Ohtsuka K, Nakamura Y
Department of Ophthalmology, Sapporo Medical University School of Medicine, Hokkaido, Japan.
Jpn J Ophthalmol. 1999 Sep-Oct;43(5):426-32. doi: 10.1016/s0021-5155(99)00091-x.
To study the effects of ethmoidal wall (one-wall) decompression using a transmedial-canthal approach (transmedial-canthal ethmoidectomy) for the treatment of dysthyroid optic neuropathy.
The ethmoidal wall and air cells were completely removed using a transmedial-canthal approach in 6 eyes of 4 patients (mean age = 55 years; age range, 46-69 years) with dysthyroid optic neuropathy. Similar surgery was performed on 2 contralateral eyes in 2 of the patients for cosmetic reasons. The preoperative corrected visual acuity in the 6 eyes ranged from hand motion to 20/100. Centrocecal scotomas were detected using automatic static threshold perimetry in the 6 eyes.
After transmedial-canthal ethmoidectomy, the corrected visual acuity improved to better than 20/20 in the 6 eyes, and the centrocecal scotomas had almost completely resolved. There were no major complications, such as cerebrospinal fluid leakage or diplopia associated with the surgery. There were no relapses during an average follow-up period of 29 months.
These findings suggest that transmedial-canthal ethmoidectomy is an effective and safe therapy for dysthyroid optic neuropathy.
研究经内眦入路（经内眦筛窦切除术）行筛骨壁（单壁）减压治疗甲状腺相关眼病性视神经病变的效果。
对4例（平均年龄55岁；年龄范围46 - 69岁）甲状腺相关眼病性视神经病变患者的6只眼采用经内眦入路完全切除筛骨壁及气房。其中2例患者的另外2只对侧眼因美容原因进行了类似手术。这6只眼术前矫正视力从手动到20/100不等。使用自动静态阈值视野计在这6只眼中检测到中心暗点。
经内眦筛窦切除术后，这6只眼的矫正视力提高到优于20/20，中心暗点几乎完全消失。手术未出现脑脊液漏或复视等严重并发症。平均随访29个月期间无复发。
这些结果表明经内眦筛窦切除术是治疗甲状腺相关眼病性视神经病变的一种有效且安全的方法。
