巩膜扣带术后的眼外肌失衡

Extraocular muscle imbalance after scleral buckling surgery.

作者信息

Smiddy W E, Loupe D, Michels R G, Enger C, Glaser B M, deBustros S

机构信息

Vitreoretinal Surgery Service, Johns Hopkins University, Baltimore, MD.

出版信息

Ophthalmology. 1989 Oct;96(10):1485-9; discussion 1489-90. doi: 10.1016/s0161-6420(89)32701-1.

DOI:10.1016/s0161-6420(89)32701-1

PMID:2587043

Abstract

Pneumatic retinopexy is advocated to treat some retinal detachment cases, in part to avoid the complication of induced strabismus sometimes associated with scleral buckling procedures (SBPs). Prospective evaluation of postoperative muscle imbalance was performed in 76 eyes of 69 patients undergoing SBP. Measureable limitation of ductions occurred in 40 (73%) of the 55 eyes for which a full set of duction measurements could be obtained. Among 53 patients without previous retinal surgery in either eye, postoperative deviations were associated with encircling scleral buckles (P = 0.00003), but not with radial scleral buckles (P = 0.6). Significant strabismus occurred in 12 patients (23%), and three required surgery or prism therapy. Candidates for pneumatic retinopexy can usually be treated by a radial scleral buckling procedure, and therefore the risk of postoperative strabismus is low if this technique is selected.

摘要

有人主张采用气体视网膜固定术治疗某些视网膜脱离病例，部分原因是为了避免有时与巩膜扣带术（SBPs）相关的诱导性斜视并发症。对69例行巩膜扣带术患者的76只眼进行了术后肌肉失衡的前瞻性评估。在55只能够获得全套转位测量值的眼中，有40只（73%）出现了可测量的转位受限。在53例双眼均未接受过视网膜手术的患者中，术后斜视与环形巩膜扣带有关（P = 0.00003），但与放射状巩膜扣带无关（P = 0.6）。12例患者（23%）出现明显斜视，其中3例需要手术或棱镜治疗。气体视网膜固定术的适用患者通常可采用放射状巩膜扣带术治疗，因此，如果选择该技术，术后斜视的风险较低。