Hou L J, Wu X M, Zhuo R, Zhang F, Lyu F
Department of Pediatric Ophthalmology, Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou 310020, China.
Zhonghua Yan Ke Za Zhi. 2016 Aug;52(8):568-73. doi: 10.3760/cma.j.issn.0412-4081.2016.08.003.
To evaluate the application of anterior segment optical coherence tomography (ASOCT) in surgical design for residual horizontal strabismus patients.
This article was a retrospective case series analysis. Total 20 residual strabismus patients (13 with residual exotropia and 7 with residual esotropia) in Eye Hospital of Wenzhou Medical University from Jan 2009 to Jan 2011 were studied. Routine strabismus examinations were completed preoperatively. The distance between insertion of horizontal rectus muscles and corneal limbus were measured with ASOCT preoperatively and calipers intraoperatively. Reoperational amount and method for residual strabismus patients were designed according to the limbus-insertion distance. The paired t test was used to compare the agreement between two methods of measurement of limbus-insertion distance. The cure rates of reoperation were analyzed.
No statistical significance was observed between the measurements with ASOCT (7.7±1.7) mm and calipers (7.8±1.1)mm (t=-1.37, P=0.19). According to ASOCT image, the second surgical method was re-recession muscle for 4 patients; re-recession of original performed muscle combined with antagonist muscle resection for 10 patients and antagonist muscle resection combined with horizontal rectus muscle recession in fellow eye for 6 patients. All the surgical processes went on successfully, no severe intraoperative and postopereative complications were noted. Sixteen cases were cured (80%) .
Horizontal rectus muscle evaluation with ASOCT preoperatively may benefit the choice of performed muscle, calculation of surgical amount, reduction of unnecessary surgical procedure and optimization second surgical design for residual strabismus patients. (Chin J Ophthalmol, 2016, 52: 568-573).
评估眼前节光学相干断层扫描（ASOCT）在残余水平斜视患者手术设计中的应用。
本文为回顾性病例系列分析。研究对象为2009年1月至2011年1月在温州医科大学附属眼视光医院的残余斜视患者（13例残余外斜视和7例残余内斜视）。术前完成常规斜视检查。术前用ASOCT测量水平直肌附着点与角膜缘的距离，术中用游标卡尺测量。根据角膜缘-附着点距离为残余斜视患者设计再次手术量和方法。采用配对t检验比较两种测量角膜缘-附着点距离方法的一致性。分析再次手术的治愈率。
ASOCT测量值（7.7±1.7）mm与游标卡尺测量值（7.8±1.1）mm之间无统计学差异（t=-1.37，P=0.19）。根据ASOCT图像，4例患者再次手术方法为再次后徙肌肉；10例患者为原手术肌肉再次后徙联合拮抗肌切除术；6例患者为拮抗肌切除术联合对侧眼水平直肌后徙术。所有手术过程均顺利进行，未观察到严重的术中及术后并发症。16例患者治愈（80%）。
术前用ASOCT评估水平直肌可能有助于残余斜视患者手术肌肉的选择、手术量的计算、减少不必要的手术步骤以及优化再次手术设计。（《中华眼科杂志》，2016，52：568-573）
