局麻下常量手术术中调整眼位治疗大角度共同性外斜视的疗效观察  

Observation of curative effect of adjustable position of eye in large-angle concomitant exotropia when routine-quantity operation is performed under local anesthesia

作　　者：慕明燕[1] 王亦山[1] 刘永红[1] 张黎[1] 

机构地区：[1]甘肃省中医院眼科,兰州730050

出　　处：《中国斜视与小儿眼科杂志》2012年第4期154-156,共3页Chinese Journal of Strabismus & Pediatric Ophthalmology

基　　金：科技支撑计划-社会发展类推荐(2011GS04358)

摘　　要：目的探讨在局麻下采用常量手术术中调整眼位至轻度过矫10△~15△的方法治疗大角度共同性外斜视的疗效。方法对40例≥-80△的共同性外斜视患者按照常量手术设计在局麻下行双眼外直肌后退联合主斜眼内直肌截除术,术中调整眼位至用三棱镜交替遮盖,33cm保留斜视度为+10△^+15△后结束手术。观察术后24h、3个月及6个月眼位。结果为在术中达到轻度过矫+10△^+15△,大部分大角度外斜视需要行3条常量水平肌手术,少数>-100△者需要行4条常量水平肌手术。术后随访6个月手术成功率87.5%。结论在局麻下手术的大角度共同性外斜视,采用常量手术且术中调整眼位至手术结束时视近过矫10△~15△的方法可以抵消外斜漂移而提高了远期手术正位率。Objective To evaluate the effect of adjustable position of eye in large-angle concomitant exotropia when routine-quantity operation is performed under local anesthesia. Methods Fourty patients with primary exotropia 〉180^Δ received a local anesthesia, and underwent routine-quantity surgery of bilateral external rectus recession and monocular medial rectus resection, and an over-correction of about ＋10^Δ -＋ 15^Δ was obtained at the end of operation. The position of eye were observed 24 hour,3 month and 6 month after surgery. Results Most of the patients who with large-angle concomitant exotropia must undergo bilateral external rectus recession and monocular medial rectus resection for getting over-correction of about ＋ 10^Δ -＋ 15^Δ in operation, three patients with primary exotropia 〉100^Δ needed four horizontal muscles surgery for obtaining target alignment at the end of the procedure. The general success rate after surgery 6 month was 87. 5%. Conclusions It is nessesery that an over-correction of about 10^Δ -15 ^Δ at the end of surgery in large-angle concomitant exotropia.. An overcorrection of about 10^Δ -15 ^Δ can reduce exotropic relapse and achieve stable position of eye.

关 键 词：大角度外斜视 调整缝线 

分 类 号：R779.6[医药卫生—眼科]