不同斜视矫正术后角膜形态及屈光状态的临床观察  

Clinical Observation of Corneal Morphology and Refractive Status after Different Correction of Strabismus

作　　者：徐琰瑛 欧阳君[1] WU Yanying;OUYANG Jun(Ophthalmology Department,Jiujiang First People's Hospital,Jiujiang 332000,China)

机构地区：[1]九江市第一人民医院眼科,江西九江332000

出　　处：《中国医药指南》2023年第22期14-17,共4页Guide of China Medicine

基　　金：江西省卫生健康委科技计划项目(SKJP220201554);江西省重点研发计划项目(S2020ZPYFB1809)。

摘　　要：目的 评价不同斜视矫正手术对角膜形态及屈光状态的影响。方法 对2019-2022年于我院行斜视矫正手术患者进行前瞻性研究。选取斜视矫正手术患者84例159眼,按斜视类型分为3组:共同性外斜组(52例,97眼)行外直肌后徙术,外斜V征组(19例,38眼)行外直肌后徙及下斜肌减弱术,共同性内斜组(13例,24眼)行内直肌后徙术。观察斜视患者术前1天、术后1天、术后1周以及术后1个月角膜顶点3 mm、5 mm、7 mm范围角膜曲率值,采用SPSS 23.0版本软件进行统计分析。排除不能定期复查的患者及有眼科手术史的患者。所有手术均由同一位眼科医师在插管全身麻醉下进行治疗。结果 共同性外斜组,角膜顶点3 mm范围内,术后1 d角膜曲率K1较术前有显著差异(P <0.05),术后1周、术后1个月K1较术前均无明显差异(P> 0.05),角膜顶点5 mm、7 mm范围内,术后K1较术前均无显著差异(P> 0.05),角膜顶点3 mm、5 mm、7 mm范围内,术后角膜曲率K2较术前均无明显差异(P> 0.05)。外斜组,角膜顶点3 mm、5 mm、7 mm范围内,术后K1较术前均无显著差异(P> 0.05),角膜顶点3mm、5mm、7mm范围内,术后K2较术前均无显著差异(P> 0.05)。共同性内斜组,角膜顶点3 mm、5 mm、7 mm范围内,术后1天、术后1周K1较术前均无显著差异(P> 0.05),术后1个月K1较术前有显著差异(P <0.05),角膜顶点3 mm、5 mm、7 mm范围内,术后K2较术前均无明显差异(P> 0.05)。结论 共同性外斜患者手术后角膜曲率的变化是短暂的,外斜V征患者手术后角膜曲率无明显变化,共同性内斜患者手术后角膜曲率的在术后1个月有改变。Objective To evaluate the effect of strabismus correction operation on corneal morphology and refractive state.Methods A prospective study was conducted on patients who underwent corrective strabismus surgery in our hospital from 2019 to 2022.A total of 84 patients with 159 eyes were divided into three groups according to the type of strabismus:concomitant exotropia group(52 cases,97 eyes)underwent external rectus muscle retromigration;external oblique V sign group(19 cases,38 eyes)underwent inferior oblique muscle reduction;concomitant extropia group(13 cases,24 eyes)underwent internal rectus muscle retromigration.Corneal curvature values in the range of 3 mm,5 mm and 7 mm at corneal apex were observed 1 day before surgery,1 day after surgery,1 week after surgery and 1 month after surgery.SPSS 23.0 software was used for statistical analysis.Patients who could not be regularly reviewed and patients with a history of ophthalmic surgery were excluded.All surgeries were performed by the same ophthalmologist under intubated general anesthesia.Results In concomitant external group,K1 within 3mm of corneal apex 1 day after operation was significantly different from that before operation(P<0.05),K1 within 1 week and 1 month after operation was not significantly different from that before operation(P>0.05),K1 within 5mm and 7 mm of corneal apex after operation was not significantly different from that before operation(P>0.05).There was no significant difference in K2 within 3mm,5mm and 7mm of corneal apex(P>0.05).In the external oblique V sign group,there was no significant difference in K1 and K2 within 3 mm,5 mm,and 7 mm of corneal apex(P>0.05),and there was no significant difference in K2 within 3 mm,5 mm,and 7 mm of corneal apex(P>0.05).In concomitant endoclinal group,there was no significant difference in K1 within 3 mm,5 mm,and 7 mm of corneal apex at 1 day and 1 week after operation(P>0.05),and there was no significant difference in K1 at 1 month after operation(P<0.05).There was no significant difference in K2 wi

关 键 词：斜视 角膜形态 角膜曲率 屈光状态 

分 类 号：R777.41[医药卫生—眼科]