显微镜下改良“十字”Parks切口斜视手术临床观察

Clinical observation of strabismus surgery with modified“cross”Parks incision under microscope

目的探讨显微镜下改良“十字”Parks切口斜视手术的优点与应用价值。方法选取2016年1月至2021年12月嘉兴市中医医院眼科收治的98例斜视手术患者,采用随机数字表法分为对照组(n=49)和观察组(n=49),对照组采用角膜梯形切口,观察组采用显微镜下改良“十字”Parks切口。对两组手术前后泪膜破裂时间(break-up time,BUT)、泪液分泌量、角膜荧光素钠染色(cotneal fluorescein staining,CFS)评分、舒适度指标、斜视角度及术后并发症发生情况等进行观察和分析。结果术后1d、1周、1个月时,对照组CFS均显著高于观察组(P<0.05)。术后1d、1周时,对照组泪液分泌量、BUT、舒适度评分均高于观察组(P<0.05);术后1个月时,两组泪液分泌量、BUT、舒适度评分比较,差异无统计学意义(P>0.05)。两组术后治愈率比较,差异无统计学意义(P>0.05),对照组出现1例术后并发症,观察组无并发症情况发生。结论显微镜下改良“十字”Parks切口斜视手术可保护泪膜稳定性,提高患者术后舒适度,同时减少术后并发症,疗效确切,值得临床普及应用。

Objective To investigate the advantages and value of microscopic strabismus surgery with a modified“cross”Parks incision.Methods A total of 98 strabismus surgery patients admitted to the ophthalmology department of Jiaxing Traditional Chinese Medicine Hospital from January 2016 to December 2021 were selected and divided into a control group(n=49)and an observation group(n=49)according to the random number table method,with the control group using a corneal trapezoidal incision and the observation group using a modified“cross”Parks incision under the microscope.The tear film break-up time(BUT),tear secretion,corneal fluorescein staining(CFS),comfort index,strabismus angle and post-operative complications were observed and analyzed before and after surgery in both groups.Results At 1 day,1 week and 1 month postoperatively,CFS was significantly higher in the control group than that in the observation group(P<0.05).At 1 day and 1 week postoperatively,tear secretion,BUT and comfort scores were higher in the control group than those in the observation group(P<0.05);at 1 month postoperatively,there was no statistically significant difference between the two groups in terms of tear secretion,BUT and comfort scores(P>0.05).There was no statistically significant difference between the two groups in terms of postoperative cure rate(P>0.05),and there was one postoperative complication in the control group and no complication in the observation group.Conclusion Microscopic strabismus surgery with a modified“cross”Parks incision can protect the stability of the tear film,improve postoperative comfort and reduce postoperative complications.The efficacy of the treatment is definite and worthy of popular clinical application.