改良的可活动结膜瓣在调整缝线斜视术的临床应用

The use of reformative astir conjunctival flap in adjustable strabismus surgery

目的观察改良的可活动结膜瓣在调整缝线治疗斜视的临床效果。方法对26例共同性水平斜视进行调整缝线术,其中共同性外斜视18例,共同性内斜视8例;初次手术者24例,二次手术者2例。在准备后徙的肌肉上进行常规调整缝线术,在缝合梯形结膜瓣时将下边的结膜瓣进行松弛打结(2个线结),以便于调整缝线;术后第一天调整缝线时掀开结膜瓣进行调整,调整后结扎结膜缝线。结果术后第1天20例正位,6例欠矫/过矫,经过调整获得正位。术后1周拆除结膜缝线,切口愈合良好;所有患者未出现结膜刺激症状。随访3～6个月全部保持正位。结论应用改良的可活动结膜瓣调整缝线治疗斜视可以避免球结膜的不良愈合、减少患者的刺激症状。

Objective To determine the effect of reformative astir conjunctival flap in adjustable strabismus surgery, Methods Twenty -six cases with concomitant horizontal strabismus were operated with adjustable strabismus surgery. 18 cases with concomitant esotropia,8 cases with concomitant exotropia. The adjustable suture was performed in the recession muscle, The lower side of the trapezia conjunctival flap was slack for easy to adjustment （2 suture）, When the adjustment was performed in the first day of postoperation the conjunctival flap was removed. After the adjustment, the conjunctival flap was ligated. Results In the first day after operation,20 cases were orthophoria and 6 cases were under/over correction, they were adjusted until orthophofia. The sutures were removed 1 week after operation, The concrescence of the incision was very good. None complain of discomfort. The follow up was 6 to 8 months, all cases were orthophoria. Conclusions Using reformative astir conjunctival flap in adjustable strabismus surgery is propitious to recover after operation,as it can avoid the stimulus of knot and the more exposure of sclera.