眼眶骨折修复手术后残余复视的手术矫正  

Surgical correction of residual diplopia after orbital fracture repairment

作　　者：周波[1] 龙华[1] 谢成益[1] 王道升[1] 

机构地区：[1]随州市中心医院,湖北随州441300

出　　处：《眼外伤职业眼病杂志》2009年第9期679-682,共4页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的探讨眼眶骨折修复手术后主要功能视野内消除复视的手术时机、方法和效果。方法筛选眼眶骨折修复手术后,对残余复视进行手术矫正的40例(40眼)进行回顾性研究。分析不同患者复视的成因,手术时机及手术方法的选择。术后随访6个月对手术疗效进行评价。结果40例术前存在Ⅲ级复视,行眼外肌手术。根据被动牵拉试验结果,选择直肌后徙悬吊、截除以及Jensen联结、眶骨膜固定等术式。术中25例角膜映光基本正位,主要功能视野内无复视,10例略过矫,5例欠矫。术后6月观察,27例主要功能视野无复视;7例正前方无复视,但下方视野残留复视:6例第一眼位残留复视,给予配戴压贴三棱镜后复视改善。结论眼眶骨折修复术后消除主要功能视野复视的手术方法应根据术前和术中牵拉试验结果以及眼球运动检查来选择,合理的手术方式可有效地消除复视、改善眼球运动功能。Objective To investigate the operation time methods and results of eliminating diplopia in the main functions field of vision after the surgical repair of orbital fractures.Methods 40 patients （40 eyes）of orbital fracture were studied retrospectivly in this paper,their residual diplopia were corrected by operation.We analyzed the different canses surgical time and surgical methods selection.All patients were followed up for 6 months to evaluate the efficacy of surgery.Results 40 cases with grade Ⅲ diplopia before operation had undergone the extraocular muscle surgery.According to passivity pull test results,suspensio rectus recession,cut-off,as well as Jensen linking,fixing orbital periosteum were selected.25 cases resumed basically without diplopia in the main function field of vision,10 cases with hypercorrection,5 cases with less correction.After 6 months of observation,27 cases got no diplopia in the main functions fiedd of vision,7 cases had no diplopia in the front field of visiop,but with residual diplopia in the below field of vision;6 cases with residual diplopia in the first eye place,but improved after wearing pressure prismatic lens.Conclusion The surgical method of elimination of diplopia in the main function field of vision after orbital fractures should be based on the pull best results intraoperativly ＆ preoperativly,a reasonable surgical approach should be effective in the elimination of diplopia and improvement of eyeball movment function.

关 键 词：眼眶骨折 眼外肌 复视 手术 

分 类 号：R779.6[医药卫生—眼科]