Suzuki Hiroko, Hikoya Akiko, Komori Miwa, Inagaki Risako, Haseoka Takashi, Arai Shinji, Takagi Yuri, Hotta Yoshihiro, Sato Miho
Department of Ophthalmology, Hamamatsu University Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, Japan.
Jpn J Ophthalmol. 2018 Sep;62(5):554-559. doi: 10.1007/s10384-018-0609-2. Epub 2018 Jul 6.
To evaluate changes in conjunctival-scleral thickness following strabismus surgery with anterior segment optical coherence tomography (AS-OCT).
Prospective, observational, consecutive case series.
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.
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.
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.
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。
前瞻性、观察性、连续病例系列研究。
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。
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。
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。