经结膜入路摘除眼眶海绵状血管瘤临床分析  

Clinical analysis of transconjunctival approach for orbital cavernous hemangiomas

作　　者：于翠杰[1] 刘桂香[2] 

机构地区：[1]临淄区人民医院眼科,山东省淄博市255400 [2]青岛大学医学院附属医院眼科,山东省青岛市266003

出　　处：《眼科新进展》2011年第11期1068-1070,1074,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨经结膜入路摘除眼眶海绵状血管瘤的适应证。方法回顾性分析17例(17眼)经结膜入路手术摘除的眼眶海绵状血管瘤患者,对所有患者主要症状、体征(如视力、眼球突出度、眼球运动异常和眼底异常等)以及影像学特点进行分析。术后随访视力、眼球突出度及眼球的运动等情况,随诊时间为6个月～48个月。结果 17例患者均为单眼发病。14例术前主诉为无痛性、渐进性眼球突出。眼球运动受限或复视6例,视力下降4例、眼睑肿胀3例、视盘水肿和黄斑异常各2例、角膜上皮点状混浊1例。影像学表现为类圆形、边界清楚、密度均匀球后肌锥内肿物,CT平均值为59Hu,所有患者肿瘤与眶尖组织无粘连,无眶骨质改变。肿瘤最大者30mm×20mm×16mm,最小15mm×10mm×6mm、18mm×10mm×5mm。随访期间无复发,无视力丧失、眼球固定等并发症。结论经结膜入路摘除影像学显示与周围组织无明显粘连、眶尖透明三角区存在的眼眶海绵状血管瘤是安全的手术方式。Objective To investigate the indications of transconjunctival approach for removal of orbital cavernous hemangiomas.Methods The retrospective study included 17 patients with orbital retrobulbar cavernous hemangiomas that were removed through transconjunctival approach.Main symptoms,sings（such as visual acuity,exophthalmos,limitation of ocular movement and fundus abnormalities,etc）and imagine characteristics were analyzed.Visual acuity,proptosis and ocular motility were observed in 6 months to 48 months follow-up period.Results In 17 cases,all patients had unilateral disease,14 patients complained of painless,progressive proptosis.Limitation of ocular movement or diplopia was found in 6 cases,decreased visual acuity in 4 cases,eyelids swelling in 3 cases,papilledema in 2 cases,macular abnormalities in 2 cases,and corneal epithelial point haze in 1 case.Imagines showed orbital hemangiomas as round,well definded,hemogeneous density retrobulbar intrconal mass.Average CT value was 59 Hu,and there was no adhesions between orbital apex and mass.The tumors did not alter the orbital bone contours.The largest tumor size was 30 mm×20 mm×16 mm,and the smallest size was 15 mm×10 mm×6 mm and 18 mm×10 mm×5 mm.All patients with primary proptosis were resolved completely,no signs of recurrence were noted in the follow-up period,no permanent visual loss,potosis and limitation of ocular movement were observed after the operation.Conclusion Transconjunctival approach is a safe surgery for orbital cavernous hemangiomas,which has no adhesion with surrounding tissues and exist of orbital apex transparent triangle by imagine.

关 键 词：海绵状血管瘤 结膜 眼眶 

分 类 号：R779.6[医药卫生—眼科]