Guo J, Qian J, Li X F, Meng F X, Ma R Q
Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Myopia Key Laboratory of Health Ministry, Shanghai 200031, China.
Zhonghua Yan Ke Za Zhi. 2017 Jun 11;53(6):424-429. doi: 10.3760/cma.j.issn.0412-4081.2017.06.006.
To analyze the change of globe position after different orbital decompression in thyroid-associated ophthalmopathy (TAO). It was a retrosective case series study. Twenty-nine TAO patients (33 eyes) underwent orbital decompression were collected between October 2014 and December 2016 at Eye & ENT Hospital of Fudan University. There were 17 males and 12 females, and the average age was 46 years (ranging from 21 to 66 years). Fifteen patients (17 eyes) underwent balanced decompression, 11 patients (11 eyes) underwent deep lateral decompression, and 4 patients (5 eyes) underwent medial decompression. CT scan was performed pre and postoperatively for each patient and a reference coordinate system was established on the three-dimensional reconstructed image. The eyeball vector EC from the eyeball center to the corneal apex was defined and the coordinates (X(E), Y(E), Z(E))(X(C), Y(C), Z(C)) were calculated. The angle M between EC and the midsagittal plane and the angle F between EC and the Frankfort plane were also calculated. Paired test and one way ANOVA were used for statistical analysis. The average value of X(C) before and after deep lateral decompression was 19.53 mm and 17.25 mm (10.87, 0.05) and average value of X(E) was 7.73 mm and 5.69 mm (12.22, 0.05). The average value of X(C) before and after medial decompression was 20.24 mm and 18.17 mm (7.93, 0.05) and average value of X(E) was 7.14 mm and 5.52 mm (9.24, 0.05). The average value of X(C) before and after balanced decompression was 22.16 mm and 18.83 mm (12.71 , 0.05) and average value of X(E) was 10.20 mm and 6.67 mm (11.91, 0.05). The average value of horizontal deviation angle M before and after medial decompression was 6.48° and 13.34° ( 8.41, 0.05). The average value of angle M before and after balanced decompression was 1.42° and 6.76° ( 2.86, 0.05). The average value of angle M before and after deep lateral decompression was 5.18° and 1.39° (2.57, 0.05). The proptosis reduction was significant after deep lateral decompression, balanced decompression and medial decompression. Additionally, the horizontal deviation tended to increase after medial and balanced decompression, whereas the horizaontal deviation tended to decrease after deep lateral decompression. .
分析甲状腺相关性眼病（TAO）患者在不同眼眶减压术后眼球位置的变化。这是一项回顾性病例系列研究。2014年10月至2016年12月期间，复旦大学附属眼耳鼻喉科医院收集了29例接受眼眶减压术的TAO患者（33只眼）。其中男性17例，女性12例，平均年龄46岁（21至66岁）。15例患者（17只眼）接受了平衡减压术，11例患者（11只眼）接受了外侧深部减压术，4例患者（5只眼）接受了内侧减压术。对每位患者在术前和术后进行CT扫描，并在三维重建图像上建立参考坐标系。定义从眼球中心到角膜顶点的眼球向量EC，并计算其坐标（X(E)，Y(E)，Z(E)）（X(C)，Y(C)，Z(C)）。还计算了EC与正中矢状面之间的夹角M以及EC与法兰克福平面之间的夹角F。采用配对检验和单因素方差分析进行统计学分析。外侧深部减压术前、后X(C)的平均值分别为19.53mm和17.25mm（10.87，0.05），X(E)的平均值分别为7.73mm和5.69mm（12.22，0.05）。内侧减压术前、后X(C)的平均值分别为20.24mm和18.17mm（7.93，0.05），X(E)的平均值分别为7.14mm和5.52mm（9.24，0.05）。平衡减压术前、后X(C)的平均值分别为22.16mm和18.83mm（12.71，0.05），X(E)的平均值分别为10.20mm和6.67mm（11.91，0.05）。内侧减压术前、后水平偏斜角M的平均值分别为6.48°和13.34°（8.41，0.05）。平衡减压术前、后角M的平均值分别为1.42°和6.76°（2.86，0.05）。外侧深部减压术前、后角M的平均值分别为5.18°和1.39°（2.57,0.05）。外侧深部减压术、平衡减压术和内侧减压术后眼球突出度均有显著降低。此外，内侧和平衡减压术后水平偏斜度有增加趋势，而外侧深部减压术后水平偏斜度有减小趋势。
