Liu Shaorui, Shen Qin, Shi Wodong, He Jie, Fan Xianqun
Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
J Craniofac Surg. 2020 Mar/Apr;31(2):420-422. doi: 10.1097/SCS.0000000000006131.
To investigate the occasion, method and effectiveness of the diplopic correction after the orbital fracture repair in Chinese patients with orbital fracture.
This was a retrospective observational study of 64 patients with remanent diplopia after the reconstructions of orbital fracture were studied between January 2014 and June 2017. The different cause, operational occasions, and surgical techniques analyzed. All patients were followed for 6 months after the surgeries.
After treatment, 64 patients with III degree diplopia were all performed the operations on extraocular muscles. Different operation was selected to different patients according to the examinational results of the extraocular muscles and passive drawer test, including rectos retropulsion, suspension, excise, Jensen's connection, and fixation to periorbital membrane. During the surgery, 25 patients had no diplopia in mainly functional visual fields, while 15 patients still had III degree diplopia. After 6 months, 27 patients had no diplopia in mainly functional visual fields, while 13 patients still had II degree diplopia. Among these 13 patients with III degree diplopia, 7 patients had no the diplopia of primary position of eye, and 6 patients had the diplopia of primary position. These 6 patients were suggested to wear the triangular prisms for improvement of the diplopia.
The operations should be selected according to the examining results about eye movements and diplopia before and during the surgeries. Reasonable operations could correct diplopia and improve the eye movements effectually.
探讨中国眼眶骨折患者眼眶骨折修复术后复视矫正的时机、方法及效果。
这是一项回顾性观察研究,对2014年1月至2017年6月间64例眼眶骨折重建术后仍有复视的患者进行研究。分析不同病因、手术时机及手术技巧。所有患者术后随访6个月。
治疗后,64例Ⅲ度复视患者均接受了眼外肌手术。根据眼外肌检查结果及被动牵拉试验,为不同患者选择不同手术,包括直肌后退、悬吊、切除、Jensen连接及眶周膜固定。术中,25例患者主要功能视野无复视,15例患者仍有Ⅲ度复视。6个月后,27例患者主要功能视野无复视,13例患者仍有Ⅱ度复视。在这13例Ⅲ度复视患者中,7例患者第一眼位无复视,6例患者有第一眼位复视。建议这6例患者佩戴三棱镜以改善复视。
手术应根据术前及术中眼球运动和复视的检查结果选择。合理的手术可有效矫正复视并改善眼球运动。