摘要
目的探讨后巩膜加固联合斜视矫正术治疗病理性近视合并斜视的可行性和效果。方法回顾性系列病例研究。2005年3月至2009年8月来温州医学院附属眼视光医院就诊的病理性近视合并斜视患者共33例，男14例，女19例，其中31例为外斜视，2例为内斜视，所有患者斜视度〉15。。53只病理性近视眼的屈光度为-8．00--30．00D，矫正视力均低于4．9。根据年龄将患者分为一组（5—18岁）、二组（19～35岁）和三组（36岁以上），并进行效果观察。对这33例患者施行改良的Snyder-Thompson的单条带式后巩膜加固联合斜视矫正术。手术前后的视力和眼轴数据的比较采用配对t检验。结果随访观察1—5．3年，后巩膜加固术的53眼术后视力都保持或好于术前。除一组眼轴稍有增长外0—2．56，P〈0．05），二组和三组眼轴与术前比较差异无统计学意义。术后1年随访，光学相干断层扫描（OCT）示，2眼黄斑出血消褪，3眼视网膜劈裂的劈裂腔消失，2眼视网膜劈裂腔缩短。有4例患者的残余斜视度约为10°，29例患者残余斜视度小于5°，33例患者都对外观改善程度满意。结论后巩膜加固联合斜视矫正术能同时达到控制病理性近视进展和改善外观的目的，减少分次手术的黏连反应和操作难度，减轻患者痛苦和经济负担，手术可行，效果满意。
Objective To investigate the effectiveness of posterior scleral reinforcement （PSR） combined with strabismus surgery for treating pathological myopia and strabismus. Methods In this case-series study, 33 patients with pathological myopia and strabismus were treated between March 2005 and August 2009 in Eye Hospital of Wenzhou Medical College. Patients ranged in age from 5 to 65 years old. In all cases, the angle of strabismus was greater than 15°; 31 patients were exotropic and 2 were esotropic. Pathological myopia ranged from -8.00 to -30.00 D. All corrected visual acuity was less than 4.9. The patients were divided into 3 groups by age. The modified Snyder-Thompson PSR and strabismus surgery were performed on the 33 patients. Data were analyzed with a paired t test. Results After 1 to 5.3 years of follow-up, only the children＇s group showed a statistically significant change in the eyes length （t=-2.56, P=0.025）. When eyes were rechecked with optical coherence tomography, the macular hemorrhage in 2 eyes had faded, the retina foveoschisis in 3 eyes had disappeared and 2 eyes had became shorter. The residual strabismus of 4 patients was 10°; the residual strabismus in the other patients was less than 5°. All patients were satisfied with the improvement in the eyes＇ appearance. Conclusion PSR combined with strabismus surgery can prevent or delay the progress of myopia, improve the eyes＇ appearance, and reduce the pain that would result if each operation were done separately. The combined surgery also reduces adherence restrictions and the difficulty of the operation for doctors. PSR combined with strabismus surgery is feasible and safe.
出处
《中华眼视光学与视觉科学杂志》
CAS
2012年第9期561-565,共5页
Chinese Journal Of Optometry Ophthalmology And Visual Science
关键词
近视
退行性
斜视
外科手术
后巩膜加固术
Myopia, degenerative
Strabismus
Surgical procedures,operative
Posterior scleral reinforcement
作者简介
通信作者：薛安全，Email：safesnow88@yahoo．com．cn
