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斜视手术后结膜-巩膜厚度的变化:采用眼前节光学相干断层扫描测量

Changes in conjunctival-scleral thickness after strabismus surgery measured with anterior segment optical coherence tomography.

作者信息

Suzuki Hiroko, Hikoya Akiko, Komori Miwa, Inagaki Risako, Haseoka Takashi, Arai Shinji, Takagi Yuri, Hotta Yoshihiro, Sato Miho

机构信息

Department of Ophthalmology, Hamamatsu University Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, Japan.

出版信息

Jpn J Ophthalmol. 2018 Sep;62(5):554-559. doi: 10.1007/s10384-018-0609-2. Epub 2018 Jul 6.

Abstract

PURPOSE

To evaluate changes in conjunctival-scleral thickness following strabismus surgery with anterior segment optical coherence tomography (AS-OCT).

STUDY DESIGN

Prospective, observational, consecutive case series.

METHODS

Distances between the conjunctival epithelium and inner scleral wall were measured with AS-OCT before and 3-5 months after strabismus surgery. The measurements were performed at 1.5 mm (limbus), 7.0 mm (insertion), and 8.0 mm (tendon) posterior to the scleral spur on the lateral rectus muscle (LR); and 1.5 mm (limbus), 4.0 mm (insertion), and 5.5 mm (tendon) posterior to the scleral spur on the medial rectus muscle (MR). Thirty-three extraocular muscles (20 LRs and 13 MRs) from 23 subjects were studied.

RESULTS

Thicknesses were significantly less at the insertion (0.95-0.78 mm; p < 0.001) and tendon (0.99-0.78 mm; p < 0.001) after LR recession and at the tendon (1.21-0.92 mm; p = 0.02) after MR recession. Thicknesses were significantly greater at the insertion (0.82-1.07 mm; p = 0.01) and tendon (0.95-1.28 mm; p = 0.01) after MR resection or plication and at the limbus, insertion, and tendon (0.75-0.90 mm, 0.94-1.19 mm, 1.03-1.28 mm, respectively; all p = 0.04) after LR resection or plication.

CONCLUSION

Conjunctival-scleral thicknesses showed various changes after recession and resection or plication. These findings may help detect previous surgical operations when conjunctival scarring and ciliary vessel changes are unclear.

摘要

目的

采用眼前节光学相干断层扫描(AS-OCT)评估斜视手术后结膜-巩膜厚度的变化。

研究设计

前瞻性、观察性、连续病例系列研究。

方法

在斜视手术前及术后3 - 5个月,使用AS-OCT测量结膜上皮与巩膜内壁之间的距离。测量在外侧直肌(LR)巩膜突后方1.5毫米(角膜缘)、7.0毫米(附着点)和8.0毫米(肌腱)处进行;在内侧直肌(MR)巩膜突后方1.5毫米(角膜缘)、4.0毫米(附着点)和5.5毫米(肌腱)处进行。对23名受试者的33条眼外肌(20条LR和13条MR)进行了研究。

结果

LR后徙术后,附着点处(0.95 - 0.78毫米;p < 0.001)和肌腱处(0.99 - 0.78毫米;p < 0.001)厚度显著变薄;MR后徙术后,肌腱处(1.21 - 0.92毫米;p = 0.02)厚度显著变薄。MR切除或折叠术后,附着点处(0.82 - 1.07毫米;p = 0.01)和肌腱处(0.95 - 1.28毫米;p = 0.01)厚度显著增加;LR切除或折叠术后,角膜缘、附着点和肌腱处(分别为0.75 - 0.90毫米、0.94 - 1.19毫米、1.03 - 1.28毫米;所有p = 0.04)厚度显著增加。

结论

后徙术以及切除或折叠术后,结膜-巩膜厚度呈现出多种变化。当结膜瘢痕和睫状血管变化不明显时,这些发现可能有助于检测既往手术操作。

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