眼眶减压术治疗甲状腺相关性眼病的研究进展

Research progress of orbital decompression for the treatment of thyroid-associated ophthalmopathy

甲状腺相关性眼病(TAO)是严重损害视功能和颅面外形的自身免疫性眼眶病。当疾病发展造成压迫性视神经病变或角膜暴露而保守治疗无效时,需通过眼眶减压术来抢救视力。随着手术方式的改进和手术切口的优化,为恢复眼部美观而行眼眶减压手术的患者也逐年增多。如何在最小的创伤下,用最精确和安全的方式来获得有效眼眶减压,是现代眼眶外科的一个新命题。近年来,眼眶梯度减压手术方案的提出,数字化眼眶外科技术的开发,内窥镜和计算机导航等手术辅助设备的应用,实现了减压范围的个体化精确设计、术中精准微创减压和术后客观评估,显著提高了眼眶减压手术在TAO中的治疗价值。

Thyroid-associated ophthalmopathy(TAO) is an autoimmune orbital disease which seriously damages visual function and craniofacial appearance.When TAO develops to compressive optic neuropathy or corneal exposure and is unable to be conservatively treated,orbital decompression surgery is the only way to save sight.With the advancement of surgical incision and procedures,more and more patients have undergone orbital decompression surgery to reconstruct craniofacial appearance.How to achieve effective orbital decompression in a most precise and safest way with minimal invasion has become a research hotspot of modern orbital surgery.Recently,with the proposition of orbital gradient decompression scheme,the development of digital orbital surgery technology,and the application of assistant devices such as endoscopes and computer navigation systems,precise customized pre-operative design for decompression range,precise intra-operative decompression with minimal invasion,and objective postoperative assessment have been achieved,which significantly improve the value of orbital decompression surgery in the treatment of TAO.