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[斜视手术对角膜地形图的影响]

[Effect of strabismus operation of corneal topography].

作者信息

Schworm H D, Ullrich S, Höing C, Dittus C, Boergen K P

机构信息

Augenklinik Klinikum Innenstadt, Ludwig Maximilians Universität München.

出版信息

Klin Monbl Augenheilkd. 1996 Nov;209(5):275-82. doi: 10.1055/s-2008-1035318.

DOI:10.1055/s-2008-1035318
PMID:9044974
Abstract

BACKGROUND

In order to determine the short- and long-term influence of strabismus surgery on corneal curvature, a prospective study was carried out measuring corneal topography before and after operation.

PATIENTS AND METHODS

Corneal topography was performed using a computer assisted videokeratoscope. 77 eyes of 74 patients were examined 1 day before and 1 day as well as 3 months after surgery. Data of the semimeridians at 0 degree, 90 degrees, 180 degrees and 270 degrees in the 3-, 5- and 7-mm zone and of the corneal center were analyzed. Objective refraction, induced astigmatism and simulated keratometer reading were evaluated. 39 horizontal recess-resect procedures. 12 inferior rectus recessions, 10 horizontal resections. 10 inferior oblique recessions and 6 other procedures were performed.

RESULTS

The spheric equivalent of objective refraction decreased by 0.23 D. The absolute astigmatism increased by 0.16 D, the maximum change was 1 D. Changes of objective refraction were statistically not significant. The simulated keratometer reading increased by 0.2 D postoperatively and returned to the initial value after 3 months. With few exceptions, corneal topographic changes were small, statistically not significant and nearly disappeared after 3 months. Corneal flattening tended to occur in the semimeridian of resection while corneal steepening was observed at the site of recession.

CONCLUSIONS

The influence of strabismus surgery on corneal astigmatism is usually small and mostly transitory. In a few cases, however, the induced astigmatism persists. Patients should be informed about this possibility preoperatively.

摘要

背景

为了确定斜视手术对角膜曲率的短期和长期影响,开展了一项前瞻性研究,在手术前后测量角膜地形图。

患者与方法

使用计算机辅助的视频角膜曲率计进行角膜地形图检查。对74例患者的77只眼在手术前1天、手术后1天以及3个月进行检查。分析了3毫米、5毫米和7毫米区域以及角膜中心0度、90度、180度和270度子午线的数据。评估了客观验光、诱导散光和模拟角膜曲率计读数。进行了39例水平后徙-切除手术、12例下直肌后徙术、10例水平切除术、10例下斜肌后徙术和6例其他手术。

结果

客观验光的等效球镜度数下降了0.23 D。绝对散光增加了0.16 D,最大变化为1 D。客观验光的变化在统计学上无显著意义。模拟角膜曲率计读数术后增加了0.2 D,并在3个月后恢复到初始值。除少数例外,角膜地形图变化较小,在统计学上无显著意义,且在3个月后几乎消失。在切除子午线处倾向于发生角膜变平,而在后退部位观察到角膜变陡。

结论

斜视手术对角膜散光的影响通常较小且大多是暂时的。然而,在少数情况下,诱导散光会持续存在。术前应告知患者这种可能性。

相似文献

1
[Effect of strabismus operation of corneal topography].[斜视手术对角膜地形图的影响]
Klin Monbl Augenheilkd. 1996 Nov;209(5):275-82. doi: 10.1055/s-2008-1035318.
2
[Comparison of classical keratometry and computer-assisted corneal topography in high grade postoperative astigmatism after perforating keratoplasty].[穿透性角膜移植术后高度散光中经典角膜曲率计与计算机辅助角膜地形图的比较]
Klin Monbl Augenheilkd. 1996 Aug-Sep;209(2-3):105-8. doi: 10.1055/s-2008-1035287.
3
[Computerized videokeratoscopy. Indications for postoperative suture removal].
Ophthalmologe. 1992 Dec;89(6):535-40.
4
[Pre- and postoperative corneal topography after combined single suture and running suture in ECCE. An analysis using the video keratoscope].
Ophthalmologe. 1993 Dec;90(6):708-10.
5
[Fourier analysis as a mathematical model for evaluating and presenting postoperative corneal topography data after non-mechanical perforating keratoplasty].[傅里叶分析作为评估和呈现非机械穿透性角膜移植术后角膜地形图数据的数学模型]
Klin Monbl Augenheilkd. 1997 Apr;210(4):197-206. doi: 10.1055/s-2008-1035042.
6
Corneal astigmatic effects of conventional recession vs suspension recession ("hang-back") strabismus surgery: a pilot study.传统后徙术与悬吊后徙术(“延迟”)斜视手术对角膜散光的影响:一项初步研究。
Binocul Vis Strabismus Q. 2006;21(4):211-3.
7
[Excimer laser versus diamond fraise: equal short-term outcome of corneal smoothing in pterygium operations].[准分子激光与金刚石磨头:翼状胬肉手术中角膜平整的短期效果相同]
Klin Monbl Augenheilkd. 2001 Jun;218(6):418-23. doi: 10.1055/s-2001-16255.
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Postoperative corneal shape changes: microincision versus small-incision coaxial cataract surgery.术后角膜形态变化:微小切口与小切口同轴白内障手术对比
J Cataract Refract Surg. 2009 Feb;35(2):233-9. doi: 10.1016/j.jcrs.2008.10.031.
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[Early corneal topographic changes after intraocular lens implantation].[人工晶状体植入术后早期角膜地形图变化]
Zhonghua Yan Ke Za Zhi. 1996 Jan;32(1):29-31.
10
[Computerized corneal topography in treatment of high grade astigmatism after perforating keratoplasty].
Klin Monbl Augenheilkd. 1995 May;206(5):312-6.

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