Pražáková L, Rezek P
Cesk Slov Oftalmol. 2015 Sep;71(5):248-52.
To evaluate the results of surgical treatment of diplopia in patients with endocrine orbitopathy.
Retrospective evaluation of the results of patients with diplopia associated with endocrine orbitopathy operation at the Department of Ophthalmology in Kolin Hospital during the period 2008-2013. All the patients included in the study group were exposed to retroposition of inferior rectus and moreover, 11 of them underwent retroposition of medial rectus. Five patients were not taken into consideration at all during the statistical analysis because of other surgical operations of extraocular muscles, which were indispensable for proper removal of diplopia in primary gaze position.All the patients underwent overall eye and orthoptic examination as well as objectification of the eye movement disorder and diplopia by Hess test preoperatively and 1 month after surgery. Deviation of the eye with worse mobility was chosen for assessment. Subjective perception of the diplopia became another criterion.
There were 72 patients without diplopia in primary gaze position. In 4 patients correction with prismatic glasses (3 pdpt) was necessary for residual vertical deviation. Thirty six patients reached functional binocular vision half a year after surgery proved by ortoptic assessment. Compensatory head position disappeared in all patients in this group.
The treatment of endocrine orbitopathy should be complex. Proper indication and timing of the surgery is mandatory for the successful results.
评估内分泌性眼眶病患者复视的手术治疗效果。
回顾性评估2008年至2013年期间在科林医院眼科接受与内分泌性眼眶病相关复视手术患者的治疗结果。研究组所有患者均接受下直肌后徙术,其中11例还接受了内直肌后徙术。5例患者因眼外肌的其他手术在统计分析时未被纳入,这些手术对于在第一眼位正确消除复视是必不可少的。所有患者在术前及术后1个月均接受了全面的眼科和斜视检查,以及通过Hess试验对眼球运动障碍和复视进行客观化评估。选择活动度较差的眼的偏斜进行评估。复视的主观感受成为另一标准。
72例患者在第一眼位无复视。4例患者因残留垂直偏斜需要佩戴三棱镜(3棱镜度)进行矫正。36例患者术后半年经斜视评估证明达到功能性双眼视觉。该组所有患者的代偿头位均消失。
内分泌性眼眶病的治疗应是综合性的。手术的适当指征和时机对于取得成功的治疗效果至关重要。