视网膜脱离手术后斜视特征与手术疗效

The characteristics and curative effects of strabismus following retinal detachment surgery

目的 探讨视网膜脱离手术后斜视的临床特征和治疗效果。方法 对 2 4例 (2 8只眼 )视网膜脱离术后斜视患者 ,应用三棱镜加交替遮盖或三棱镜映光法 (Krimsky法 )测定客观斜视角 ,并进行眼球运动及复视像检查 ;观察斜视手术患者同时行取巩膜环扎带或局部外加压物及 (或 )人工晶状体植入手术的治疗效果。术后随访 1～ 2 4个月。结果 (1) 16例 (19只眼 )孔源性视网膜脱离术后患者斜视的性质与巩膜外加压物的位置有关。 (2 )斜视术后复视消失 9例 ,改善 12例 ;眼位正位 14例 ,改善 7例。结论 (1)视网膜脱离手术后斜视属于限制性斜视 ,临床特征与麻痹性斜视不同 ;(2 )斜视手术可改善复视症状 ,矫正眼位。

Objective To describe the clinical characteristics and evaluate the surgical results in strabismus eyes which all had undergone retinal detachment surgery. Methods This study covered 24 strabismus cases (28 eyes) following retinal detachment operations. For these, examinations involving prism with alternative cover test or Krimsky test, eyeball movement, and diplopia analysis were performed. Strabotomy was carried out combined with or without scleral buckling removal or secondary intraocular lens implantation. The post-operative follow-up period ranged from 1 month to 24 months. Results (1) The main clinical feature in 16 strabismus cases (19 eyes) having managed by rhegmatogenous retinal detachment surgery was that the character of strabismus was related to the location of scleral explants. (2) Diplopia completely disappeared in 40.9% and partly disappeared in 54.5% of the cases. Strabismus was completely corrected in 63.6% of 27 eyes and partly corrected in 31.8% of them. Conclusions (1) The strabismus following retinal detachment surgery is a restrictive strabismus, the clinical characterastics of which are different from that of palsy strabismus. (2) Strabotomy is effective in the treatment of restrictive strabismus.