婴儿型眼球震颤综合征的眼外肌手术临床效果评价  

Evaluation of the clinical efficacy of extraocular muscle surgery for infantile nystagmus syndrome

作　　者：李志刚[1] 王爽[1] 郎丽娟[1] 许丽敏[1] 荣军博[1] 张陆希 Li Zhigang;Wang Shuang;Lang Lijuan;Xu Limin;Rong Junbo;Zhang Luxi(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Henan Provencial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2020年第5期373-378,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：国家卫生健康委科学研究基金—河南省医学科技攻关计划省部共建项目(SB201901013);河南省基础与前沿技术研究计划项目(142300410235);河南省医学科技攻关计划项目(201403025)。

摘　　要：目的:评价眼外肌手术治疗婴儿型眼球震颤综合征的临床效果。方法:前瞻性研究。郑州大学第一附属医院2016年8月至2018年10月婴儿型眼球震颤综合征36例,根据代偿头位特点行眼外肌手术治疗。术后随访观察1年。结果:术前第一眼位状态下双眼视力(BCVA,logMAR)为0.707±0.0805,术后1年提高0.307±0.0873。手术前后各时间点BCVA比较差异有统计学意义(F=70.025,P=0.000)。其中34例伴有代偿头位者,以水平方向面朝右或朝左者30例,术前头位扭转角为24.020°±2.5735°,术后1年改善为7.510°±0.5013°,手术前后各时间点头位扭转角相比,差异有统计学意义(F=258.574,P=0.000)。以垂直方向下颌内收或上抬者4例,术前头位扭转角度为18.000°±1.3191°,术后1年改善为6.050°±0.4796°。手术前后各时间点头位扭转角度相比,差异有统计学意义(F=237.911,P=0.000)。术后1年,34例(94.44%)视物清晰度改善,主观满意度增加。结论:根据婴儿型眼球震颤综合征的临床特征针对性实施眼外肌手术,可提高视力、改善头位,增加满意度。Objective To evaluate the clinical efficacy of extraocular muscle surgery for infantile nystagmus syndrome(INS).Methods This was a prospective study.Total of 36 cases with INS accepted extraocular muscle surgery from Aug.2016 to Oct.2018 in the First Affiliated Hospital of Zhengzhou University based on the feature of abnormal head postures degree(AHD).The patients were followed up and observed for 1 year after operation.Results BCVA(logMAR)of 36 cases at 1 year after surgery improved from 0.707±0.0805 preoperatively to 0.307±0.0873 in primary position.The difference was statistically significant between before and after surgery(F=70.025,P=0.000).There were 34 cases with AHD,30 cases were hortzontally facing right or left.The position of null zone improved from 24.020°±2.5735°preoperatively to 7.510°±0.5013°at 1 year after surgery.The difference was statistically significant between before and after surgery(F=258.574,P=0.000).And the rest 4 cases with AHD were chinned up or down in vertical direction.The position of null zone improved from 18.000°±1.3191°preoperatively to 6.050°±0.4796°.The difference was statistically significant between before and after surgery at 1 year after surgery(F=237.911,P=0.000).The subjective satisfaction improved in 34 cases(94.44%)with self-descriptive visual clarity enhancement.Conclusion The extraocular muscle surgery based on the clinical characteristics of INS can improve BCBVA,AHD,and subjective satisfaction.

关 键 词：综合征 眼球震颤 婴儿型 手术 眼外肌 头位 代偿 满意度 

分 类 号：R779.6[医药卫生—眼科]