眼科 ›› 2012, Vol. 21 ›› Issue (6): 367-370.

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甲状腺相关眼病限制性斜视的治疗

艾立坤    

  1. 100730 首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科学与视觉科学重点实验室
  • 收稿日期:2012-10-31 出版日期:2012-11-25 发布日期:2012-11-26
  • 通讯作者: 艾立坤,(Email:likun_ai2406@yahoo.com)
  • 基金资助:

    北京市科技新星项目(2004B36)

Treatment of restrictive strabismus in thyroid associated ophthalmopathy

 AI  Li-Kun   

  1. Beijing Ophthalmology & Visual Science Key Lab., Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University,  Beijing 100730, China
  • Received:2012-10-31 Online:2012-11-25 Published:2012-11-26
  • Contact: AI Li-Kun,,(Email:likun_ai2406@yahoo.com)

摘要: 【摘要】 甲状腺相关眼病引起的限制性斜视是一种较难处理的特殊类型斜视。活动期可采用三棱镜等进行光学矫正。斜视角稳定6个月后,对于有明显复视,运动受限或代偿头位的患者可进行手术矫正。其中对眼压高或视野受损的病例可适当提前手术。手术以松解周围限制及进行相关眼外肌后徙为主,手术量不能按常规斜视手术量设计,对于多数病例以术毕时轻度欠矫为宜。术后远期大多数病例可在功能眼位恢复双眼单视,但部分下直肌大量后徙的患者偶可出现下睑退缩,值得进一步探讨。(眼科,2012, 21: 367-370)

关键词: 甲状腺相关眼病;斜视, 限制性;眼外肌

Abstract: 【Abstract】 Restrictive strabismus which due to thyroid associated ophthalmopathy (TAO) is challenging to a surgeon as well as related medical team. With help of optometrist or orthoptist, Fresnel prism can be used at active stage. Usually surgery should be scheduled at least 6 months after the deviation becomes stable, unless high intraocular pressure or visual field defect was detected. Surgical release of surrounding fibrotic tissue (both orbit side and globe side) should be done thoroughly before the muscle recession. Mild under-correction right after the surgery is suggested in most cases, except restricted hypertropia. In terms of long term result, most patients achieved single vision at primary and down gaze. Even though some prophylactic approach had been applied during the inferior rectus recession, post-operation lower lid retraction still occurred occasionally, which require further study. (Ophthalmol CHN, 2012, 21: 367-370)

Key words: thyroid associated ophthalmopathy, restrictive strabismus, extraocular muscle