Kim Seung-Hyun, Rotberg Leemor, Sprunger Derek T
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana.
Binocul Vis Strabismus Q. 2009;24(2):86-92.
Techniques for the surgical treatment of thyroid related strabismus vary and include non-adjustable (standard), [postop'] adjustable suture, and a newer procedure aimed at correcting restriction rather than using dose/response tables.This study reports the results utilizing standard strabismus procedures for the treatment of thyroid ophthalmopathy.
Charts of 31 consecutive patients who underwent surgery in the pst 5 years for restrictive strabismus secondary to thyroid ophthalmopathy were retrospectively reviewed. All surgery was performed by recession and reattachment of the muscle to the globe, allowing for no postoperative adjustment. Standard doses were used for all primary surgery and slightly modified in some cases of reoperation, but the general principal was from a standard published nomogram.
All 31 patients had preoperative diplopia and restricted motility. 22 patients wore prisms prior to surgery. Of the 31 patients who underwent surgery 9 required a second operation. After reoperation 5 patients (16%) continued to have diplopia. However, 4 of these patients were able to achieve single binocular vision with a small amount of prism. Only 2 patients were unable to achieve single binocular vision with or without prism. 22 patients (71%) had full ocular motility after surgery. After one surgery, 25 of 31 patients (81%) were satisfied with the results of surgery. This increased to 29 patients (94%) after reoperation.
The results of this study indicated that strabismus surgery for restrictive thyroid ophthalmopathy using standard technique and table amounts of surgery can provide excellent results and patient satisfaction.
甲状腺相关斜视的手术治疗技术各不相同，包括不可调节（标准）、[术后]可调节缝线，以及一种旨在纠正限制而非使用剂量/反应表的新方法。本研究报告了使用标准斜视手术治疗甲状腺眼病的结果。
回顾性分析了过去5年中连续31例因甲状腺眼病继发限制性斜视而接受手术的患者的病历。所有手术均通过将肌肉后退并重新附着于眼球进行，术后不进行调整。所有初次手术均使用标准剂量，在某些再次手术的病例中略有调整，但总体原则来自已发表的标准图表。
所有31例患者术前均有复视和眼球运动受限。22例患者术前佩戴棱镜。在接受手术的31例患者中，9例需要再次手术。再次手术后，5例患者（16%）仍有复视。然而，这些患者中有4例通过少量棱镜能够获得双眼单视。只有2例患者无论是否使用棱镜都无法获得双眼单视。22例患者（71%）术后眼球运动完全恢复。一次手术后，31例患者中有25例（81%）对手术结果满意。再次手术后，这一比例增至29例患者（94%）。
本研究结果表明，使用标准技术和标准手术量对限制性甲状腺眼病进行斜视手术可取得良好效果并提高患者满意度。
