甲状腺相关眼病眼眶减压术的疗效分析

The outcome of orbital decompression for thyroid associated ophthalmopathy

目的 探讨眼眶减压术在甲状腺相关眼病中治疗的价值。方法 回顾性分析中山眼科中心 1993～ 2 0 0 0年 2 7例 (30只眼 )经全身和眼部临床检查 (视力、视野或视觉诱发电位等 )确诊为甲状腺相关眼病患者采用眼眶减压术 (一壁、二壁及三壁减压 )治疗的临床资料 ,观察其手术前和手术后患者视力、眼球突出度及眼球运动的变化。术后随访 2个月至 7年 ,平均 13 7个月。结果 视力 :19只眼 (6 3 3% )明显提高 ;4只眼 (13 3% )轻度提高 ,视力均保持在 0 2～ 0 8;4只眼 (13 3% )视力无变化 ,其中 3只眼 (10 0 % )视力下降。 2 4只眼 (80 0 % )眼球突出后退≥ 3 0mm ,2 8只眼 (93 3% )眼球突出后退≥ 2 0mm ,平均眼球突出后退 3 6mm。结论 眼眶减压术可提高甲状腺相关眼病患者的视力 。

Objective To evaluate the therapeutic results of orbital decompression for severe thyroid orbitopathy Methods The records of 27 patients (30 eyes) having undergone orbital decompression of one wall, two walls and three walls for severe thyroid orbitopathy were analyzed for changes in visual acuity, visual field or pattern visual evoked potential, movement and reduction in proptosis The indications were corneal exposure, severe proptosis and optic neuropathy Results After surgery, the patients were followed up for a mean of 13 7 months The visual acuity improved obviously in 19 eyes (63 3%), visual acuity was improved slightly in 4 eyes (13 3%), visual acuity kept in 0 2-0 8 (no change) in 4 cases (13 3%), visual acuity deteriorated obviously and not recovered in 3 eyes (10 0%) Proptosis was decreased by a mean of 3 6 mm (range 1-7 mm), the decrease ≥2 0 mm being in 93 3% eyes Conclusion Orbital decompression is effective in improving vision in most patients with severe thyroid associated ophthalmopathy, and the proptosis can be effectively improved