白内障术后复视及上睑下垂的相关因素分析

Analysis of diplopia and ptosis after cataract extraction

目的 :探讨白内障术后复视及上睑下垂的机制。方法 :对 8例白内障术后复视及上睑下垂患者进行病史查阅 ,眼球运动检查 ,复视像检查及上睑运动功能检查 ,并对相关因素进行分析。结果 :所有病例均为球后或球旁麻醉、开睑器开睑引起 ,而与上直肌牵引缝线、结膜下注射无关。结论

Objective:To determine the factors causing diplopia and ptosis after cataract extraction.Method:8 patients with cataract (8 eyes) developed diplopia (6 eyes) and ptosis (2 eyes) at first postoperative day.Their surgical histories were reviewed and ophthalmic examinations including eye movements,prism covering tests and movement of upper lid were done.Results:In the 6 eyes with diplopia,there was paralysis of lower rectus in all the 6 eyes,and paralysis of elevator muscle in the 2 eyes with ptosis of upper lid.All patients were operated with peribulbar or retrobalbar anesthesia and a lid speculum was used.Bridle suture was used in 6 eyes and antibiotic or cortico steroid not injected.All patients were followed up for 1～3 months.6 patients recovered spontaneously within 1 month postoperatively,while 2 patients recovered within 3 months postoperatively after medical treatment.Conclusion:Diplopia and ptosis after cataract extraction may be caused by a myotoxic effect of the local anesthetic.