显微镜下斜视矫正术

Strabismus diorthosis under microscope

摘要:

目的:观察采用普通显微器械显微镜下斜视矫正术的可行性。方法:把斜视病例分为两组:显微镜下斜视矫正术组:36例各类斜视患者,均采用显微技术在显微镜下行斜视矫正术。直视下斜视矫正术组:45例,直视下行斜视矫正术。结果:追踪观察2wk~6mo,显微镜下斜视矫正术组:术后反应轻,结膜水肿、充血消褪较快,伤口愈合好,无1例并发症发生。直视下斜视矫正术组:术后发生肌肉滑脱的2例,球结膜伤口充血、结膜下出血、水肿者40例,结膜瘢痕10例,结膜囊肿2例,结膜息肉3例。结论:显微镜下斜视矫正术较传统直视下斜视矫正术具有较明显优势,可以清晰地看清肌肉、血管、及针在巩膜内的走行、深浅,使手术较易掌控,可以使手术量及手术操作准确无误,缩短手术时间、避免出血、穿透巩膜等直视下手术常见的并发症的发生,同时组织分离准确,操作减少,也直接减轻了术后反应,缩短了术后恢复时间,适合所有需斜视手术患者,优势为初学者易掌握巩膜进针深度。

Abstract:

AIM: To investigate the feasibility of strabismus diorthosis under microscope using general micro equipments. METHODS: Divided the cases with strabismus into two groups: 36 cases underwent strabismus diorthosis under microscope using general micro equipments; and 45 cases underwent traditional strabismus diorthosis directly. RESULTS: The follow-up lasted for 2 weeks to 6 months. The post operation reaction in the group under microscope was light, conjunctival edema and congestion disappeared quickly, wound healed well, no complication occurred. In the other group, muscle slippage occurred in 2 cases, bulbar conjunctiva hyperemia, subconjunctival hemorrhage and edema occurred in 40 cases, conjunctival scar occurred in 10 cases, conjunctiva cyst 2 cases and conjunctival polypus 3 cases. CONCLUSION: Strabismus diorthosis under microscope has clear advantages compared with traditional strabismus diorthosis (without microscope). The muscle, blood tube and the move of needle in sclera as well as the depth can be seen clearly during the operation which make the operation easy to control, so we can properly and correctly perform the operation, shorten the operation time and avoid complications like blooding, penetrate sclera which often occur during the traditional operation. The strabismus diorthosis under microscope using general micro equipments can also separate structure correctly with fewer operation steps, light reaction after operation, sooner recovery after operation, which is suit to patient who needs strabismus diorthosis.