Lu Zhi-qing, Yan Jian-hua
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China.
Zhonghua Yan Ke Za Zhi. 2007 Nov;43(11):982-6.
To investigate the dose-effect relationship of strabismus surgery in patients with thyroid associated ophthalmopathy (TAO).
Thirty cases (32 eyes) with TAO treated with extraocular muscle surgery by the author seen between Jan 1999 and March 2006 in Zhongshan Ophthalmic Center, Sun Yat-sen University, China were reviewed retrospectively.
Out of the 30 cases (32 eyes), 19 cases were male and 11 were female, with their age ranging from 22 to 68 (mean 49.4 years). The right eye was involved in 11 cases and the left one in 21 cases. The extraocular muscle surgery included recession of inferior rectus muscle (10 muscles), recession of superior rectus muscle (10 muscles), recession of medial rectus muscle (6 muscles), recession of inferior rectus muscle combined with medial rectus muscle (2 eyes), recession of superior rectus muscle combined with medial rectus muscle (1 eye), tenotomy of superior rectus muscle (3 muscles). Thirty cases obtained excellent results, and the rate of ocular alignment was 93.75%. By calculating the dose-effect on 28 successfully corrected (<or= +/- 5 degrees) cases who were undergone recession, we found out that the deviation of (3.93 +/- 1.67) degrees on average can be corrected by one millimeter recession of rectus muscle surgery. The corrected amount in superior rectus muscle was minimum, which was (2.63 +/- 0.83) degrees /mm, and the maximum was in medial rectus muscle, which was (5.33 +/- 1.46) degrees /mm; the corrected amount in inferior rectus muscle was (4.11 +/- 1.55) degrees /mm. If the preoperative deviation was equal to or less than 15 degrees, the corrected amount on average was (2.30 +/- 1.09) degrees /mm; if the preoperative deviation was in the range of 16 degrees to 30 degrees , the corrected amount on average was (3.56 +/- 0.79) degrees /mm, and if the preoperative deviation was more than 30 degrees, the corrected amount on average was (6.02 +/- 1.01) degrees /mm.
The patients with strabismus in TAO whose corrected amount of deviation by one millimeter recession of rectus muscle on average was greater than that of patients with other kinds of strabismus. The larger the deviation, the more the corrected amount of one millimeter recession of rectus muscle. It was difficult to estimate the surgical effect on patients with strabismus in TAO before surgery.
探讨甲状腺相关眼病（TAO）患者斜视手术的剂量效应关系。
回顾性分析1999年1月至2006年3月在中山大学中山眼科中心由笔者施行眼外肌手术治疗的30例（32眼）TAO患者。
30例（32眼）中，男19例，女11例，年龄22～68岁（平均49.4岁）。右眼受累11例，左眼受累21例。眼外肌手术包括下直肌后徙术（10条肌肉）、上直肌后徙术（10条肌肉）、内直肌后徙术（6条肌肉）、下直肌联合内直肌后徙术（2眼）、上直肌联合内直肌后徙术（1眼）、上直肌断腱术（3条肌肉）。30例效果优良，眼位矫正率为93.75%。对28例成功矫正（≤±5度）且接受后徙术的病例计算剂量效应，发现直肌后徙1毫米平均可矫正（3.93±1.67）度的斜视度。上直肌的矫正量最小，为（2.63±0.83）度/毫米，最大的是内直肌，为（5.33±1.46）度/毫米；下直肌的矫正量为（4.11±1.55）度/毫米。若术前斜视度≤15度，平均矫正量为（2.30±1.09）度/毫米；若术前斜视度在16度至30度之间，平均矫正量为（3.56±0.79）度/毫米；若术前斜视度＞30度，平均矫正量为（6.02±1.01）度/毫米。
TAO斜视患者直肌后徙1毫米的平均斜视度矫正量大于其他类型斜视患者。斜视度越大，直肌后徙1毫米的矫正量越多。TAO斜视患者术前难以预估手术效果。
