局麻下术中调整眼位的共同性外斜视手术的术后眼位漂移的观察  

The observation of postoperative drift under local anesthesia surgery to adjust the eye position in concomitant exotropia

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》2013年第3期11-13,共3页Chinese Journal of Strabismus & Pediatric Ophthalmology

基　　金：甘肃省科技支撑计划--社会发展类2011GS04358

摘　　要：目的探讨在局麻下术中调整眼位至轻度过矫10△~15△的方法治疗共同性外斜视的疗效及术后眼位漂移的研究。方法对40例≤60△共同性外斜视患者分为2组,第一组按照常量手术设计在局麻下行单眼截退手术,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。第二组按照常量手术设计在全麻下行单眼截退手术,观察两组术后24h、1周、1月、3月及6月眼位。结果测量两组的平均眼位漂移在术后24h~半年的眼位漂移量视近分别是-9.10△±5.95△和-7.75△±4.46△;视远分别是-7.85△±5.99△和-8.75△±5.17△。两组之间差异无统计学意义(P>0.05)。局麻组术后半年的正位率为90.00%高于全麻组的75.00%。两组术后24h^6月视远外斜漂移量相似。结论在局麻下手术的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眼位过矫10△~15△目标眼位以抵消外斜漂移而获得早期0^+10△目标眼位,从而获得远期稳定的正位眼位。Objective To evaluate the postoperative drift of adjustable surgery under local anesthesia in concomitant exotropia. Methods Twenty patients with primary exotropia 〈60 pd received a local anesthesia,and undergoing routine-quantity surgery of two horizontal muscles squint surgery,and An over-correction of about 10-15pd is to be made at the end procedure. Another twenty patients with primary exotropia 〈60 pd received a general anesthesia,and undergoing routine-quantity surgery of two horizontal muscles squint surgery. Measurements using prism cover test were obtained when surgery over and again 24 hour, 1 week,1 month,3 month and 6 month after surgery. Results The mean drift in alignment from the first 24 hours to 6 month measured is -9.10±5.95 prism diopters and - 7.75±4.46prism diopters at near, -7.85±5.99 prism diopters and -8.75±5.17 prism diopters at distance ,and two groups was not significantly different （ P 〉 0.05） . The general success rate was 90% of local anesthesia group after six months higher than 75.00% in the general anesthesia group. Condutions It is nessesery that an over-correction of about 10±15a as target alignment is to be made at the end of surgery in concomitant exotropia.An overcorrection of about 10A±15△ can check the exodrift to obtain target alignment in early post-operative （0-＋10△） , then to obtain the steady of long-term post-operative alignment.

关 键 词：局麻 共同性外斜视 调整眼位手术 外斜漂移 

分 类 号：R779.6[医药卫生—眼科]