Jaycock P D, Mather C M, Ferris J D, Kirkpatrick J N
Department of Ophthalmology, Cheltenham General Hospital, UK.
Eye (Lond). 2001 Oct;15(Pt 5):583-6. doi: 10.1038/eye.2001.189.
To describe three cases of rectus muscle trauma in patients undergoing phacoemulsification cataract extraction and intraocular lens implantation under sub-Tenon's local anaesthesia via the inferonasal quadrant.
Retrospective review was carried out of 3 cases from 1080 patients who underwent phacoemulsification cataract extraction and intraocular lens implantation under sub-Tenon's local anaesthesia in our unit over a 3 year period up to April 2000.
Two patients complained postoperatively of vertical diplopia and were shown to have restriction of elevation of the eye, which was found at surgical exploration to be due to inferior rectus muscle restriction. One patient had post-operative horizontal diplopia due restriction of abduction and exploration of the medial rectus muscle was planned.
Rectus muscle trauma is proposed as a complication of sub-Tenon's local anaesthesia and caution is advised to operators to clearly identify the sub-Tenon's space for injection of local anaesthetic.
描述三例在经鼻下象限行球后局部麻醉下进行超声乳化白内障摘除及人工晶状体植入术的患者发生直肌损伤的情况。
回顾性分析了我院在2000年4月前的3年时间里，1080例行球后局部麻醉下超声乳化白内障摘除及人工晶状体植入术患者中的3例。
两名患者术后主诉垂直复视，检查发现眼球上抬受限，手术探查发现是由于下直肌受限所致。一名患者术后因外展受限出现水平复视，计划对内直肌进行探查。
直肌损伤被认为是球后局部麻醉的一种并发症，建议手术者在注射局部麻醉药时要谨慎，明确球后间隙的位置。
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