甲状腺相关性免疫眼眶病眼外肌病变的手术治疗  

Surgical management of strabismus associated with thyroidrelated immune orbitopathy

作　　者：吴中耀[1] 颜建华[1] 杨华胜[1] 毛羽翔[1] 

机构地区：[1]中山医科大学中山眼科中心,510060

出　　处：《中国斜视与小儿眼科杂志》2002年第2期51-54,共4页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的　探讨甲状腺相关性免疫眼眶病眼外肌病变的手术治疗特点。方法　回顾分析我院自1 993年 1月到 1 999年 1 2月施斜视矫正术的 2 0例甲状腺相关性免疫眼眶病眼外肌病变患者。其中男1 4例 ;女 6例 ;年龄 2 8 0 67 0岁 (平均 5 0 2岁 )。手术方式包括下直肌后退术 (1 2条 ) ,上直肌后退术 (7条 ) ,下直肌缩短术 (4条 ) ,上直肌缩短术 (2条 ) ,上直肌断腱术 (2条 ) ,内直肌后退术(1条 ) ,外直肌缩短术 (1条 )。术后平均随访 1年。结果　术后 9例达到正位 ,复视消失 ;7例术后斜视度小于或等于 5° ,4例有小度数斜视但复视明显改善 ;手术并发症为 :肌肉缝线撕脱 2例 ,过矫3例 ,欠矫 4例 ;轻度眼睑退缩 5例。过矫 3例中 2例是由于术后手术肌肉缝线撕脱所致 ,经手术探查肌肉复位后眼位矫正满意。结论　甲状腺相关性免疫眼眶病眼外肌病变的手术治疗效果满意。To study the unique characteristics of surgical treatment of strabismus in patients with thyroid related immune orbitopathy. Methods Twenty patients of strabismus associated with thyroidrelated immune orbitopathy who were managed by strabismus surgery in our hospital from Jan 1, 1993 to Dec 31, 1999 were retrospectively analyzed 14 patients were male and 6 were female, with their age ranging from 28 to 67 years old (mean, 50 2 years). The strabismus surgery procedure included recession of inferior rectus muscle (12 muscles), superior rectus muscle (7 muscles) and medial rectus muscle (1 muscle); resection of inferior rectus muscle (4 muscles), superior rectus muscle (2 muscles) and lateral rectus muslce (1 muscle); and myectomy of superior rectus muscle (2 muscles). The patients were follow up for an average of 1 year. Results Normal ocular alignment was obtained in 9 patients with no diplopia after operation. 7 patients had an undercorrecton of equeal to or lessthan 5°, and 4 patients still had a small deviation but the diplopia was improved a lot. Surgical complications included the slippage of rectus muscles due to suture laceration (2 cases) which were corrected after reoperation, overcorrection (3 cases), undercorrection (4 cases) and eyelid retraction (5 cases). Among the three cases of overcorrections, two were caused by the slipped muscles. Conclusion The effect of surgical treatment of strabismus associated with thyroid related immune orbitopathy was remarkably good in our hands. Themost optimal time when surgery should be performed, the choice of procedure and some special attention in performing surgery were discussed in detail.

关 键 词：甲状腺相关性免疫眼眶病 眼外肌病变 眼外科手术 

分 类 号：R779.6[医药卫生—眼科]