眼眶减压术治疗Graves眼病的临床效果

Clinical efficacy of orbital decompression in patients with Graves ophthalmopathy

摘要:

目的：探讨眼眶减压术治疗Graves眼病的效果及安全性。

方法：选取2011-02/2016-02在我院治疗的Graves眼病患者55例77眼，均行眼眶减压术治疗，观察患者术后6mo视力、眼球突出度及并发症。

结果：患者术后6mo最佳矫正视力(0.23±0.09)明显较术前(0.46±0.07)有所提高，差异有统计学意义(P<0.05)； 患者术后6mo眼球突出度(16.20±1.99mm)明显较术前(20.13±1.87mm)有所减少， 差异有统计学意义(P<0.05)； 术后CAS评分≤3分眼数为56眼(73%)，明显较术前15眼(19%)有所增加，差异有统计学意义(P<0.05)； 术前共有50眼(65%)存在色觉障碍，术后有42眼(55%)视觉障碍明显改善，8眼(10%)无变化； 77眼术后6mo眼球突出度平均下降3.87±1.03mm； 术后出现新复视患者5例8眼，新发复视率10%，随访3mo后，复视消失。

结论：眼眶减压术治疗Graves眼病是一种有效方法，但应注意术后复视等并发症发生。

Abstract:

AIM: To evaluate the efficacy and safety of orbital decompression in the treatment of Graves ophthalmopathy.

METHODS: Totally 55 patients 77 eyes with Graves eye disease were selected in our hospital from February 2011 to February 2016. All eyes underwent orbital decompression, the visual acuity, exophthalmos and complications of the patients were followed up for 6mo.

RESULTS:Postoperatively 6mo, the best corrected visual acuity were 0.23±0.09, which were better than that of preoperative 0.46±0.07(P<0.05). Postoperatively 6mo, the degree of exophthalmos of the patients were 16.20±1.99mm, which was significantly lower than that preoperative 20.13±1.87mm(P<0.05). Postoperative CAS score was ≤3 points in 56 eyes(73%), significantly increased compared with preoperative 15 eyes(19%), the difference was statistically significant(P<0.05). There were 50 eyes(65%)with color vision disorder before operation; after operation, 42 eyes(55%)had significant improvement in visual impairment, and there was no change in the eye in 8 eyes(10%). Postoperatively 6mo, the average decreased degree of exophthalmos were 3.87±1.03mm; 5 cases were found postoperative diplopia, new diplopia rate was 10%; followed up for 3mo, diplopia disappeared.

CONCLUSION:Orbital decompression is an effective method for the treatment of Graves ophthalmopathy, but attention should be paid to postoperative complications such as diplopia.