使用表面麻醉对Graves病患者实施眼肌手术  

Muscle surgery in patients with Graves’dis-ease using topical anesthesia

作　　者：侯慧媛 Kalpadakis P Rudolph G Mueller A Boergen K.-P 

机构地区：[1]University Eye Hospita l,Ludwig -Maximilians-University,M unich,Germany.Dr.

出　　处：《世界核心医学期刊文摘（眼科学分册）》2005年第1期57-57,共1页Digest of the World Core Medical Journals:Ophthalmology

摘　　要：Purpose To report our experience in e xtraocular muscle surgery for Graves’disease using topical anesthesia.D e-sign Retrospective,noncomparativ e,observational case series.Participants In 135patient s with Graves’disease,a total of 200ocular muscles were operated during the past20years at the Department of Ophthalmology,Lud-wig-Maximilian-University,Munic h,Germany.Methods Surgery was performed under topical anesthesia with tetra-caine hydrochloride 1%eyedrops.Be cause of the restric-tive nature of the motility impairme nt,recession of the muscles was used in all patients.The exact amount of re-cession was determined during the op eration with active cooperation from the patient.Main o utcome measures Binocular single vision and the angle of deviation were e-valuated preoperatively and postop eratively.Results Post-operative binocular single vision i n the primary position was achieved by 78.7%of the patients on t he first postopera-tive day.Subsequent evaluation dem onstrated binocular single vision in 91.9%of all patient s and in 96.4%of the group with only 1muscle(inferior rectus)operated.Con-clusions The authors have demonstra ted that topical anes-thesia is a feasible and reliable method for performing ex-traocular muscle surgery in patient s with Graves’disease.Intraoperative patient discomfort seemed insignificant,and the active cooperation of the patien t in finding the appro-priate extent of surgery was advanta geous.The overall re-sults showed that deviation surgery with the use of topical anesthesia is highly successful in r estoring binocular single vision in patients with endocrine orbitopathy.Purpose To report our experience in e xtraocular muscle surgery for Graves’disease using topical anesthesia.D e-sign Retrospective,noncomparativ e,observational case series.Participants In 135patient s with Graves’disease,a total of 200ocular muscles were operated during the past20years at the Department of Ophthalmology,Lud-wig-Maximilian-University,Munic h,Germany.Methods Surgery was performed under topical anesthesia with tetra-caine hydrochloride 1%eyedrops.Be cause of the restric-tive nature of the motility impairme nt,recession of the muscles was used in all patients.The exact amount of re-cession was determined during the op eration with active cooperation from the patient.Main o utcome measures Binocular single vision and the angle of deviation were e-valuated preoperatively and postop eratively.Results Post-operative binocular single vision i n the primary position was achieved by 78.7%of the patients on t he first postopera-tive day.Subsequent evaluation dem onstrated binocular single vision in 91.9%of all patient s and in 96.4%of the group with only 1muscle(inferior rectus)operated.Con-clusions The authors have demonstra ted that topical anes-thesia is a feasible and reliable method for performing ex-traocular muscle surgery in patient s with Graves’disease.Intraoperative patient discomfort seemed insignificant,and the active cooperation of the patien t in finding the appro-priate extent of surgery was advanta geous.The overall re-sults showed that deviation surgery with the use of topical anesthesia is highly successful in r estoring binocular single vision in patients with endocrine orbitopathy.

关 键 词：表面麻醉 GRAVES病 双眼单视 眼球活动 下直肌 单眼视力 盐酸丁卡因 滴眼剂 偏差角 眼眶病 

分 类 号：R614[医药卫生—麻醉学]