先天性和共同性斜视眼外肌病理变化的比较

Comparative study on pathological changes of extraocular muscles in congenital and concomitant strabismus

目的观察先天性斜视、共同性斜视眼外肌的病理变化,探讨共同性斜视、先天性斜视等肌源性病变特点。方法对50例先天性斜视及共同性斜视患者行斜视矫正术,将截除的眼外肌标本及选取的2例正常眼外肌标本制作石蜡切片,行HE染色并置于光镜下观察眼外肌的病理特点。结果正常眼外肌标本未见纤维组织增生;先天性内、外斜视眼外肌标本显示出不同程度的眼外肌纤维化、玻璃样变及肌纤维变性、结构消失等改变,以先天性内斜视改变较为显著。共同性内、外斜视可见肌纤维体积减小、数量减少,排列紊乱,发病较早、手术年龄大的共同性斜视患者多可见肌肉部分萎缩、肌纤维间隙增宽,胶原含量增多等改变。结论先天性斜视会引起眼外肌纤维化等的改变,而共同性斜视也会出现轻度眼外肌病理性改变。

Objective To observe the pathological changes of extraocular muscles in congenital and concomitant strabismus by light microscope,and investigate their muscle source pathological changes.Methods Fifty cases of congenital and concomitant strabismus patients were conducted corrected surgery for strabismus.The extraocular muscles which were resected during surgery were made into paraffin section and observed the pathological features by HE staining under light microscope.Results The extraocular muscles of both congenital and concomitant strabismus displayed alterations such as fibrosis,hyaline degeneration,muscle fibers denaturation and disappearance of the structure with vary degrees,especially in congenital esotropia.Reduction in volumes and quantities,and disarrangement were customarily seen in extraocular muscles of concomitant esotropia and exotropia.Muscular atrophy,widen of space between muscles and increase of collagen fibers were found in concomitant patients with early age of onset or operation at elder age.Conclusion Some fibrosis in extraocular muscles appears in congenital strabismus,whereas concomitant strabismus also exhibits slightly pathological changes.