strabismus,and 15 cases of internal oblique.All patients received a small incision in the lower conjunctiva of Guyon strabismus.The children were followed up for 6 months.The visual acuity,conjunctival incision,eye movement,eye position and complications were observed.Results Fifty-one eyes received conjunctival incision intervention,among which 2 eyes were sutured with 3 needles,12 eyes were sutured with 2 needles,and 37 eyes were sutured with 1 needle.The conjunctival edema in the eye surgery area is severe in 2 eyes;among which 1 eye was secondary surgery,and the other eye was a retrograde rectus muscle Y-shaped open surgery.And 13 eyes have mild edema in the conjunctival area with slight bleeding.The remaining 115 eyes of the conjunctival incision had ideal alignment,with no significant incision scar,and a little subconjunctival hemorrhage.Ninety-eight eyes were with normal movement 6 months after surgery.Ninety-one cases(119 eyes)were cured,and the first eye position obtained the ideal eye position.Five cases(8 eyes)were improved.Two cases(3 eyes)were unhealed,both of them were common strabismus with poor visual acuity before operation.Eighty-two children had different degrees of binocular monocular function,5 patients were unable to view binocular monocular vision,and 11 patients had no binocular monocular vision.Conclusion In patients with strabismus surgery,the use of Guyton strabismus hook via lower conjunctival small incision ensures the efficacy,also reduces the

关 键 词：水平斜视 Guyton斜视钩 穹窿结膜小切口 

分 类 号：R779.6[医药卫生—眼科]